The role of the primary health care physician
Each baby's primary health care provider plays a key role in ensuring the appropriate follow-up occurs for those babies who did not pass the initial hearing screening and those needing audiologic assessments and evaluations by medical specialists. The primary care provider (PCP), in cooperation with the audiologist, directs and coordinates, as needed, the evaluation and referral process within the child's medical home by:
- Referring a newborn that does not pass a hearing screening to a pediatric audiologist for a diagnostic evaluation. View a list of Audiology Facilities in Nebraska. Consider Tele-Audiology services for families who live outside the metro areas of eastern Nebraska.
- Providing a statement to parents stressing the importance of follow-up, the time and location of the follow-up appointment, and the telephone number of the screening audiology center.
- Referring a baby identified as deaf or hard of hearing to appropriate agencies capable of providing early intervention services and to appropriate medical specialists (i.e., otolaryngologist and geneticist) as may be indicated by the diagnostic audiologic evaluation.
- Monitoring individual cases to assure that the diagnostic evaluation was completed and facilitating the infant's receipt of amplification if needed and linkage to the Early Intervention services.
- Providing updates regarding the infant's hearing status to the Nebraska Early Hearing Detection and Intervention Program Department of Health and Human Services.
- Providing on-going monitoring and surveillance of ALL children, especially those with risk factors for late-onset and progressive hearing loss. If the child has any risk factors for late onset or progressive hearing loss, those risk factors need to be reported to NE-EHDI using the Risk Factor Reporting Form.
Next Steps
What to do if patient does not pass the hearing screening
A child not passing the hearing screening should be referred to a pediatric audiologist for an outpatient diagnostic evaluation that typically begins with a second hearing screening. It is important that parents understand that this does not necessarily mean their baby is deaf or hard of hearing. Information about hearing screening should be provided to parents in a professional and compassionate manner while stressing the importance of prompt and appropriate follow-up. Hearing screenings should be completed for an infant within one month of age and a full diagnostic audiologic evaluation should be completed before three months of age.
View a list of Audiology Facilities in Nebraska. Consider Tele-Audiology services for families who live outside the metro areas of eastern Nebraska.
Patient Referrals to Specialists
A referral to a specialist such as an otolaryngologist and geneticist may be indicated by the diagnostic evaluation. The majority of children who are born deaf or hard of hearing have a genetic component, even if they do not have syndrome or dysmorphic features.
Additional medical referrals may need to be made to neurology, cardiology, nephrology and developmental pediatrics. See Beyond Newborn Hearing Screening: Recognizing the Signs of Late Onset Hearing Loss in Infants and Young Children for a list of syndromes commonly associated with hearing loss.
Additional Information & Resources
Risk Factors for Late Onset & Early Childhood Hearing Loss
The Joint Committee on Infant Hearing (JCIH) recommends that infants who have a risk factor for late onset or progressive hearing loss should have at least one comprehensive audiologic evaluation by 24 to 30 months of age. Testing should occur any time there is a parent, caregiver, or professional concern regarding communication development.
Infants and Young Children with Risk Factors for late onset or progressive hearing loss should be periodically monitored. If you know of a child with Risk factors, please report them to your state EHDI program. Click here for the Nebraska Risk Factors Reporting Form.
How Do I Help Families Find Parental Support
Hands and Voices/Guide By Your Side of Nebraska (GBYS) is a support program for families of children and toddlers who are identified as deaf or hard of hearing. GBYS gives these families the opportunity to meet face-to-face and talk with a Parent Guide; a trained and experienced parent of a child who is deaf or hard of hearing.
Parent Training Institute Nebraska (PTI) is a statewide resource for families of children with disabilities or special health care needs, enabling parents to have the capacity to improve educational outcomes for their children.