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MNAAP Newsletter

Early Hearing Detection and Intervention

Lisa Schimmenti

AbbyMeyer

By Lisa A. Schimmenti, MD, Mayo Clinic School of Medicine, and Abby Meyer, MD, Children’s Minnesota

 The 2018 Early Hearing Detection and Intervention (EHDI) National Meeting was held March 18-20, 2018 in Denver, Colorado. As Minnesota’s AAP EHDI Chapter Champions, we attended the meeting and met with other Chapter Champions from across the country to review the most recent data and to strategize for the upcoming year.

On a national level, data from the 2015 CDC EHDI Hearing Screening & Follow-up Survey (HSFS) showed that 98 percent of infants had their hearing screened, 96 percent by the benchmark timeframe of before 1 month of age. Nearly 72 percent had confirmed diagnosis by 3 months of age with a 28 percent loss to follow up/loss to documentation rate. About 88 percent of infants identified as deaf or hard of hearing (DHH) were referred to Early Intervention (CI) and 65 percent of DHH infants were enrolled by 6 months of age. For further details, go to: www.cdc.gov/ncbddd/hearingloss/ehdi-data.html.

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Expanding Help Me Grow in Minnesota


ElsaKeeler
By Elsa Keeler, MD, MPH

When a child age birth to five is at risk for or identified with developmental delays, referral for education evaluation through Minnesota’s current Help Me Grow connects the family to evaluation and possible early intervention/special education services. This robust system has positive developmental resources and assures early intervention for positive developmental outcomes (see sidebar).

Yet, we know that not all children at risk are referred, and even if referral takes place, many may not qualify for education-based early intervention services. We understand the need to refer a child with a medical diagnosis to early intervention. However, we also know that social determinants and toxic stress contribute to mental and physical health and developmental outcomes. That is, even a healthy appearing baby may be on an at-risk developmental trajectory when his family encounters environment stress, parent mental health concerns, trauma, poverty, or lack of social supports. For pediatric clinicians, knowing what referral resources are available to offer families can be challenging, given factors such as family culture, preference, and community.

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Building Healthy Development for a Lifetime Effect

By Michael Georgieff, MD, FAAP

Every child has a right to optimal cognitive, social and emotional behavioral development. Since behavior is the efferent expression of the brain, medical stakeholders — including pediatricians — have a stake in ensuring brain health across the lifespan. Brain health begins prenatally and likely even pre-conceptionally, implying that the first point of education/prevention may be in non-pregnant women of child-bearing age. Many of the principles of developmental (i.e., fetal) origins of adult metabolic health (obesity, type 2 diabetes, hypertension) apply to adult health (e.g., depression, anxiety, schizophrenia). Thus, the metabolic and structural brain development that occurs early in life provides a scaffold for complex adult mental capabilities. New brain/behavior assessment tools have allowed identification of important environmental events that promote or pose risks to normal brain development and identify critical and sensitive periods for these environmental effects.

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