National Center for Hearing Assessment and Management Organization Overview

National Center for Hearing Assessment and Management

Organization Rundown

National Center for Hearing Assessment and Management

Organization Overview

Purpose

Contributors: Brianna DiGiovanni, Meagan Sietsema, and Erika Ziebart

Purpose

Scope & Scale of Influence

Principle

Activities

Sources of Funding

Scope & Scale of Influence

Principle Activities

• All infants are screened for hearing loss, and those who do not pass, receive diagnostic evaluations before 3 months of age, and those with hearing loss are enrolled in early intervention before 6 months of age.

• All families of infants identified with permanent hearing loss receive culturally-competent support and information, and are linked to a family-centered medical home.

• All young children are screened periodically for hearing loss and receive appropriate follow-up.

• All State Early Hearing Detection and Intervention (EHDI) systems are linked to other relevant public health information systems, use ongoing quality improvement methods to continually enhance services, and disseminate appropriate and timely information to families, health care providers, and other relevant stakeholders.

Sources of Funding

Positions

Regarding principle activities, NCHAM provides: Webinars, Events and EDHI News, all of which serve to keep families informed and educated.

They also have resources and tools from EDHI/UNHS to provide help for families with a child that has hearing loss. A list of resources can be found here: https://www.infanthearing.org/resources_home/

References

Materials and activities described by NCHAM were funded by:

Mission

EHDI National Resource Center contains committees and networks maintained by various individuals to support families which are listed below:

Family Advisory Committee: “The advisory committee is comprised of diverse parent leaders in the categories of: ethnicity, age of children, modality/communication, geography, and deaf plus. The 2015-2020 FAC includes” twelve members ("Family Advisory Committee", n.d).

Collaborating Agencies: Contains over 40 agencies to support deaf and hard of hearing people in various ways such as through intervention, access for speech, and more and sign language resources ("Collaborating Agencies", n.d.). Visit the link for all organizations:

https://www.infanthearing.org/tas/agencies.html

These tools include educational & training videos, assessments, programs, intervention courses, guides, deaf and hard of hearing adult involvement, and meetings and conferences to give families support through connections with other families and professionals within America and their state (EHDI/ UNHS Resources, n.d.).

Positions

(A selections of NCHAM publications)

• Maternal and Child Health Bureau (MCHB) of the Health Resources and Services Administration (HRSA) at the United States Department of Health and Human Services.

• Infant Hearing of National Resource Center for EDHI

• Utah State University

• Updating Hearing Screening Practices in Early Childhood Settings (2008)

"OAE screening technology has proven to be reliable screening method, used extensively by hospitals implementing newborn hearing screening programs, and most recently, by number of Head Start programs serving children from birth to 3 years of age. Successful OAE screening in early childhood settings is dependent on consultation from an experienced pediatric audiologist, selection of appropriate equipment, adherence to an appropriate screening and follow-up protocol. When these elements are present, children with wide range of hearing health conditions can be identified in timely manner."

Scope & Scale of Influence Continued

Principle Activities, Examples

Large majority of states indicated the loss of federal funding would have a major or catastrophic impact on their EHDI program. In light of this finding, most state programs are currently funded primarily through grants awarded by the MCHB and CDC (Centers for Disease Control and Prevention) .

• Background of The National Center for Hearing Assessment &

Management (NCHAM). (2020). Retrieved April 24, 2020, from https://www.infanthearing.org/background/index.html

• Eiserman, W. D., Shisler, L., Foust, T., Buhrmann, J.,

Winston, R., & White, K. (2008). Updating hearing screening practices in early childhood settings. Infants & Young Children, 21(3), 186-193.

• Moeller, M. P., White, K. R., & Shisler, L. (2006). Primary

care physicians' knowledge, attitudes, and practices related to newborn hearing screening. Pediatrics, 118(4), 1357-1370.

• Munoz, K., Shisler, L., Moeller, M. P., & White, K. R.

(2009, August). Improving the quality of early hearing detection and intervention services through physician outreach. In Seminars in Hearing (Vol. 30, No. 03, pp. 184-192). © Thieme Medical Publishers.

NCHAM, (n.d.). Collaborating Agencies Retrieved from

https://www.infanthearing.org/tas/agencies.html

• NCHAM, (n.d.). EHDI/ UNHS Resources. Retrieved from

https://www.infanthearing.org/resources_home/

• NCHAM, (n.d.). Family Advisory Committee Retrieved from

https://www.infanthearing.org/tas/family-advisory-committee.html

• NCHAM, (n.d.). Quality Improvement in EHDI Programs.

Retrieved from

https://www.infanthearing.org/quality-improvement/

• NCHAM, (n.d.). Technical Assistance Network. Retrieved from

https://www.infanthearing.org/tas/network.html

• Smith, R. J., Bale Jr, J. F., & White, K. R. (2005).

Sensorineural hearing loss in children. The Lancet, 365(9462), 879-890.

• White, K. R. (2004). Early hearing detection and

intervention programs: opportunities for genetic services. American Journal of Medical Genetics Part A, 130(1), 29-36.

Mission

• Improving the Quality of Early Hearing Detection and Intervention Services through Physician Outreach (2009)

Technical Assistance Network:

(Locations and representatives are shown below.)

Examples of support the Network provides include:

• Supporting State Advisory Groups, such as serving on state EHDI advisory boards and attending meetings
• Conducting needs assessments
• Consulting with various stakeholders in the state
• Disseminating current information

Making presentations at conferences (Technical Assistance Network, n.d.)

"Physicians and other health-care providers should play central role in helping families of children with permanent hearing loss receive timely and appropriate screening, diagnostic, and early intervention services. Because the technology and procedures for ensuring timely and appropriate services for infants and young children with hearing loss have changed so dramatically over the past 15 years, many health-care providers are not well informed about the best ways to provide effective services."

The goal of the National Center for Hearing Assessment and Management (NCHAM) at Utah State University is to ensure that all infants and toddlers with hearing loss are identified as early as possible and provided with timely and appropriate audiological, educational, and medical intervention.

• Primary Care Physicians' Knowledge, Attitudes, and Practices Related to Newborn Hearing Screening (2006)

An example of NCHAM's activities to provide support to children with hearing loss can be found in their assistance for EDHI to continue programs like Quality Improvement (QI).

They support implementation of plans to continue "by conducting a QI needs assessment, providing ongoing technical assistance and support, and connecting EHDI program staff with similar interests to work together in implementing QI strategies" (Quality Improvement, n.d.).

Once a child with hearing loss is identified, programs like these are able to assist parents to follow up with documentation that helps identify the child's needs and how to meet them.

Another tool is a tele-health conference where the family can connect to professionals online without leaving the house.

"Pediatricians and other primary care providers recognize the benefits of early detection and intervention for permanent hearing loss in infants. The current system of newborn hearing screening can be enhanced by strengthening the medical community’s involvement in the process from screening to follow-up."

History

Positions cont.

• Sensorineural hearing loss in children (2008)

These resources and tools mentioned above corresponds to NCHAM's principles.

"These changes in the incidence of SNHL (sensorineural hearing loss) have not been seen in children living in less developed countries, where the prevalence of consanguinity is high in many areas, and both genetic and acquired forms of SNHL are more common, particularly among children who live in poverty. Focused genetic counseling and health education might lead to a decrease in the prevalence of inherited SNHL in these countries. Establishment of vaccination programmes for several vaccine-preventable infectious diseases would reduce rates of acquired SNHL."

• Early Hearing Detection and Intervention Programs:Opportunities for Genetic Services (2004)

History: continued

"Congenital hearing loss is relatively frequent and has serious negative consequences if it is not diagnosed and treated during the first few months of life. Babies with hearing loss who are identified early and provided with appropriate intervention develop better language, cognitive, and social skills."

- As a result of this collaborative work, dramatic increases in screening have occurred with over 97% of newborns nationwide now being screened for hearing loss at birth. Much remains to be done, however, to ensure that children who do not pass the newborn hearing screening receive the diagnostic and intervention services they need. Additional initiatives are also needed to advance periodic screening during early childhood.

A full list of NCHAM's position statements are listed on this link: http://www.infanthearing.org/ncham/index.html#publications

Overview

Discussion

Examples of biopower and medicalization in NCHAM organization rundown:

History

In examining the National Center for Hearing Assessment and Management organization, we have noticed patterns of biopower in medicalizing the home environments of children with disabilities, including deafness. Even though there are introductory ASL classes offered on the homepage in this organization’s website, all resources, funding, and coordination are with groups, organizations, and associations that support listening and speaking philosophies, which demonstrates a systematic phonocentric perspective. The sensory politics surrounding phonocentrism show where the value lies in terms of language use and social access. The valuation of normalization emphasizes that deaf children are an aspect of humanity to be improved upon.

● Overview: The emphasis on therapies and family training that focus on listening and speaking is shown through NCHAM’s history. Wide spread networking with organizations that have the same or similar philosophies that reinforce normalization and encourage socialization with families who have similar communication approaches all point to a clear hierarchical value of listening and speaking over other modes of communication.

● Principle Activities & Scope and Scale of influence: Even though NCHAM’s activities and supports are given through various means, there is favoritism for spoken language over sign language. While NCHAM does not claim to hold a bias, many resources and services they provide are through professionals that support a phonocentric view. No mention of Deaf culture or the Deaf community was found. The word deaf was used only in reference for its medical term.

● Sources of funding: Seeing that NCHAM is mainly funded by organizations that promote listening and speaking philosophies as the most efficient method of normalizing a deaf child, the biopower of phonocentric belief is evidently present.

● Position Papers: Provided that most position papers emphasizes on the importance of early hearing screening and spoken languages in a deaf child’s development, it appears that the biopower of NCHAM attempts to insulates their phonocentric belief by rendering other methods as inefficient.

- In 1990, the National Center for Hearing Assessment and Management (NCHAM) was established at Utah State University.

-Building on Consortium strategies, NCHAM has continued to assist hospital-based Universal Newborn Hearing Screening and state-based Early Hearing Detection and Intervention (EHDI) programs in their efforts to ensure that all infants are screened for hearing loss at birth, and that infants who refer from screening receive timely and appropriate diagnostic and intervention services.