Information for Physicians
Role of the Medical Home
The medical home is responsible for ensuring appropriate and timely referrals to providers that are capable of performing evaluations and knowledgeable in congenital hearing impairment. This can be achieved by:
- Obtain written results of newborn hearing screening from birthing facility on all newborns.
- By one month of age, ensure that all newborns have at minimum one hearing screening or a secondary screening if infant “referred” inpatient hearing screening.
- Refer for audiological diagnostic evaluation for infants “referring” secondary screening before three months of age.
- Provide referrals to early intervention, otolaryngologist, ophthalmologist and genetics after diagnosis of permanent hearing impairment.
- Manage otitis media with effusion.
- Closely monitor for signs of hearing loss for infants who pass newborn hearing screening and refer for audiological evaluation per JCIH recommendations, developmental/speech delay, or parental concern, as hearing loss may develop at any age.
Best Practice Guidelines
- UNHSI Medical Home Flow Chart (link to flow chart we adapted from AAP)
- Joint Committee on Infant Hearing 2007 Position Statement (http://www.jcih.org/posstatemts.htm)
- NCHAM EHDI E-Book Chapter 6: Medical Home and EHDI[PDF]
- Newborn and Infant Hearing Screening Initiative (National Center of Medical Home Initiatives for Children with Special Needs)
Mandatory Reporting of Hearing Loss in Georgia
In July 2002, the Board of Human Resources approved a request to add childhood hearing impairment to the state's Notifiable Disease List. Birth defects are reportable under State Law, Official Code of Georgia Annotated (O.C.G.A.) 31-12-2 and 31-1-3.2, which mandate the reporting of notifiable diseases.
The following conditions related to hearing loss are required to be reported to Public Health:
- Newborns “referring” the initial or follow-up hearing screening (suspected hearing impairment): Newborns that “refer” a newborn hearing screening are to be reported to the Children 1st (C1st) Coordinator in the health district where the child resides, using the Children 1st Screening and Referral Form immediately following screening or at least within 7 calendar days. All information on the form that is known to the screener/evaluator/audiologist should be filled out and submitted.
- Children through the age of five (5) years with the initial confirmation/diagnosis of hearing loss/impairment, which is suspected to be permanent, measured and described by a licensed audiologist is required to be reported within 7 days of diagnosis. The "Surveillance of Hearing Impairment in Infants and Young Children"** form is used by the audiologist and/or physician with knowledge of the hearing impairment and should be sent to the health district where the child resides.
- Hearing loss/impairment is defined as a threshold average of 15 dB or greater between 500Hz - 4000Hz, whether unilateral or bilateral.
**Link “Surveillance of Hearing Impairment in Infants and Young Children” to Surveillance form
EHDI E-mail Express
The EHDI E-mail Express is a monthly e-newsletter from the AAP Improving the Effectiveness of Newborn Hearing Screening, Diagnosis and Intervention through the Medical Home project. It is designed to provide AAP EHDI Chapter Champions and EHDI stakeholders with resources and current clinical and other relevant information. See an archive of EHDI E-mail Express issues.