Develop a working relationship with a pediatric audiologist who will help you establish your screening program, address questions as they arise, and promptly evaluate children not passing the screening. For help in locating a pediatric audiologist, you may contact your state's Newborn Hearing Screening or Early Hearing Detection and Intervention (EHDI) Public Health Program (http://www.infanthearing.org/status/cnhs.html).

The "Resources" section of this website includes all of the materials you should need to implement an OAE screening program including the resources an audiologist needs to provide a Head Start program with training and technical assistance.

Use the checklist below as you plan and implement your screening program in collaboration with the audiologist. This checklist and the accompanying handout for audiologists can be downloaded for use in planning meetings with your staff and consulting audiologist:

OAE Screening Implementation Checklist

• Downloadable PDF of this checklist

__ 1. Decide on the specific screening and follow-up protocol to be followed (see Instructional Guide [PDF: 8 MB], Snapshot of OAE Screening Protocol [PDF], and OAE Screening Form [PDF]).

__ 2. Determine how often children will be screened as a matter of standard practice (at a minimum, annually). Decide how often children with risk factors and other concerns will be screened. [PDF]

__ 3. Get acquainted with your state's newborn hearing screening or Early Hearing Detection and Intervention (EHDI) Program which has valuable information that can help with your screening program activities.

__ 4. Select and purchase OAE equipment demonstrated to work effectively for screening children 0-3 years of age. Current cost of OAE equipment is approximately $3400- $4000. Also purchase disposable probe tips. (See Elements to Consider When Purchasing OAE Equipment [PDF] and a Sample Grant Application [.rtf] that you can use to solicit funds for equipment purchase.)

__ 5. Identify who will perform the OAE screening, and when and where the screening will be conducted.

__ 6. Train all individuals responsible for screening and follow-up using the enclosed CD-ROM video (also viewable here). The training should be supervised by an audiologist and include a review of the protocol and hands-on practice screening children. See the Instructional Guide [PDF: 8 MB] for your staff and the Training Manual [PDF: 1.5 MB] for your consulting audiologist.

__ 7. Designate where the OAE equipment will be stored and who will be responsible for equipment care, maintenance, ordering supplies, coordinating use of equipment, etc.

__ 8. Review the OAE Hearing Screening Form [PDF] and determine whether adaptations are necessary. (Note, this form is also found on page 22 of the Instructional Guide [PDF: 8 MB]).

__ 9. Determine what documentation of screening results will be provided to parents, health care providers and audiologists when children refer from screening and need further evaluation.

__ 10. Establish a two-way referral system whereby you transmit information on children not passing the screening to their health care providers AND obtain results of subsequent diagnoses and treatments. You will then need to rescreen children or facilitate referral to an audiologist or other specialist.

__ 11. Determine how each individual child's screening results, and any subsequent diagnostic or treatment information, can be thoroughly documented in your tracking system.

__ 12. Monitor pass/refer rates, adherence with protocol and timelines, and follow-up on referrals. Access technical assistance and support from the audiologist when needed. See Monitoring for Quality Guidelines [PDF].

__ 13. Provide Information for Teachers [PDF] on how they can support children identified with hearing loss.

__ 14. Report to your state EHDI Program any child identified with a permanent hearing loss. Your EHDI program may have additional resources to help your program and/or the child's family.

Give the handout below to any audiologist from whom you are seeking assistance.

The Audiologist's Role in Helping Head Start Programs

• Downloadable PDF of this handout

Currently, many Head Start programs serving children 0 - 3 years of age are seeking the assistance of audiologists to help them update their hearing screening practices through the use of Otoacoustic Emissions (OAE) technology. A set of resources have been developed by the National Center for Hearing Assessment and Management at Utah State University for audiologists to use as they train Head Start staff on how to appropriately implement OAE screening and follow-up practices. See Training Resources for Audiologists.

Background

Early Head Start (EHS) and Migrant and Seasonal Head Start programs serve children 0 - 3 years of age. Head Start requires that all children receive a hearing screening within the first 45 days of enrollment. Traditionally, most programs have had to rely on subjective screening methods; however, recent feasibility studies have demonstrated that Head Start staff can be trained to successfully update their screening practices using objective OAE screening methods. As a result, increasing numbers of children with hearing disorders have been identified, including children with sensorineural hearing loss and a range of other conditions. A concerted effort is now being made by the Office of Head Start to inform all programs about OAE screening practices.

Role of Audiologists

Head Start programs undertaking OAE screening of 0 - 3 year-old children are strongly encouraged to do so only with the involvement of a pediatric audiologist who can provide training, technical support and consultation in program planning. Some audiologists also play a supervisory role in monitoring screening and follow-up activities which can significantly contribute to the long-term quality of the screening program.

The following are some ways that you, as an audiologist, can help a Head Start's OAE screening program:

• Assist Head Start staff with completing the enclosed OAE Screening Implementation Checklist [PDF].
  
  
• Explain the recommended 2-step screening and referral protocol [PDF] and screening form [PDF] .
  
  
• Evaluate and help select which OAE equipment will be purchased (see Elements to Consider When Purchasing OAE Equipment [PDF].
  
  
• Identify potential partners who may help with training and technical assistance and with whom information and resources can be exchanged (such as state Early Hearing Detection and Intervention program staff, individuals/entities implementing other state screening efforts, local health care providers, state American Academy of Pediatrics Chapter Champions for newborn hearing screening, etc.)
  
  
• Identify local charitable organizations from whom funds for equipment purchases can be solicited (See Sample Grant Application [.rtf]).
  
  
• Provide hands-on training on conducting OAE screening and on implementing an appropriate screening and follow-up protocol (see An Audiologist's Training and Technical Assistance Manual for Audiologists [PDF: 1.5 MB]).
  
  
• Provide follow-up technical assistance and additional training once screening is underway (See Monitoring for Quality Guidelines [PDF]).
  
  
• Provide audiological diagnostic evaluations for children not passing evaluations (or direct Head Start staff to other audiologists who can provide this service).
  
  
• Review screening and referral outcomes and oversight on pass and refer rates, adherence with the screening protocol, general follow-up concerns for children not passing the screening, and equipment care and maintenance concerns.
  
  

Additional resources for completing the above activities are found here.