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NCHAM: National Center for Hearing Assessment and Management, Utah State University

Appendices to the Implementation Guide for UNHS Programs

Cover of the Implementation Guide
Section 1. Enlisting Support for Newborn Hearing Screening
Can I Hear You? (Colorado) [PDF]
American Academy of Pediatrics Task Force on Newborn and Infant Hearing (02/1999) (AAP)
Recommendations of the NIDCD Working Group on Early Identification of Hearing Impairment on Acceptable Protocols for use in State-Wide Universal Newborn Hearing Screening Programs (09/1997) (NIH)
Joint Committee on Infant Hearing (12/1994) (ASHA) [PDF]
Comments of the National Association of the Deaf In the Matter Of: Early Hearing Detection and Intervention (09/1997) (NAD) [PDF]
1996 Position Statement of the Directors of Speech and Hearing Programs in State Health and Welfare Agencies (1994) (DSHPSHWA) [PDF]
History of Recommendations for Newborn Hearing Screening (CDC)
Sample Letter Sent to Garner Support for a UNHS Program (Colorado) [PDF]
NCHAM Fact Sheet on Universal Newborn Hearing Screening [PDF]
Longmont United Hospital Birthplace Fact Sheet on Support for UNHS Programs (Colorado) [PDF]
UNHS Summary Brochure (Minnesota) [PDF]
The Early Identification Kit for Infant Hearing [PDF]
Public Service Announcement: Early Identification of Hearing Loss (California) [PDF]
Video! What Can Baby Hear? Auditory Tests and Interventions for Infants with Multiple Disabilities [PDF]
Section 2. Determining the Appropriate Protocol for your Hospital
A Guide To Selecting Equipment for a Newborn Hearing Screening Program (NCHAM)
Implementation of Hospital-Based Newborn Hearing Screening Programs (Marion Downs)
Newborn Hearing Screening Technologies (Marion Downs)
Methods for Newborn Hearing Screening (NIH)
Questions You Need to Ask When Starting A Newborn Hearing Screening Program [PDF]
Genesis Medical Center Departmental Policy Regarding Neonate Hearing Screenings (Iowa) [PDF]
Flow Charts of Screening Activities for Various Hospitals (Part I) [PDF]
Flow Charts of Screening Activities for Various Hospitals (Part II)
Newborn Hearing Screening Policy for Longmont United Hospital (Colorado) [PDF]
Excerpt from Policy and Procedures Manual for Newborn Hearing Screening at Greater Staples Hospital (Minnesota) [PDF]
Protocol For Hearing Screening Using The Transient Evoked Otoacoustic Emissions (Oregon) [PDF]
Section 3. Dealing With Procedural Issues
Newborn Hearing Screening Program Structure Decisions[PDF]
Organizational Elements of a Successful State Newborn Hearing Program (Marion Downs)
Example of Hospital Procedures Model (Utah)
Newborn Hearing Screening Guide for Screeners (Utah) [PDF]
Job Description for 1/2 Time Technician/Screener for the Newborn Hearing Screening Program [PDF]
Audiology Assistant Specific Duties and Responsibilities [PDF]
Newborn Hearing Screening Audiologist's Weekly Data Management Duties [PDF]
Audiologist Assistant Position Description/Performance Appraisal (Iowa) [PDF]
Informed Consent Form (Mississippi) [PDF]
Summary of Hospital's Implementation Procedure(Iowa) [PDF]
Transferred Babies Form [PDF]
Informed Consent Form (Utah) [PDF]
Questions to Answer in Setting Up a Universal Newborn Hearing Screening Program [PDF]
Daily Checklist for Inpatient Newborn Hearing Screening (Hawaii) [PDF]
Responsibilities for Doing Newborn Hearing Screening (Illinois) [PDF]
Section 4. Communicating With Parents, Physicians, and Hospital Staff

Parent Education: Prior to the Baby's Birth

Can Your Baby Hear? (Utah) [PDF]
How Well Can My Baby Hear? (Connecticut) [PDF]
Newborn Hearing Screening (Utah) [PDF]
La Examinacion del oir para el Recien Nacido (Utah) [PDF]
Infant Hearing and Screening (Utah) [PDF]
A Note About Your Baby's Hearing (Iowa) [PDF]
Project H.A.P.I. (Hearing Assessment Program for Infants) (Arkansas) [PDF]
A Sound Beginning for All Babies (Colorado)

Informing Health Care Professionals About the Program

Sound Start: Universal Newborn Hearing Screening Program (Utah)
Universal Newborn Hearing Screening (California)
Handout for Hospital Staff (Iowa) [PDF]
Information for Physicians Regarding Early Identification of Hearing Loss (Hawaii) [PDF]
Letter to Physicians about need for follow-up [PDF]

Reporting Results to Health Care Professionals

Initial Screen Report (Illinois) [PDF]
Need for Follow-up Testing (Iowa) [PDF]
Summary of HiTrack Reporting Capabilities
Special Care Baby Notification to Screeners [PDF]

Informing Parents About Screening Results

I Just Had My Very First Hearing Test! (Utah) [PDF]
!Acabo de Tener mi Primera Examinacion del oir! (Utah)
I Just Had My Very First Hearing Test! (Utah) [PDF]
Sound Beginnings (Rhode Island) [PDF]
Your Baby's Hearing (Arizaona) [PDF]
Congratulations on the Birth of Your Child (Hawaii) [PDF]
Your Infant's Hearing Will Be Screened (Utah) [PDF]
I had my hearing screened! (Utah) [PDF]
I just had my first hearing test. (Iowa) [PDF]
Baby Hearing Test (Colorado) [PDF]
Congratulations on the Birth of Your Child (Washington DC) [PDF]
Waiver of Newborn Hearing Test (Colorado) [PDF]

Parent Education for Babies Who Pass

To the Parents of Baby: (Washington DC) [PDF]
Your Baby Must Have Good Hearing to Learn to Talk (Hawaii) [PDF]
Can Your Baby Hear? (Arizona) [PDF]
Otitis Media (Utah) [PDF]
Infeccion del Oido Medio (Utah) [PDF]
Hearing in Babies (Utah) [PDF]

For Parents of Babies Who Are Referred

Just a Reminder (Utah) [PDF]
Reminder Card (Utah) [PDF]
Just a Reminder (Utah) [PDF]
Rescreen Notification (Utah) [PDF]
To the Parents of Baby: (Washington DC) [PDF]

Follow-up When Hearing Loss Is Diagnosed

Communicating from Birth: Do You and Your Child Need Help (Utah)
Denver Ear Institute: The Children's Comprehensive Program (Colorado)
Now What? (American Academy of Audiology)
Colorado Home Intervention Program (Colorado)
Getting Started (Massachusetts)
Getting Started (Massachusetts) [PDF]
Section 5. Training Newborn Hearing Screeners
Screener's Feedback Form (Utah) [PDF]
Screener Evaluation Form (Hawaii) [PDF]
TEOAE-Based Newborn Hearing Screening Training Program (Iowa) [PDF]
Universal Infant Hearing Screening Workshop (West Virginia) [PDF]
Section 6. Keeping Referral Rates Low
How can I minimize the referral rate for a newborn hearing screening program? (NCHAM)
Section 7. Managing Data and Patient Information
Data Management Technologies (Marion Downs National Center)
NCHAM HiTrack Patient Information and Data Management Software
OZ Corporation's SIMS program
Data Management Form for Newborn Hearing Screening [PDF]
Your Baby's Hearing Checklist [PDF]
Section 8. Financing the Program
NCHAM Spreadsheet for determining what does a Newborn Hearing Screening Program Cost (NCHAM)
Longmont United Hospital Comparison of Universal Newborn Hearing Screening Programs (Colorado) [PDF]
Iowa Small Grants Program (Iowa) [PDF]
Letter Requesting Participation in State Funded UNHS Project (Utah) [PDF]
Section 9. Caring for Equipment and Supplies
Section 10. Reporting
Genesis Medical Center Parent Satisfaction Survey (Iowa) [PDF]
Genesis Medical Center Newborn Hearing Screens - Six Month Review (Iowa) [PDF]
Each Screening Program Must Report [PDF]
Reasonable Efforts Defined [PDF]
Information Hospitals are Required to Give to Parents and Primary Care Providers [PDF]
First Steps Newborn/Infant Hearing Screening Report (Mississippi) [PDF]
Confirmed Hearing Loss Report (Colorado) [PDF]
Hospital Monthly Report (Colorado) [PDF]
Referral for Diagnostic Evaluation Form (Utah) [PDF]
Article in hospital magazine: What Can Babies Hear? (Missouri) [PDF]
Press Release: Longmont United Hospital Purchases New Equipment (Colorado) [PDF]
Newspaper Article: Finely tests infant hearing (Iowa) [PDF]
Article in hospital magazine: Building a Foundation for Good Hearing (Iowa) [PDF]
Summary of program for distribution to hospital staff (Iowa) [PDF]
Thank You Note To Hospital Board (Colorado) [PDF]
Summary of program for distribution to hospital staff (Iowa) [PDF]
Section 11. Completing Audiological Diagnosis and Follow up
Assumptions Underlying Diagnositic Audiometry In Newborns and Infants (Texas DOH)
Support for Parents with Children with Hearing Loss (ASDC)
Diagnostic Evaluation Referral Form (Utah) [PDF]
Section 12. Coordinating with the State System
State Contacts for Newborn Hearing Screening (NCHAM)
State Contacts for Early Intervention Programs: Birth through Two (NECTAS)
State Contacts for Early Intervention Programs: Three through Five (NECTAS)
What's a Medical Home? [PDF]
Section 13. Legislative Mandates
Summary of State's Legislative Mandates for Neonatal Hearing Screening (NCHAM)
Text of State Laws Related to Newborn Hearing Screening (NCHAM)