Title: 'Providing Sound Beginnings for Children by Recognizing Risks of Late-onset Hearing Loss'
Track: 4-Medical Home
Keyword(s): Late on-set hearing loss; progressive hearing loss; medical home; risk factors
Learning Objectives: 1. Understand the importance of monitoring for hearing loss in pediatric patients as it relates to developmental outcomes 2. Identify risk factors for late-onset hearing loss 3. Understand the role of the medical home in helping identify and caring for children with late-onset hearing loss in the context of AAP standards of care


A young child may have typical hearing as an infant, and then begin to lose hearing as time progresses. This is known as late-onset hearing loss. Late-onset hearing loss can occur any time outside the perinatal period to a child who initially passed the newborn hearing screen. There are a number of risk factors that can increase the risk of late-onset hearing loss, including genetics/family history, infections such as cytomegalovirus (CMV), extreme prematurity, head/face/ear anomalies, and more. The paper, Beyond Newborn Hearing Screening: Recognizing the Signs of Late Onset Hearing Loss in Infants and Young Children, categorizes the common causes of late-onset hearing loss as acquired, structural, and genetic. Performing surveillance and screening within the medical home is critical in order to monitor infants and young children for late-onset hearing loss, as primary care providers see young children frequently and are able to review developmental language milestones at well-child visits.
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Rachel St. John - Healthcare Education Consulting
     Credentials: MD, NCC, NIC-A
     Other Affiliations: Adjunct Professor, Gallaudet University Department of Counseling
      Rachel St. John is a board-certified pediatrician, and a certified sign language interpreter through the Registry of Interpreters for the Deaf. She received her BS degree in psychology at George Mason University. She completed her MD degree at the University of Virginia School of Medicine, and then attended Georgetown University Hospital for her residency in pediatrics. She also holds an MA degree in counseling from Gallaudet University. Previously, she served as Assistant Professor of Clinical Pediatrics and Director of the Kids Clinic for the Deaf at Georgetown University Hospital in Washington, DC. Currently, she is a health education consultant at the state and national level, as well as a freelance interpreter specializing in medical encounters. Dr. St. John is Adjunct Faculty in the Gallaudet Department of Counseling, and is a member of the AAP Task Force on Improving the Effectiveness of Newborn Hearing Screening, Diagnosis and Intervention.