Title: 'Pediatrician's Connection of Children to Hearing Evaluation Services Following ASD Screening'
Track: 5 - Medical Home
Keyword(s): Autism, Screening, Evaluation,
Learning Objectives:
  1. understand the importance of hearing evaluations for children for whom ASD screening shows concern
  2. develop strategies to ensure that children who show concerns from ASD screening receive hearing evaluations


The American Academy of Pediatrics recommends that all children receive screening for Autism Spectrum Disorders (ASD) at their 18 and 24 month well child visits. The most widely used tool for ASD screening is the Modified Checklist for Autism in Toddlers (M-CHAT). The M-CHAT is a 20 item, parented completed questionnaire. An easy scoring system identifies children with developmental concerns consistent with ASD. Many of the items also relate to children with hearing loss. For this reason, it is recommended that children who do not pass the M-CHAT receive an audiology evaluation to rule out hearing loss as the major contributor to concerns that the M-CHAT raises. Connecticut Children's Medical Center has implemented an ASD practice quality improvement program for pediatricians in need of certification credits from the American Board of Pediatrics. Pediatricians who participate in the program complete monthly chart audits on 18 and 24 month well child visits. They enter information about ASD screening, including success of connecting children who show concerns from screening to hearing evaluation services. A review of the resulting data shows that 75% of children who show concerns on the M-CHAT are not linked to diagnostic audiology services. This raises concerns about audiology diagnostic services for children after the newborn period. To help providers improve this aspect of care, two strategies have been employed: 1) office visits stressing the importance of considering the late onset and progressive hearing loss when children exhibit language/communication delays and 2) development of a resource list of audiology services for children beyond the newborn period. This session will review the M-CHAT screening, data on pediatricians' connection of children to audiology services following M-CHAT screening and strategies for improving linkages. Presenters will discuss Connecticut's experience and engage attendees in discussions of successful strategies used in other states.
Presentation: 1176LisaHonigfeld.pdf

Handouts: Handout is not Available
Lisa Honigfeld - Primary Presenter
Child Health and Development Institute
     Credentials: Ph.D. Medical Sociologist
     Other Affiliations: Vice President for Health Initiatives, Child Health and Development Institute
      Lisa Honigfeld directs CHDI’s efforts to strengthen pediatric primary and preventive care. Her responsibilities include work designed to test innovations in child health services delivery, policy and systems. Lisa has more than 25 years of experience working in child health organizations, such as the American Academy of Pediatrics, Saint Francis Hospital in Hartford and ProHealth Physician. She serves on several statewide committees related to medical home, care for children with special health care needs, family support, pediatric training and quality improvement. Her work focuses on: care coordination, developmental screening, the interface between primary care and community and services, and expanding the capacity of pediatric primary care to address mental health issues. Lisa has a BA in sociology from the University of Massachusetts and an MA and PhD, both in sociology, from the University of Chicago. She holds a faculty appointment in Pediatrics at the University of Connecticut School of Medicine.

Financial - No relevant financial relationship exist.

Nonfinancial - No relevant nonfinancial relationship exist.
Brenda Balch - Co-Presenter
Private Practice Pediatrician
     Credentials: Board certified pediatrician, CT AAP Chapter Champion for EHDI, Member EHDI Advisory Board
     Other Affiliations: Connecticut Children's Medical Center clinical staff
      Dr. Balch serves as the CT AAP EHDI Chapter Champion. In this role she works with the state EHDI program and child health providers across Connecticut to support the goals of early detection and intervention. Dr. Balch also is very active in efforts to provide relief to children in Haiti as well as other medical missions.

Financial -

Nonfinancial -