Title: 'It’s Not Always About the Hearing: Case Studies in a Holistic Approach to Deaf and Hard of Hearing Patient Care'
Track: 5 - Medical Home
Keyword(s): medical home, multiple diagnoses, interdisciplinary collaboration
Learning Objectives:
  1. Recognize the clinical presentation overlap that can exist between hearing status and other conditions (genetic, neurologic, behavioral, etc)
  2. Appreciate conditions in which hearing status can become the clinical focus to the exclusion of other conditions


Children who are deaf and hard of hearing can have issues unrelated to their hearing status that can affect development, behavior, and cognitive success. Often, the hearing status becomes the focal point for all concerns at hand, which can lead to incorrect diagnosis and failure to implement appropriate supports and services. This workshop uses real clinical case studies from the Family-Focused Center for Deaf and Hard of Hearing Children at Dallas Children’s Medical Center, which uses a low-volume/high-complexity patient care model to provide assessment and ongoing coordinated care support to families with deaf and hard of hearing children. This workshop will illustrate patient scenarios that presented as hearing-related, but actually involved a previously undiagnosed etiology (including genetic, behavioral, and neurologic conditions co-existing with the hearing status). Take home points that will be emphasized include: • There is a tendency to “blame the hearing” for a host of behavioral and educational challenges, and lose sight of the possibility of a co-existing condition. • Conversely, there also may be a tendency to minimize the impact of the hearing status because it’s assumed not enough to not cause problems (as is often the case with mild/unilateral involvement). • Establishing interdisciplinary professional relationships between providers, rather than referring to an office or phone number, support a well-coordinated diagnosis and plan • Having “buy-in” at the upper levels of clinical departments is crucial in planning for appropriate time commitment and collaboration to working with patients who have complex clinical pictures
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Handouts: Handout is not Available
Rachel St John - Primary Presenter
UT Southwestern Medical Center
     Credentials: MD, FAAP
      Rachel St. John is a board-certified pediatrician, and a NIC-Advanced certified sign language interpreter through RID. She received her BS degree in psychology at George Mason University, completed her MD degree at the University of Virginia School of Medicine, and then jointly attended Georgetown University Hospital for her residency in pediatrics and Gallaudet University for her MA degree in counseling. Dr. St. John is the director of the Family-Focused Center for Deaf and Hard of Hearing Children at Children’s Medical Center Dallas/UT Southwestern Medical Center. The FFC provides support for families to make informed decisions regarding their deaf/hard of hearing child, as well as provides education and collaborative support to providers caring for these patients in keeping with national standards. She also serves as a member of the American Academy of Pediatrics Early Hearing Detection and Intervention Leadership Team.

Financial - No relevant financial relationship exist.

Nonfinancial - No relevant nonfinancial relationship exist.