Title: 'Family Perceptions and Experiences with the Early Hearing Detection and Intervention System in Rural Communities'
Track: 7 - Family Perspectives and Support
Keyword(s): Rural Family EHDI Perceptions
Learning Objectives:
  1. To outline the difficulties families face in rural areas of Appalachia in receiving hearing health care for children
  2. To discuss parental perceptions and experiences in the rural EHDI process.
  3. To understand barriers to timely hearing health for rural families


Introduction: Although universal newborn hearing screening (UNHS) is currently practiced in most states and managed by Early Hearing Detection and Intervention (EHDI) systems, many rural regions, such as Appalachia, face significant disparities in hearing health care. Rural children are frequently delayed in identification and treatment of hearing loss. The accessibly of care and the barriers in the EHDI system in rural communities is not well understood. We sought to understand the problems faced by rural parents of families involved in the EHDI system. Methods: Families of children who failed newborn hearing screening and were involved in the EHDI system in Appalachian counties of Eastern Kentucky were identified. 55 participants were contacted by phone and participated in phone interviews assessing demographics and family experiences with the EHDI system. The interview assessed the timing of UNHS, family knowledge of UNHS results, the process of follow-up testing, and evaluation of further intervention from a family perspective to gain an understanding of problems and barriers to access of care. Qualitative coding analysis was conducted to find commonalities that families are facing in rural communities. Results: Families reported financial barriers to care such as a lack of reliable transportation as well as limited access to local care. Many families reported traveling great distances to hearing health provider offices. They also reported barriers to timely diagnosis such as mechanical failure of diagnostic equipment (causing extended wait times) and lack of appropriate provider scheduling timeframes. Conclusion: We gained a greater understanding of the difficulties rural Appalachian families face regarding access to care of the timeliness of the care received. Considering the importance for timely pediatric hearing healthcare, this information can be used to identify and implement mechanisms for change within EHDI programs providing care for rural residents.
Presentation: Tuesday_Coe_215_MatthewBush_1595.pdf

Handouts: Handout is not Available
CART: Topical Session 6- 1595.docx
Matthew L. Bush, M.D. - Primary Presenter,Author,POC
University of Kentucky Dept. of Otolaryngology
     Credentials: Assistant Professor, Department of Otolaryngology - Head and Neck Surgery
     Other Affiliations: Chief, Veterans Affairs Medical Center, Lexington, KY
      Matthew L. Bush, M.D. is an Assistant Professor in the Department of Otolaryngology – Head and Neck Surgery. He earned his M.D. degree at Marshall University in Huntington, WV in 2003. He completed Otolaryngology residency at the University of Kentucky in 2008 followed by a post-doctoral research fellowship and Neurotology & Cranial Base Surgery fellowship at The Ohio State University (2008-2011). Board certified in Otolaryngology and Neurotology, Dr. Bush’s clinical practice focuses on disorders of hearing and balance, including pediatric cochlear implantation. This clinical practice blends well with Dr. Bush’s research interests, which are directed at assessing and addressing rural pediatric and adult hearing health disparities. A K23 Career Development Award from the NIH National Institute of Deafness and Communication Disorders and a Triological Society Career Development Award supports this research. Recent research has been published in The Journal of Pediatrics, Ear & Hearing, The Laryngoscope, and Otology & Neurotology.

Financial -

Nonfinancial - No relevant nonfinancial relationship exist.
Mandy Hatfield - Author
University of Kentucky Dept. of Otolaryngology
     Credentials: MSW
      Mandy Hatfield is the Research Coordinator for the Department of Otolaryngology - Head and Neck Surgery at the University of Kentucky.
Julia Elpers - Co-Presenter,Author
University of Kentucky College of Medicine
     Credentials: BA
      Julia Elpers is a third year medical student at the University of Kentucky College of Medicine.

Financial -

Nonfinancial -
Jennifer Shinn - Author
University of Kentucky Dept. of Otolaryngology
     Credentials: Ph.D. Associate Professor
      Jennifer Shinn, Ph.D. is the director of Audiology and an Associate Professor in the Department of Otolaryngology - Head and Neck Surgery at the University of Kentucky.