TVR_106-3

Recommendations

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Figure 3. Per child funding from Part C of IDEA. This point is also emphasized by the Year 2000 Position Statement from the Joint Committee on Infant Hearing (JCIH), which notes that: In accordance with the Individuals with Disabilities Education Act (IDEA), referral to a public agency must take place within 2 working days after the infant has been identified as needing evaluation. Care can be facilitated by involving a public agency, as the role of this agency is to appoint a service coordinator, identify an audiologist to complete the audiologic evaluation, and identify other qualified personnel to determine the child’s level of functioning. Unfortunately, many state EHDI programs are not well coordinated with Part C programs. In a survey of state EHDI coordinators conducted by NCHAM (2006a), only 57% of state EHDI coordinators indicated that they had “good or excellent coordination and cooperation” with their state Part C program. Of state EHDI coordinators, 34% did not know or said there was not someone on the Part C Interagency Coordinating Council with expertise and experience in serving infants and toddlers with hearing loss and 16% of the state EHDI programs indicated they did not report children identified with hearing loss to the state’s Part C programs. Only 40% of the state EHDI programs reported that children enrolled in the state Part C programs for reasons other than permanent hearing loss were regularly checked for hearing status. Infants who do not pass the newborn hearing screening are clearly at risk for permanent hearing loss and should be included in the Part C child-find system. Unfortunately, given the current funding limitations, it is unlikely that Part C programs will assume responsibility for another substantial population. As shown in Figure 3, per child funding for Part C of IDEA has been declining since 1999. In terms of real dollars from initial program funding in Finishing the EHDI Revolution 247
1991, there is only about $1,000 available per child to cover all of the Part C services, including child-find activities. Given the number of children currently served, the expectation that Part C will be responsible for conducting diagnostic evaluations of all of infants referred from newborn hearing screening programs is unrealistic. This means that Part C would be responsible for approximately 33% more children in their child-find activities, which would be very difficult given the resources Part C has available. Nonetheless, it is imperative that state EHDI programs and Part C programs find ways to collaborate more effectively on child-find activities. At the very least, better information sharing between programs and more systematic evaluation of hearing loss of children already enrolled in Part C programs should be established. Given the requirements in the IDEA regulations for completing evaluations and developing an individualized family service program for children identified with disabilities within 45 days of referral, Part C and EHDI programs must work together to eliminate waiting periods for diagnostic evaluations so that services can be provided in a timely manner. Comprehensive System of Personnel Development IDEA requires state early intervention systems to operate “a comprehensive system of personnel development [that promotes] the preparation of early intervention providers who are fully and appropriately qualified to provide early intervention services (34 CFR 303.168).” As the age of identification for DHH children has decreased and cochlear implants and digital hearing aids have become more widely available, the nature of early intervention services for DHH children has changed. Approximately 95% of DHH children are born to hearing parents (Mitchell & Karchmer, 2004). Given recent evidence about the ability of DHH children who received early cochlear implants and high-quality early intervention to achieve similar levels as their hearing peers (Cheng et al., 2006; Geers, 2004), it is not surprising that increasing numbers of parents are choosing auditory/oral programs, which focus on teaching DHH children to listen and speak, rather than sign language-based programs, which, historically is how most DHH children were educated. For example, Brown (2006) compared the choices made by parents of DHH children in North Carolina in 1995 and again in 2005. North Carolina is one of the few states in the country that has a well-developed early intervention program for DHH children that includes a full range of auditory/oral and sign language-based options. In 1995, 40% of families chose auditory/ oral options compared to 60% who chose sign language-based options. In 2005, 85% of families chose auditory/oral options compared to 15% who chose sign language-based options. Such a dramatic change over a ten-year period has important implications for how early intervention program providers are trained. 248 White
Page 1 and 2: Volume 106, Number 3 ISSN 0042-8639
Page 3 and 4: The Volta Review Early Hearing Dete
Page 5 and 6: The Volta Review, Volume 106(3) (mo
Page 7 and 8: Center at Bar Ilan University, Rama
Page 9 and 10: identified the most significant pre
Page 11 and 12: Figure 1. Percentage of newborns sc
Page 13 and 14: Figure 2. Percentage of infants and
Page 15 and 16: components will contribute to impro
Page 17: that includes timelines and provide
Page 21 and 22: parents, when they are given an opt
Page 23 and 24: Historically, the federal Departmen
Page 25 and 26: with unilateral profound losses, bi
Page 27 and 28: Culbertson, J., & Gilbert, A.M. (19
Page 29 and 30: Office of Special Education and Reh
Page 31 and 32: University of North Carolina at Cha
Page 33 and 34: When children begin to walk and the
Page 35 and 36: years is attributable to partnershi
Page 37 and 38: hearing loss, including audiologic
Page 39 and 40: infants and toddlers who are deaf o
Page 41 and 42: early intervention program personne
Page 43 and 44: audiology symposium that brings tog
Page 45 and 46: Cyndie Bennett, superintendent of t
Page 47 and 48: 2001), places an emphasis on parent
Page 49 and 50: family involvement strongly influen
Page 51 and 52: Table 1. Demographic Characteristic
Page 53 and 54: In the self-efficacy section, mothe
Page 55 and 56: the Reynell Developmental Language
Page 57 and 58: Table 4. Definitions and Examples o
Page 59 and 60: Table 6. Relationships Between Mate
Page 61 and 62: Table 8. Summary of Regression Mode
Page 63 and 64: Roper & Dunst, 2003). Everyday occu
Page 65 and 66: References Akey, T., Marquis, J., &
Page 67 and 68: Lerner, G. (1952). Mr. Potato Head
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Appendix Scale of Parent Involvemen
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Parents want to know why their chil
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Incidence of UHL Impact of UHL Defi
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Children with UHL are at risk for a
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with this population of children to
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who have UHL and the BAHA implant s
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Progression of hearing loss is a co
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ongoing services because of a speci
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Environmental and Acoustic Modifica
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negative effects of unilateral hear
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of children with unilateral sensori
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The Volta Review, Volume 106(3) (mo
Page 93 and 94:
Theories on Speech Development Theo
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indicating an interaction of a norm
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as Spanish, automatically there are
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In summary, young children with sev
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documenting speech production patte
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were determined by the child’s pr
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Table 1. Observed-to-Expected Ratio
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His Spanish language use did impact
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implants: Profiles and implications
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http://eire.census.gov/popest/data/
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Introduction Since the early 1980s,
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delayed, thereby increasing parenta
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fitting the second processor easier
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quickly and naturally. Children who
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Figure 2. Graphic example of a loud
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Table 2. Patients Patient ID Time L
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Speech Discrimination Tasks In addi
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The last two children with equal mo
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Figure 7. Loudspeaker arrangement f
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children will retain monaural stimu
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van Hoesel, R., Tong, Y., Hallow, R
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with hearing loss who receive early
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5 years (i.e., met the age cut-off
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location. Informed consent was obta
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Figure 1. Loneliness score and age
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analysis was conducted to determine
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eceive cochlear implants, significa
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effective public school programs fo
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for promoting EHDI in developing co
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Table 1. Levels of Prevention for C
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or unilateral hearing loss because
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were usually higher when babies wer
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Table 2. World Bank Classification
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total public expenditure (Gottret &
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is more cost effective to institute
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Figure 2. Proportion of births in h
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scant, although they are likely to
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a widely reported controversy conce
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their babies at such an early age b
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active, ongoing, culturally appropr
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this goal achievable. Reservations
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Clemens, C.J., Davis, S.A., & Baile
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Kale, R. (1995). Traditional healer
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A dream realized or nightmare in th
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Penn, C. (1998). The study of child
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Watkin, P.M., Baldwin, M., & McEner
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education or general education, the
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for both developmental and remedial
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Table 1. Type and Number of RSP Con
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process of closing the language gap
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phonologic and phonemic awareness;
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Westchester Institute for Human Ser
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Bohnert, Andrea; Spitzlei, Vera; Li
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TVR_106-3

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