Prepare for Screening and Get to Know Your Partners in Hearing Health Care
As you prepare to conduct annual Otoacoustic Emissions (OAE) hearing screenings with new children entering your program, as well with those already enrolled, remember to take advantage of screener training tools described in a previous newsletter.
Also, be sure to look at the updated ECHO Initiative Resources to help you with your screening efforts this year including a fun sing-along video for children, letters to parents and health care providers, screening forms and tracking tools. Be sure your equipment is functioning, has had its annual calibration provided by the manufacturer or distributor and that you have purchased the disposable probe covers you will need when screening your children this year.
As a part of preparing for screening, it is helpful to understand the different services that a Health Care Provider (sometimes called a Primary Care Provider), an Ear, Nose and Throat Specialist and a Pediatric Audiologist provide and the roles they will play when children do not pass the OAE screening you provide.
In most cases, if a child does not pass the OAE screening after two attempts, a referral is made to the child's Health Care Provider (HCP) to assess whether there is physical blockage or impacted wax in the child's ear canal or if a child has an infection affecting the middle ear (otitis media). Tools that the HCP will often use include otoscopy, pneumatic otoscopy, or tympanometry. The HCP can treat many common conditions that affect the outer and middle ear by physically removing blockage or by prescribing an antibiotic. It is important to note, however, that HCPs do not typically have OAE equipment needed to assess inner ear functioning.
When chronic ear infection or a structural problem in the hearing pathway is identified by the HCP, a referral is often made to an Ear, Nose and Throat (ENT) Specialist (sometimes called an otolaryngologist or otorhinolaryngologist). ENTs are medical doctors who can provide specialized treatment in the medical aspects of hearing problems (e.g., middle ear infections, surgery, etc.) One of the most common surgical procedures that ENTs perform on young children is the placement of Pressure Equalization (PE) tubes in the eardrum (tympanic membrace) that help to clear fluid from behind the middle year. Most ENTs do not have the equipment needed to perform OAE screening or assess a chld's hearing status, however.
Because PCPs and ENTs do not usually have OAE screening equipment, you will need to conduct an OAE Rescreen after outer and middle ear problems have been resolved.
Professionals who have the skills and tools to assess a child's hearing are often called "Pediatric Audiologists." If a child cannot pass the OAE Rescreen, it is critical that a pediatric audiologist conduct a comprehensive evaluation. Also, if a child is consistently uncooperative and you cannot conduct an initial OAE screening, referral to a pediatric audiologist may be necessary to complete the screening. Pediatric Audiologists have the equipment and skills necessary to perform OAE screening as well as other kinds of hearing assessments that are appropriate for children of different ages. Pediatric Audiologists can assess hearing and diagnose conditions that cause hearing loss, but they cannot prescribe medication or perform surgery.
Thus, hearing screeners in Early Head Start programs, HCPs, ENTs, and Audiologists each play a different role in finding and treating hearing disorders in children.