The ECHO Initiative staff was pleased to host 39 motivated individuals, representing 19 and Territories, at two Training-of-Trainer meetings held in Salt Lake City, UT, October 28th- 30th. Instruction and discussion focused on how participants could best deliver
otoacoustic emissions (OAE) hearing screening training to Early Head Start (EHS) and other early child care and education providers

serving children 0-3 years of age. States and Territories represented included CA, CO, CT, FL, HI, IA, ID, KY, MD, ME, MI, MN, MT, PR, TN, TX, UT, VT and WA.
While efforts to improve childhood hearing screening practices are in the early stages in several states, in many others, previous work has taken root and is bearing fruit in a variety of settings. For example:
- In Kentucky, OAE equipment has been purchased and placed at fifteen points of entry in Part C Early Intervention programs and data is being shared with the State Early Hearing Detection and Intervention (EHDI) program.
- In Florida, two EHS programs trained to conduct OAE screening have been able to assist the State EHDI in locating and screening three children who were lost to follow-up from newborn screening.
- In Vermont, the four existing EHS programs have been conducting OAE screening for some time, sharing their data with the State EHDI program, and OAE screening has been expanded into ten pediatric primary care provider offices.
After reviewing the current status of OAE training efforts in each state, ECHO Initiative staff provided in-depth training examples and recommendations to participants who will be instrumental in providing future state-based trainings. Participants set specific "next step" goals for what they intend to do in the months ahead. Additionally, over the next five months ECHO Initiative staff will be traveling to ME, CT, FL, ID, and MN to provide in-state Training-of-
Trainer workshops.
In the spirit of Thanksgiving, we want to thank all of the individuals, in every State and Territory, who are making quality hearing screening and followup a reality for more children each and every year.