Handbook and Book of Abstracts
Gold Sponsors
Gold Sponsors
Mā te rongo, ka mōhio;
Mā te mōhio, ka mārama;
Mā te mārama, ka mātau;
Mā te mātau, ka ora.
Through feeling comes awareness;
through awareness comes understanding;
through understanding comes knowledge;
through knowledge comes life and well-being.
AcknowledgementsThe Australasian Newborn Hearing Screening 2013 Committee would like to thank the following
organisations for their generous contributions and support
Satchel Insert Sponsor
Conference Dinner SponsorBronze Sponsor
1
Contents
Page
Welcome 2
ConferenceOrganisingCommittee 3
AustralasianNewbornHearingScreeningCommittee 4
Venuedirectory 5
Exhibition 6
Exhibitordirectory 7
Keynotespeakers 9
Openingspeakers 11
Panelspeakers 13
Programme 15
Socialprogramme 20
Keynotepresentationabstracts 21
Abstracts
OralFriday 27
OralSaturday 43
Poster 73
Workshops 77
Generalinformation 80
2
Welcome to the ANHS Conference
AstheChairmanoftheAustralasianNewbornHearingScreeningCommittee(ANHSC),itismypleasure
towelcomeyoutothe7thAustralasianNewbornHearingScreeningConference.Thisisthefirsttimethat
thisconferencewillventure‘acrosstheditch’andwearelookingforwardtoconveningtheconferencein
thevibrantcityofAuckland,NewZealand.
SincetheestablishmentoftheANHSCin2001,greatprogresshasbeenmadeinestablishingscreening
programmesinbothAustraliaandNewZealand.Itmustbeacknowledged,however, thatfurtherwork
isneededtoensurethatstandardsofdeliveryaremaintainedandthattherecontinuestobeafocuson
programmesimprovementanddevelopment.Withthisinmind,thethemeofthisconferenceisabout
nurturing,growing,andenrichingnewbornhearingscreeningprogrammes.
Theprogrammefortheconferenceincludesamixofplenaryandconcurrentsessions,andthetopics
coveredinclude:
• culturalissuesinscreening
• parentalexperiencesatpointofidentification
• crosscollaborationandmultidisciplinaryteamapproachestonewbornscreening
• maintainingmotivationandqualityinestablishedscreeningprogrammes
• effectiveevidencebasedwaysofdeliveringearlyinterventionprogrammes
There isstrongrepresentationbypresentersanddelegates frombothAustraliaandNewZealand,as
wellasattendeesfromoutsideofAustralasia.Wewelcomethisopportunitytoshareideaswithandlearn
fromcolleaguesinternationally.
Theconferencebringstogetherawiderangeofprofessionalsandperspectives involved innewborn
hearing screening and early intervention, including medicine, audiology, education, therapy, and
parents.Thismeetingaimstoprovideacomprehensiveselectionofpracticalpresentationstomeetthe
needsandinterestsofthisdiversegroup.
Wehopeyoufindtheconferenceanexcitingandstimulatingenvironmenttodevelopnewskillsand
knowledge,interactwithcolleagues,andmakenewfriendsorrenewoldacquaintances.
Professor Greg Leigh
Chairman
ANHS Committee
3
Conference Organising CommitteeGregLeigh(NSW)
ZeffiePoulakis(VIC)
KirstyGardner-Berry(NSW)
AlisonKing(VIC)
AnnPorter(VIC)
RachelBeswick(Qld)
MoiraMcleod(NZ)
DamienMansfield(SA)
TheOrganisingCommitteethankstheNewZealandorganising
and logistics committee which includes members from the
MinistryofHealthandMinistryofEducation.
Welcometothe7thAustralasianNewbornHearingConferencehereinAuckland.TheMinistryofHealth
andMinistryofEducationareexcitedtobehostingthisconferenceforthefirsttimeinNewZealand.
Thank you for your support of this conference.This is a valuable opportunity for us all through the
learningsthatwillbegainedfromthewidespectrumofpresentationsandtheworkshopstoconsider
howwecandevelopandstrengthenournewbornhearingscreeningprogrammes.Itisacknowledged
thattheNewZealandhearingscreeningprogrammehashadchallengesoverthelastyearhoweverfrom
aNationalScreeningUnitperspectivewestronglyendorsethethemeoftheconference“nurture,grow,
enrich”asanopportunitytolearntogether,shareandcontinuetodevelopthescreeningprogramme
andmakeadifferencetothebabieswescreen.
Jane McEntee
Group Manager
National Screening Unit
Ministry of Health
Conference ManagersConferenceInnovatorsLtd
POBox28084
Remuera
Auckland1541
Tel:+6495252464
Fax:+6495252465
4
The Australasian Newborn Hearing Screening Committee
TheAustralasianNewbornHearingScreeningCommitteeaimstofostertheestablishment,maintenanceandevaluationof
• highqualityscreeningprogramsfortheearlydetectionofpermanentchildhoodhearingimpairmentthroughoutAustralia
andNewZealand;
• accessibleandappropriateassessmentandinterventionforchildrenidentifiedwithsuchhearinglosses;
• accessibilitytoinformationandsupportforparentsandofchildrenidentifiedwithpermanentchildhoodhearingloss;and
• anationaldatabaseofnewbornhearingscreening.
TheCommitteealsoaimstofacilitatediscussionandsharingofexperienceamongprofessionalsandparentsinvolvedinprogrammes
aimedattheearlydiagnosisofpermanentchildhoodhearinglossinAustralia,aswellaspromotingresearchintothedeliveryofand
outcomesfromtheseprogrammes.ThisConferenceisakeyactivityundertakenbytheCommitteetoachievetheseaims.
TheCommitteeadvocatesatbothNationalandStatelevelsforprogressandinnovationinpolicyandresourcingfortheareaofearly
detectionandinterventionforchildrenwithahearingloss.
The Committee consists of members from every state and territory in Australia, as well as representatives from New Zealand.
Committeememberscoveranumberofelementsofearlydetectionprocessincludingprogrammeadministrationandmanagement,
parents,audiology,paediatrics,otorhinolaryngology,habilitation,andearlyintervention/education.
Website:www.newbornhearingscreening.com.au
E-mail:[email protected]
Committee Members
Chair: GregLeigh
CommitteeSecretary: ZeffiePoulakis
Members:
AustralianHearing: AlisonKing(Vic)
ParentRepresentatives: JoQuayle(Vic),GrantVesper(Qld),AnnPorter(NSW)
Education: GregLeigh(NSW)
DeafnessForum: Vacant
Audiology: KirstyGardner-Berry(NSW),TeganKeogh(Qld),Lee Kethel(Tas),LaraShur(WA)
Otolaryngology: FionaPanizza(Qld),StephenRodrigues(WA),
Paediatrics/ChildHealth: DamienMansfield(SA),MelissaWake(Vic)
PopulationHealth: Vacant
StateProgramRepresentatives: Rachel Beswick (Qld); Zeffie Poulakis (Vic), Lisa Dawson (NT),Sharon Price (SA), Isobel Bishop
(NSW),JudyMathews(WA),LaraShur(WA),Lee Kethel(Tas);JenniferBursell(ACT)
NZUNHSEIPRepresentative: MoiraMcLeod(NZ)
ProjectHEIDIRepresentative: Vacant
Correspondence: c/-RIDBCRenwickCentre,PrivateBag29,Parramatta,NSW,2124,Australia.
5
Venue DirectoryRendezvous Grand Hotel, Level 1
1 Registration&InformationDesk AtriumLounge,level1
2 IndustryExhibition&Catering Pre-FunctionArea
3 ConcurrentSessions RendezvousBallroom1
4 MainPlenary RendezvousBallroom1&2
5 ConcurrentSessions RendezvousBallroom2
6 PosterDisplays AnnexeFoyer
7 ComputerStation TasmanRoom1
8 ConcurrentSessions TasmanRoom2
1
43 5
8
26
7
REG
ISTR
ATIO
N D
ESK
6 6
Exhibition
Exhibitor Index (in alphabetical order)
Organisation Booth Number
CochlearLimited 10
GNOtometrics 9
Interacoustics 8
Med-elHearingImplants 5
MinistryofEducation 11
MinistryofHealth 11
OZSystems 7
PhonakNewZealand 2
Scanmedics 1
Siemens 6
SonicInnovations 3
WidexNZLtd 4
Exhibitor Index (by booth order)
Organisation Booth Number
Scanmedics 1
PhonakNewZealand 2
SonicInnovations 3
WidexNZLtd 4
Med-elHearingImplants 5
Siemens 6
OZSystems 7
Interacoustics 8
GNOtometrics 9
CochlearLimited 10
MinistryofHealth 11
MinistryofEducation 11
Stand11
76
Exhibitor Directory
Company (alphabetical order) Booth
Cochlear Limited 101UniversityAvenueMacquarieUniversity,NorthRydeNSW
2109,Australia
C: LindaBallam-Davies
T: 1800620929(Aust)0800444819(NZ)
W: www.cochlear.com/au
Hear now. And Always with Cochlear. Our mission is to help
people hear and be heard, empowering them to connect
withothers.Wewillhelpchangethewaypeopleunderstand
and treat hearing loss and provide an innovative range of
implantablehearingsolutions,deliveringalifetimeofhearing
outcomes.
GN Otometrics 94FredThomasDrive,Takapuna,Auckland0750
C:ChrisWebber
T: +61297439707|+61406096472
W: www.otometrics.com
Otometrics is the world’s leading manufacturer of hearing
and balance instrumentation and software. Over the last 50
years, we have provided solutions ranging from newborn
hearingscreeningapplicationsandaudiologicdiagnosticsto
comprehensivehearinginstrumentfittingandbalancetesting.
Interacoustics / Oticon 8AU:Suite4,Level4,BuildingB,11Talavera,RoadNorthRyde
NSW2113,Aus
NZ:142LambtonQuay,Wellington6141,NewZealand
W: www.interacoustics.com/www.oticon.com
Withmorethan45yearsexperience,Interacousticsisdedicated
to supplying its customers with the best possible diagnostic
solutionsfortheirprofessionalneeds.
Oticon Paediatrics: offering dedicated hearing solutions and
servicestoenablehearingprofessionalshelphearingimpaired
childrenachievetheirfullpotential
MED-EL Implant Systems Australasia Pty Ltd 538RickettyStreet,MascotNSW2020,Australia
C: RosanneFava
T: +61421754898
W: www.medel.com
MED-EL offers the broadest portfolio of hearing implant
solutions available to meet the needs of candidates with
varying types and degrees of hearing loss. Our products
are supported by a comprehensive range of rehabilitation
materialsandadedicatedclinicalsupportteam.
Ministry of Education 11NationalOffice,PipiteaStreet,Wellington
C: MarkDouglas
T: +64272845526
W: www.minedu.govt.nz
The Ministry of Education provides support for children
and young people with developmental needs, behaviour
challenges,anddisabilityincludingchildren/studentswhoare
deaf and hearing impaired. A significant part of the support
is for the families/whānau and educators who support the
children and young people. The Ministry also works closely
withHealthandSocialServiceproviders.
Ministry of Health 11POBox5013,Wellington6145
C: MoiraMcLeod
E: [email protected][email protected]
W: www.health.govt.nz
TheMinistryofHealthleadsNewZealand’shealthanddisability
system,andhasoverallresponsibilityforthemanagementand
development of that system. Through its whole-of-sector
leadership of the health and disability system, the Ministry
helpsensureNewZealanders live longer,healthierandmore
independent lives, while delivering on the government’s
priorities. The Ministry advises the Minister of Health, and
government as a whole, on health issues, and has a role as
a funder, purchaser and regulator of health and disability
services.
8
OZ Systems 7USA,Australia,Switzerland,Mexico
C: SteveMontgomery
W: www.ozsystems.com
OZ Systems develops and implements the world’s smartest
technology platforms, bridging crucial information gaps and
helpingchildrenthrivethroughimproveddataaccountability,
performancemeasurement,qualitycertification,andanalytics.
OZ’s platforms have advanced electronic information
exchange,standards,dataintegrity,metrics,accountabilityand
interoperabilityaroundtheglobe.Itallstartshere.
Phonak New Zealand Limited 2Level1,159HurstmereRoad,Takapuna,Auckland0622
C: BrentTustin
T: 0508746625
W: www.phonakpro.co.nz
Phonak has played a key role in developing and supplying
hearingsolutionsforchildrenfor40years.Innovationsinclude
SoundRecover,anon-linearfrequencycompressionalgorithm
that enhances audibility of crucial high-frequency speech
soundsandrecentlytheintroductionofRoger,anewstandard
in wireless communication which will deliver unparalleled
speechinnoiseperformance.
Scanmedics 1Unit6,15-17GibbesSt,ChatswoodNSW2067Australia
C: MargoWoods
T: +61298822088
W: scanmedics.com
Scanmedics represents NATUS Medical in Australia & New
Zealand specialising insolutions for thenewborn, including
newborn hearing screening devices, Natal LX Incubators,
Phototherapy, Cerebral Brain Function monitoring and brain
cooling. In particular Scanmedics offers a range of NATUS
AABR® ALGO technology offering screening of the entire
hearing pathway in one simple step. NATUS Echoscreen
complimentshearingscreeningchoiceswithOAEand ABRfor
additionalformsofhearingtesting.
Siemens Hearing Instruments 655HugoJohnstonDrive,PenroseAuckland1061
C: BonytaWatson
T: 0800666671
W: www.siemens.co.nz/hearing
For over 130 years now, Siemens has been developing and
making hearing instruments. Our innovations constantly set
newtechnologicalbenchmarksinthemarket.Siemenscaters
to itsyoungerclientelebyofferingafullselectionofhearing
instrumentsandstreamingaccessories.
Sonic Innovations 3POBox301872,Albany,Auckland0752
C: MichaelStockhammer
T: +6421445712
W: www.sonici.co.nz
Sonic has been manufacturing and distributing high quality
hearing instrumentssince1980and isproudthat itssuccess
has been based on advanced technology, superior product
quality, professionalism and impeccable customer service.
Sonicisalsooneofthelargestandmostversatiledistributors
ofaudiologicalequipmentinAustraliaandNewZealand.Sonic
distributesproductsofsomeofthemostpopularandreputed
manufacturersfromallovertheworld.
Widex NZ Ltd 422WilliamsonAve,Ponsonby,Auckland
C: SamJeffs
T: 021542510
W: www.widex.co.nz
Widex is the leading supplier of high quality and reliable
hearingaidsinNewZealand.Widexcontinuestosupportthe
NewZealandhearingprofessionthroughourtrademarkhigh
qualityserviceandsupportnationwide.
9
Gwen CarrGwenCarrisDeputyDirectoroftheNHSNewbornHearingScreening(NHSP)andtheNHSNewborn
InfantandPhysicalExamination(NIPE)ProgrammesinEngland.SheisalsoDeputyDirectorofthe
MRCHearingandCommunicationGroup,whichhoststhetwoNHSProgrammes,basedattheRoyal
FreeHospitalNHSTrustinLondonandHon.SeniorResearchAssociateattheUCLEarInstitute.
Gwen’s early career was in educational audiology and deaf education, specialising in the early
development of language and communication and in supporting very young deaf children
and their families. Following wide experience supporting deaf children in early years, specialist
schools and mainstream settings, she spent 10 years as Head of Sensory Support Services in a
MetropolitanAuthorityduringwhich timeshewas responsible forpartnershipworkingwith the
HealthAuthorityandworked jointly inclinical settings inPaediatricAudiologyandENT. In2001,
she led the implementationofNewbornHearingScreening inherarea, asoneof thefirstwave
pilotsitesinEnglandandsubsequentlybecameaconsultanttothenationalprogramme,leading
onthedevelopmentofearlyinterventionservicesandmulti-disciplinaryteams.Beforejoiningthe
MRCHearingandCommunicationGroupin2006shespent4yearsasDirectorofUKServicesatthe
NationalDeafChildren’sSociety(NDCS)whereshewasresponsibleforalltheSociety’sdirectwork
withfamiliesandtheprofessionalswhoworkwiththemacrosstheUK.
TogetherwithProfessorAdrianDavis,GwenisresponsibleforthestrategicdirectionoftheNHSP
and NIPE Programmes’ work and specifically leads on the Quality Assurance and Improvement,
ServicesDevelopment,andEarlyInterventionagendas.Herparticularinterestsareinthepromotion
of Informed Choice, the development of family friendly services, outcomes for children and
families, multi-professional teamwork and family support and sharing the news of the diagnosis
ofdeafnesswithfamilies.Shealsoplaysaleadroleinthecrossscreeningprogrammeworkwithin
the UK National Screening Committee’s wider agenda for development and integration of non-
cancerscreeningprogrammesandworkscloselywithScreeningLeadsandRegionalNewbornand
Ante-Natal Screening Co-ordinators across the country to ensure programme maintenance and
improvementatlocalandregionallevels.
AsaconsultanttotheGovernment’s‘EarlySupport’programmeinEngland,Gwencontributedtothe
productionoftheEarlySupportServicesAuditToolandtheMonitoringProtocolforDeafBabies,and
editedtheDeafnessInformationbookletforParents.Shesubsequentlyco-ledtheUKgovernment
fundedresearchanddevelopmentstudy‘InformedChoice,FamiliesandDeafChildren’leadingto
theproductionofnationalguidanceforprofessionalsandacomprehensivehandbookforparents.
ShewasalsopartoftheresearchteamattheUniversityofManchesterwhichundertookthe‘Positive
Support’studyontheimpactofearlyidentificationonchildandfamilyoutcomesincollaboration
withUniversityCollegeLondonandDeafnessResearchUK.SheistheauthoroftheNDCSbooklet
forparentsentitled‘Communicatingwithyourdeafchild’,basedonInformedChoiceprinciples,and
continuestosupportparentsofdeafandhearingimpairedchildreninrelationtocommunication
developmentthroughinvolvementwiththecharity’snetworkofresidentialsupportweekendsfor
familiesofnewlyidentifiedchildren.
GwensitsonseveralworkinggroupsinrelationtoChildhoodDeafness,NewbornHearingScreening
and Early Intervention at home and abroad, and has presented extensively both in the UK and
overseasonallareasofherspecialistinterestsandwork.Shealsoundertakestrainingandservice
developmentworknationallyandinternationallytosupporttheimplementationanddevelopment
of EHDI systems and the enhancement of professional practice and collaborative multi-agency
teamwork.
Keynote Speakers
10
Dr Capi WeverCapiWever isanotolaryngologistandfacialplasticsurgeonwhose involvement inthedetection
andtreatmentofmoderateandseverehearing lossextendsbeyondsurgicalandtechnicalskills.
Forover15yearshehasexploredthedecision-makingissuesandethicaldilemmasofthefieldand
offers a consensus building approach to bring together the various stakeholders and disciplines
involved.
Hehasstudied,workedandtaughtinTheNetherlands,Belgium,theUnitedStatesandtheCaribbean.
DrWeverhasbeeninvolvedintheDevelopmentalEvaluationofChildren:ImpactandBenefitsof
EarlyhearingscreeningstrategiesLeiden(DECIBEL)collaborativestudy.Thestudyinvolvedchildren
bornintheNetherlandsovera3yearperiodassessingtheverbalskillsandotherdevelopmental
markers in those who received newborn hearing screening compared with distraction hearing
screeningat9monthsofage.
DrWeverhasextensivelyexploredtheissuesrelatingtopaediatriccochlearimplants.Asasurgeon
hevaluestheroleoftheparentandfamily,atopicheexploredinanarrative-ethicalanalysisaspart
ofhisPh.D.dissertation.
He is an auditor for the hospital accreditation process in the Netherlands and sits on quality
improvementcommitteeswhereheincorporateshisgroundedapproachtopatient-centredcare.
HeisbasedintheLeidenareaoftheNetherlands.
11
Greg LeighGregLeighisDirectorofRenwickCentreforProfessionalEducationandResearchattheRoyalInstitute
for Deaf and Blind Children (RIDBC) in Sydney, Australia. He is conjointly Professor and Deputy
DirectoroftheCentreforSpecialEducationandDisabilityStudiesattheUniversityofNewcastle.
HehaspreviouslyheldacademicappointmentsatDeakinUniversityandasanInternationalVisiting
ScholarattheNationalTechnicalInstitutefortheDeafinRochester,NewYork.
ProfessorLeighholdsdegreesinEducationandSpecialEducationfromGriffithUniversity;aMaster
ofScience(SpeechandHearing)degreefromWashingtonUniversity;andaPhDinSpecialEducation
fromMonashUniversity.HeisaFellowoftheAustralianCollegeofEducators.
Professor Leigh serves on the editorial boards of Deafness and Education International and
Phonetics and Speech Sciences and on various government committees related to deafness—
bothstateandfederal.Notably,since2005,hehasbeenChairoftheAustralasianNewbornHearing
ScreeningCommittee.Throughthatpositionhehasplayedasignificantroleinadvocacyfor,and
implementation of, neonatal hearing screening in Australia. He is a former National President of
theEducationCommissionfortheWorldCongressoftheWorldFederationoftheDeafandisChair
of the InternationalSteeringCommitteesofboth theAsia-PacificCongressonDeafnessand the
InternationalCongressonEducationoftheDeaf.
Pat Tuohy DrPatTuohytookupthepositionofChiefAdvisorChildHealthinDecember1997.Laterin1998Pat’s
roleexpandedtoincludeyouthhealth.Hisresponsibilitiesincludecoordinationandleadershipof
childandyouthhealthwithrespecttotheMinistryofHealth,districthealthboardsandchildand
youthhealthprofessionalsandorganisations.
Patisaspecialistpaediatricianwithaparticularinterestincommunitychildhealth.Afterstudying
medicineattheOtagoMedicalSchool,andqualifyingin1979,Patundertookpostgraduatetraining
inPaediatrics inWellington,MelbourneandNottingham.ForthreeyearsheworkedasaGeneral
PaediatricianinNewPlymouthandjoinedthePlunketSocietyin1991asitsRegionalPaediatrician
basedinWellington.PatwaslaterappointedtothepositionNationalPaediatricianforPlunketatthe
headofficeinDunedin,untilhismovetotheMinistryin1997.
CurrentlyPathasanumberofroleswithintheMinistry. HehasbeentheNational Immunisation
Coveragechampionforsixyears,and isamemberofanumberofnationaladvisorycommittees
including theNationalScreeningUnitGovernanceGroup,ChildandYouthMortalityCommittee,
PaediatricClinicalnetworkSteeringgroup,andrepresentstheMinistryona numberofcrossagency
workgroupsincludingtheChildren’sCommissioner’sCOMPASSgroup,andthedevelopmentofthe
Children’sActionplan.
Pat’s particular interests are in the areas of developmental and behavioural paediatrics, SUDI,
immunisationandchildprotection.
Pat ispassionateaboutWellChildinitiatives,andcontinuestobeastrongadvocatefornewborn
hearingscreeninginNewZealand,
Opening Speakers
12
Brian CoffeyBrian istheGroupManagerforSpecialEducationStrategyattheMinistryofEducation.Hecame
tothispositionthreeyearsagoandhaspreviouslyworkedasamanagerinSpecialEducation,an
educationalpsychologist,andateacher.
HeisofTeAtiawadescentandisnowbackhomelivingintheHuttValleybuthasworkedineducation
ontheEastCoast,Gisborne,Nelson,Auckland,HuttValley,ChristchurchandnowbackinWellington.
Brianismarriedwithfourkidsandanincreasingnumberofmokopuna.
SomeofthekeyworkprogrammesinwhichBrianis,hasbeen,involvedorled:
• ThedevelopoftheSpecialEducationService
• ThemergeroftheSpecialEducationServicewiththeMinistryofEducation
• Thereviewofseverebehaviourservices
• ThedevelopmentandimplementationofPositiveBehaviourforLearning(2009)
• TheReviewofSpecialEducation(2009)and“SuccessforAll-EverySchool.EveryChild”
• The Resource Teacher: Learning and Behaviour (RTLB) transformation and merger of the
SupplementaryLearningSupport(SLS)service
• TheReviewofResidentialSpecialSchoolsandtheestablishmentoftheIntensiveWraparound
Service
• The merger of the van Asch and Kelston Deaf Education Centre Boards and aggregating of
resources for the deaf education centres and Blind and LowVision Education Network New
Zealand(BLENNZ)
• Anumberofkeyacrossgovernmentinitiatives
Brain remainscommitted toa fairgo forallNewZealandkids, theopportunitiesavailable forall
througheducationandlearningandaschoolingsystemandsocietythatcontinuetoenablefull
presence,participationandachievementofstudentswithspecialeducationneeds.
13
Jane O’HallahanDrO’HallahanisaPublicHealthMedicineSpecialistwith25years’experienceworkingintheNew
Zealandhealthsystem,workingatDistrictHealthBoard,MinistryofHealthandnon-government
organisation levels. Highlights of her career to date include: Leading the development and
implementationofanationalstrategyforthehighriskrolloutoftheMeningococcalBImmunisation
Programme.The programme was delivered within the $200m budget over a period of 5 years,
Leadingtheestablishmentofacomprehensivesafetysurveillancesystemtomonitornewvaccine
thathasbeen recognisedas‘worldclass’by internationalexperts,NationalDirectorof thePublic
HealthTrainingProgrammeandActingCEOCollegeofGeneralPractitioners.
JaneistheClinicalLeaderfortheNationalScreeningUnit.
Jane McEnteeJaneMcEnteetookontheroleofGroupManager,NationalScreeningUnit inJuly2012.Janehas
worked for theNationalScreeningUnit,and itspredecessor, sinceDecember1998andover this
timehasworkedacrossthefivescreeningprogrammesandonequalityimprovementinitiativethat
the Unit is responsible for leading. Initially her role was National Screening Coordinator for both
the breast and cervical screening programmes. Jane was then the Manager, NCSP from 2002 –
2008. From 2008 - 2012 Jane was Manager, Antenatal and Newborn Screening overseeing the
AntenatalHIVScreeningProgramme,AntenatalscreeningforDownsyndromeandotherconditions,
Newborn Metabolic Screening Programme and Universal Newborn Hearing Screening and Early
InterventionProgramme.
JaneinitiallytrainedasaRegisteredNurseandpreviouslyworkedfortheAucklandCancerSociety
for8years.ShealsohasaBAinNursingandEducationandaGraduateDiplomainHealthScience
(HealthManagement).
Moira McLeodMoiraMcLeodistheProgrammeLeaderforthenationalUniversalNewbornHearingScreeningand
EarlyInterventionProgramme.BasedattheMinistryofHealthAucklandofficeinPenroseaspartof
theAntenatal&Newbornteam,MoirahasbeenintherolesinceJuly2012.Priortoworkingatthe
MinistryofHealthinNewZealand,MoirawastheBreastScreenAotearoaProgrammeManagerat
BreastScreenWaitemataNorthlandforsevenyearsandwasalsoProgrammeManagerfortheBowel
CancerScreeningProgrammepilotatWaitemataDHB.
Moirahasabackgroundinnursingmanagementandaspecialinterestincommunitybasedprimary
healthcareinitiativesandcollaboration.
Zeffie PoulakisZeffie Poulakis has been with the Victorian Infant Hearing Screening Program (VIHSP) since its
inceptionin1992.Herresearchcareerhasfocusedonearlyidentificationofcongenitalhearingloss
andpromotionofoptimaloutcomesamongstchildrenwithhearingloss.Zeffiecurrentlypractises
asaseniorclinicalpsychologist,andVIHSPco-director.
Panel Speakers
14
Kylie BollandKylie is currently working at HuttValley District Health Board as Head Audiologist and UNHSEIP
coordinator.ShehasbeenworkingatHuttHospitalforthepastfiveyearspredominantlyworking
inpaediatricAudiology.
Prior to this Kylie spent four years at the Nuffield Hearing and Speech Centre, RNTNE hospital
in London. Here Kylie was introduced to the challenges of newborn hearing screening as the
programmehadrecentlybeenrolledoutacrosstheUK.
With a large catchment area she saw large numbers of babies referred from the screening
programmesandworkedwithinamultidisciplinaryteamtoprovideaccuratediagnosticassessments
andmanagement.
Andrew KeenanAndrewistheGroupManagerforQualityandClinicalSafetyatAucklandDistrictHealthBoard.This
role includes the consumer experience portfolio, National Project director for hand hygiene and
surgicalsiteinfectionprojects.
Andrew is also a privacy officer and protected disclosure officer for ADHB and is a practising
advancedcareparamedic.
15
P R O G R A M M EFriday 17 May 2013
0800-1800 Registrationdeskopen RendezvousAtriumLounge
0945 GatheringforPowhiri
1000-1030 Powhiri RendezvousBallroom1&2
PiripiDavis,Ngati Whatua
1030-1100 Welcome and conference opening
HonJoGoodhew,Associate Minister of Health
ProfessorGregLeigh,Chairman ANHS Committee
1100-1130 New Zealand Newborn Hearing Screening and Early
Intervention Programme
DrPatTuohy,Chief Advisor, Child & Youth, Ministry of Health
BrianCoffey,General Manager, Special Education, Ministry of Education
1130-1215 Keynote Address
Dr Capi Wever
Theideaof“savingdeafchildren”–theroleoffamilycenteredcounselling
andinformedchoice
1215-1300 Lunchamongsttheindustryexhibition
16
1300-1315 Nic Mahler
Family-centredearlyintervention
forchildrenwithapermanent
hearingloss:insightsfromparental
consultation
1315-1330 Elfriede Rohrs
Caregivers’experienceswiththe
diagnosisofhearingloss
1330-1345 Yetta Abrahams
“Howearlyistooearly?”–The
outcomesofcochlearimplantation
ininfantsunder6months,7-9
monthsand10-12months
1345-1400 Lydia O’Connor
Adaptingacoordinatedearly
interventionservicetobestsupport
thefamiliesofbabiesscreenedunder
UNHS–aNewZealandperspective
1400-1415 Maree McTaggart
Bilateralcochlearimplantationin
childrenidentifiedinnewborn
hearingscreening:whytherush?
1415-1430 Janeen Jardine
Journeytoacochlearimplant
followingahearingloss
1430-1445 Yetta Abrahams
“Nodisciplineisanisland”:working
togethertosupportfamilieswho
needitthemost
1445-1500 Carolyn Cottier
Newbornhearingscreening
facilitatesearlydiagnosisof
congenitalCMVinfection
Angela Deken
Naturaldisastersandanewborn
hearingscreeningprogramme:
maintainingservices,qualityand
sanity
Rachael Beswick
Implementationofanearlyhearing
detectionmanagementand
informationsystemtoimprove
qualityandstandardisationin
Queensland
Loren Catherine
Reflectionsonaninvestigationinto
reportedchangesinratesofreferral
fromscreeningtodiagnostic
assessment
Gabrielle Kavanagh
Screeninginfantswhoareyoung
andtooyoung:ananalysisof
gestationalageatscreeningin
Victoria
Bronwyn Craig
Howahearingscreening
programmedatabasecanresult
inbothqualityimprovementsand
costsavings.
Rosemary Douglas
Whenaunilateralreferrevealsa
bilaterallossondiagnosis:causefor
concern?
Zeffie Poulakis
VicCHILD:establishmentofthe
world’sfirstpopulation-based
childhoodhearingimpairment
longitudinaldatabank
Andrea Kelly
Screeninganomaliesinnewborn
hearingscreeningprogrammes
inNZ
Tasman Room 2
Concurrent 1C
DHB Newborn Hearing
Screening Workshop
1215-1230 Lunch(inworkshop
room)
1230-1400 Roleplayineveryday
situations:
-Screeningunder
pressure
-Givingresults
-Workingwithother
healthprofessionals
1400-1415 Shortbreak
1415-1515 Gettingitright
fromthestart:the
roleofscreeners
incontributingto
positiveoutcomesfor
childrenandfamilies
-ScreeningintheUK
-Videosofreal-life
experiences
Rendezvous Ballroom 1
Concurrent 1A – Supporting
families (Part I)
Chair:KathyBendikson&
SuePrimrose
Rendezvous Ballroom 2
Concurrent 1B – Maintaining
motivation and quality
assurance in newborn hearing
screening programme (Part I)
Chair:GregLeigh&
SarahGreensmith
17
1500-1530 Afternoonteaamongsttheexhibitors
1530-1630 Plenary / Panel session RendezvousBallroom1&2
Expect the unexpected: managing incidents and improving quality
in screening programmes
Chair:DrJaneO’Hallahan
Panel
JaneMcEntee,Group Manager, National Screening Unit, Ministry of Health,
New Zealand
MoiraMcLeod,UNHSEIP Programme Leader, National Screening Unit,
Ministry of Health, New Zealand
AndrewKeenan, Quality and Safety, Auckland District Health Board,
New Zealand
DrZeffiePoulakis,Director,Victorian Infant Hearing Screening
Program, Australia
KylieBolland,Hutt Valley District Health Board, New Zealand
1630-1730 Keynote Address
Gwen Carr
Noteverythingthatcountscanbecountedandnoteverythingthatcan
becountedcounts:Perceptionsofqualityinnewbornhearing
screeningprogrammes
1730 Close of day
JillLane,Director, National Services Purchasing, Ministry of Health, New Zealand
1900 Conference Dinner
AttheGrandTearoom,HeritageHotel,refertopage20
18
Rendezvous Ballroom 1
Concurrent 2A – Effective
evidence-based ways of
delivering early intervention
programmes
Chair:MarkDouglas&JoDavies
0900-0915 Kirsten Smiler
NgaKohungahungaTuri:
envisioningawhanau-centred
approachtoearlyintervention
0915-0930 Melissa McCarthy
Developingablendedservice
modeltodeliverfamily-centred
earlyintervention
0930-0945 Helen-Louise Usher
Barrierstoearlyinterventionservice
deliveryforchildrenwithhearing
loss–theQueenslandexperience
0945-1000 Valerie Green
“Learningtolistentoababywho
cannothear”
1000-1015 Kirsty Gardner-Berry
Impactofthepresenceofauditory
neuropathyspectrumdisorderon
outcomesat3yearsofage
1015-1030 Felicity Hodgson
Respondingtotheneedsoffamilies
ofchildrenwithunaidablemildand
borderlinehearinglosses
1030-1045 Jackie Brown
Tele-Practice:deliveringearly
interventionandaudiologyservices
tofamiliesinruralandremoteareas
1045-1100 Melissa McCarthy
Ahomebasedmodelofcochlear
implantation:theroleoftelepractice
Rendezvous Ballroom 2
Concurrent 2B – Maintaining
motivation and quality
assurance in newborn hearing
screening programme
(Part II)
Chair:ZeffiePoulakis&
JuthikaBadkar
Moira McLeod
Thepiecesofthejigsawpuzzle:
Therangeoftoolsandresources
requiredtodeliveraquality
newbornhearingscreening
programmeinNewZealand
Felicity Hood
Identifyingethicallyimportant
scenariosinnewbornhearing
screening
Aishwarya Nallamuthu
Overcomingchallengesof
deliveringanewbornhearing
screeningprograminatertiarycare
hospitalinIndia
Jill Clarke
Arewescreeningthecorrectbaby?
Melinda Barker
RescreeninginfantsinVictoria
2011-2012
Donna Barker
Culturalissuesinhearingscreening
Jenny Woodward
Maintainingandretaininga
competentscreenerworkforce
Sian Burgess
Holdingontothetailofthetiger:
educationandtrainingofthe
newbornscreeningworkforcein
NewZealand
Tasman Room 2
Concurrent 2C
Paediatric Audiology Professional
Development Workshop
0830-0850 Introductionand
updateonchanges
includingLittleEars,
issueswiththeUNHS
programme
0850-0935 UpdateonUK
programmeand
measuresputinplace
forareasofweakness
e.gABR
0935-0955 Managementissuesfor
complexpopulations
e.gDownSyndrome,
cleftpalateanddraft
ofanationalprotocol
foraudiological
assessment
0955-1105 Caseexamplesand
developmentof
nationalprotocols
1105-1110 Wrapup
1110-1130 Morningtea
Saturday 18 May 2013
0800-1530 Registrationdeskopen RendezvousFoyer,AtriumLounge
0830-0900 Welcome day two
19
1500-1530 Conference Close RendezvousBallroom1&2
JaneMcEntee
ProfGregLeigh
1100-1130 Morningteaamongsttheindustryexhibition
1130-1230 Keynote RendezvousBallroom1&2
Dr Capi Wever
NHS–Whydidwestartit,whatareweachievingandwheredowewanttogo
1230-1300 Lunchamongsttheindustryexhibition
Rendezvous Ballroom 1
Concurrent 3A – Mixed sessions.
Targeted surveillance, late
onset hearing loss and cochlear
implantation
Chair:KirstyGardner-Berry&
MoiraMcLeod
1300-1315 Rachael Beswick
Recommendationsformonitoring
hearinginchildrenusingariskfactor
registry
1315-1330 Andrea Kelly
Successofriskindicatorsfor
detectinglateonsetandprogressive
hearingloss–ananalysisofthe
NewZealandprotocol
1330-1345 Suzanne Harris
Weavingthetapestry
1345-1400 Zeffie Poulakis
Universal,riskfactorand
opportunisticscreeningfor
congenitalhearingloss:5-6yearold
populationoutcomes
1400-1415 Pat Tuohy
Sequentialcochlearimplantation
inchildren–doesageatsecond
implantmatter
1415-1430 Beth Atkinson
Pathwaystocochlearimplantation
followingidentificationofhearing
lossfromnewbornhearing
screening
1430-1445 Suzanne Harris
Creatingabaseline
Tasman Room 2
Concurrent 3B – Supporting
families (Part II)
Chair:SianBurgess&
HedwigvanAsten
Sharon Ewing
Parentsanddeafandhardof
hearingadults:supportingfamilies
inscreeningprograms
Liz Ray
Theexperiencesofhearingsiblings
whenthereisadeafchildinthe
family
Julie Gillespie
TheVictorianinfanthearing
screeningprogramearlysupport
service
Kym Adamson
Coordinatedtertiarycare:
childhoodhearingclinics,
Queensland
Suzanne Harris
Culturalissuesinscreening
Karin Van Der Merwe
Theevaluationofa2000hzauditory
steadystateresponsenewborn
hearingscreeningprotocol
Sargunam Sivaraj
Workshopsforparentsofchildren
withunilateral/mildhearing
lossidentifiedthroughUNHSEIP
programme
Rendezvous Ballroom 2
Concurrent 3C
Early intervention workshop
1300-1500 Thephilosophical
frameworkof
informedchoice:
fromtheoryinto
practiceinEarly
Interventionand
supportforfamilies.
For more information
refer to page 79.
20
TheConferenceGalaDinnerwillbeheldattheGrandTearoomintheHeritageHotel
andpromisestobeadelightfuleveningwhereconferencedelegatescansocialise
overadeliciousmealinbeautifulsurroundings.
Location: HeritageHotel,35HobsonStreet,Auckland
Date: Friday17thMay2013
Time: 1900–2230
Cost: $80.00perperson
Dresscode: SmartCasual
Cashbarfacilitiesavailable
Social Programme
Friday 17 May
Conference Dinner
Getting there:
Driving: Apublicpay&displaycarparkbuildingislocatedonthecornerofHobsonStreetandWyndhamStreet.
Walking: WalkstraightfromRendezvousGrandHotelontoFederalStreet,turnleftontoVictoriaStreetWestandrightonto
HobsonStreet.Thewalkwilltakeyouapproximately10minutes.
Taxi: TheRendezvousGrandHotelconciergecanorganiseataxiforyouatyourownexpense.
HOBSON ST
ALBERT ST
QUEEN ST
NELSON ST
WYN
DH
AM
ST
DRIVEMAYORAL
VINCENT ST
RENDEZVOUS GRAND HOTEL
HERITAGE HOTEL
WEL
LESL
EY S
T W
EST FEDERAL ST P
Kindly sponsored by
21
K E Y N O T E P R E S E N T A T I O N A B S T R A C T S
Friday 17 May, 1100-1130
New Zealand newborn hearing screening and early intervention programme
PatTuohy,Chief Advisor, Child & Youth, Ministry of Health
BrianCoffey,General Manager, Special Education, Ministry of Education
NOTES
22
K E Y N O T E P R E S E N T A T I O N A B S T R A C T S
Keynote AddressFriday 17 May, 1130-1215
The idea of “saving deaf children” – the role of family centered counseling & informed choice
Wever,C
Wever Facial Plastics, Wassenaar, The Netherlands
Socialpolicy-makingbydefinitionrequiresamoralguidelineor“worldview”toleaditsactions,howtodesignthe“ideal”societysoto
say.TwocentralthemesthathaveevolvedintimeandthatcanberatherdiametricalareFreedomandRationalism.
The Enlightment marked the beginning of a high belief in“rationalism”, of“value-free thought”, of thought freed from religion
andothersuperstition,thatcouldhencelead–butalsolegitimize–politiciansandsocialthinkerstowardstheirultimategoalof
creating the“ideal society”whilevexingaccusationsof idiosyncrasy, subjectivism,classism,orevenstatedespotism.Freed from
thesurveillanceofreligion,earlyEnlightmentthinkersbelievedthatabetter,moretrueandhonestworldcouldbefoundthrough
rationality,andthatmankind–orsomeofusatleast–wereabletoactuallythinkinsuchterms.TheunderlyingEnlightmenttheme
is–muchofitunknowingly–thatscienceinitselfsomehowallowsan“objective”analysisofthingsandconsequentlycanleadto
solving“allofhuman’sproblems”.Emotion,superstition,stupidity,andprejudicearetheclassicadversariesofrationality,sometimes
clusteredaroundahierarchicalnotionofmankind,societyandculture.
Today,thisviewcontinues,throughanincreasinglyintensealliancebetweenscienceandPublicHealth.Yetmanyhavecriticized
thesebasicassumptions,byrepudiatingtheunderlyingsimilaritybetweenthestudyofthenaturalworldofmathandphysicsand
thatofmankind,culture,ethicsandvalues.In“Birthoftheclinic”FrenchphilosopherMichelFoucaultfocusesonthemostnatural
ofhumansciences,namelymedicine,andrevealshowittoois inseparablefromthepanopticsystem,andhencefunctionsasa
normalizingagencyindefiningnormalfromdeviant.PreventivemedicineanditspoliticalanaloguePublicHealth–skyrocketingin
popularityandinfluence–nowdefines“deviant”basedonassumed“future”healthissues.Lifestyleissuessuchaseating,smoking,
breastfeeding,sexualpromiscuityinrelationtoHIV,iPoduse,andTVconsumptionarejustafewcontemporaryexamples.Typicalof
all“panoptic”systemsisthattheyconstructsabridge“betweenfactandvalue”,extracting“identity”from“individualbehavior”(Vaz
&Bruno).InObesity,forexample,inspiteofthecomplexplethoraofcausesitisparticularlytheassumedfrailtyinindividualself-
controlstandsout.
The abysmal idea of silence, of the lack of language, the lack of a means to cognitive, social and emotional development – to
humanityreally–hasstronglydrivendeafeducatorsandscientistssincetheearliestoftimes.Thatlanguageistobeperceivedasa
primerofhumanityappearsaratheruniversalvalue,butnotsothedegreetowhichlanguageisallowedtomonolithicallyoverrun
othermeaningfularguments.Asaconsequence,emotionsofurgency–of theneedofsavior–havedominatedthefieldsince
earliestwritings.Approachestosolvetheassumedprobleminabsolutetermstogain“totalcontrol”havebeentwofoldfromtheget-
go,alternatingbetweenspokenlanguageandsignlanguageparadigmswiththeirconsequentnarrativesandvalues.Yetarguments
havebeenlargelytheoreticaldriven–acrossthedivide–andstronglyvaluebasedaswell–complyinglargelywiththepanoptic
perspectivedescribedpreviously.Evenmodernstudiesonneurologicalbiomarkersofcognitiondonotchangethisperspective
categorically.
Acomplicatingfactorisinvolvedwhendealingwithdeafness–namelythe“problem”ofparents.Pediatricsisagoodexampleof
wherethingscanleadwhenparentsareinvolved:asaprofessiontheytendtoperceivethemselvesasresponsibleforthesakeof
children,parentsarealmostbydefinitiondistrustedandapproachedskeptically,and literature is fullofexplorationsofparental
competence. In the earlier days, deafness was institutionalized, and parents naturally abandoned their parental role and rights
aroundthetimeofdiagnosis.Sincethe1950’sallinstitutionsofauthority–includinginstitutionsforthedisabled–havebeenon
asteepdeclinethroughouttheWesternworld.Parentsofdisabledchildrenhavesincebecomemoreeducated,moreverbaland
havereclaimedtheirroleofguardians.Inthiscontext,informedchoiceisnotjustaformalstrategy.Itistheonlyappropriateattitude
inproxydecisionsfromthepositionofLiberalism: itoughttobethestartingpointofallprofessionalsthatdealwithchildhood
deafness.ThevaluesoftheFrenchrevolutionmorecloselyrepresentthevaluesofFreedom:Liberty&Equality,Autonomy,Fraternity
(thelatterwasaddedatalatertime).Libertyisbeingdefinedas“beingabletodoanythingthatdoesnotharmothers”.Inthislecture
thesetopicswillformthebackdraftofaviewonfamilycenteredcounselingparentsofdeafchildren.
23
K E Y N O T E P R E S E N T A T I O N A B S T R A C T S
NOTES
24
K E Y N O T E P R E S E N T A T I O N A B S T R A C T S
Plenary/Panel session Friday 17 May, 1530-1630
Expect the unexpected: managing incidents and improving quality in screening programmes
Chair:JaneO’Hallahan
Panel
JaneMcEntee,Group Manager, National Screening Unit, Ministry of Health, New Zealand
MoiraMcLeod,UNHSEIP Programme Leader, National Screening Unit, Ministry of Health, New Zealand
AndrewKeenan,Quality and Safety, Auckland District Health Board, New Zealand
ZeffiePoulakis,Director, Victorian Infant Hearing Screening Program, Australia
KylieBolland, Hutt Valley District Health Board, New Zealand
NOTES
25
K E Y N O T E P R E S E N T A T I O N A B S T R A C T S
Keynote AddressFriday 17 May, 1630-1730
Not everything that counts can be counted and not everything that can be counted counts: perceptions of quality in newborn hearing screening programmes
Carr,G
Afundamentalaimofuniversalnewbornhearingscreeningprogrammesistoenableallchildrenbornwithhearinglosstoachieve
their optimal language, communication, socio-emotional and educational outcomes through early identification followed by
timely,accurateassessmentandeffectiveearly interventionandfamilysupport. Professionals inpolicy,strategyandpractice in
bothhealthcareandeducationstrivecollaborativelytoprovideequitableandintegratedservicesinpursuitofthisgoal,anddevelop
qualitystandards,protocolsandbestpracticeguidelinestounderpinprogrammedelivery.
Asweseekto‘nurture,growandenrich’programmes,itisofcoursevitaltoensureongoingmonitoringandevaluationofprogramme
performancetoenablecontinuingimprovementanddevelopmentandtoqualityassureservices.Collectionofroutinedata-and
regularanalysistoinformunderstanding-playsacriticalpartinthatprocess,andmatureprogrammesarenowdata-rich.Keeping
inmindPlato’sassertionthatgooddecisionsare‘basedonknowledgenotnumbers’however,howcanwebesurethatthedatawe
collectarethe‘right’data,usedinthemostmeaningfulway,topositivelyimpactondesiredoutcomesandtakeforwardthequality
agenda?Whatelse,perhapslessamenabletoroutinedatacollection,reallycountswhenitcomestomeasuringqualityinservice
planning,deliveryandevolution?Keystakeholdersmayhavedifferentperceptionsofwhatconstitutesqualityinnewbornhearing
screeningprogrammes,dependingontheirroles,responsibilities,accountabilitiesandexperienceswithinthesystem.What‘quality’
looks likeand feels like tooneconstituencymaydiffer fromwhat itmeans toanother,and judgmentsofquality fromdifferent
perspectivescanbeusefullyexploredandcombinedtogiveaddedvaluetoexistingdata.Howcanwemakesurethatashared
vision reflects a multi-faceted understanding of what really counts in the assessment of quality and that everything that really
mattersgetscounted?
NOTES
26
K E Y N O T E P R E S E N T A T I O N A B S T R A C T S
Keynote AddressSaturday 18 May, 1130-1230
NHS – why did we start it, what are we achieving and where do we want to go?
Wever,C
Wever Facial Plastics, Wassenaar, The Netherlands
Explains deafness and its interventions as a narrow-margin condition.This implies that screening and interventions only work
effectivelyifthingsaresetrightinplace,andevenundertheseconditionshealthymodestyiscalledfor.Theunderlyingpremisesof
NHShavebeensilentlyideologicalaswellaspolitical.Ideologicallyitappearstobesilentlyassumed–orsoitseems–that“early”
isthenewestweaponinthepersistentbeliefthatsciencecanindeedsolve“all”ofdeafnessproblems.Mediocreresultsincochlear
implantation–forexample–areoftendisallowedbasedontheassumptionthatmoderndaytechnologyandearlierintervention
makesforadifferentworld.Politicallyitappearsthattheage-olddichotomybetweensignandspokenlanguagebasedinterventions
iscategoricallyshunned.MuchhasbeensaidaboutthebenefitsofNHS,butasasurgeonIamskepticasIhaveseeneurekabeen
calledandabandonedovermore thana single surgicalprocedure.Certainly it ismuchbetter toavoid latediagnostics suchas
witnessedundertheEwingera,butIhavenotseenunambiguousempiricalevidencethatargumentsgobeyondthis–upclose
thingsalwayslookimpressiveofcourse.NHSalsoimpliesthatweare–atleasttheoretically–loweringthethresholdforcochlear
implantation,whichhasitownsetofbenefitsandliabilities.Parentsaremuchlessknowledgeableaboutdeafnessundertheageof
12months,andmuchmorepronetoyieldtotherouteofnormalcythatissetout.FinallyIwillexplorewhatthismayimplyforthe
positionofminorities,whichrepresentsasignificantproportionofnewlydiagnoseddeafchildreninNewZealand.
NOTES
27
O R A L A B S T R A C T S F R I D A Y
Concurrent Session 1A: Supporting families – Part I 1300-1315
Family-centred early intervention for children with a permanent hearing loss: Insights from parental consultation
Mahler,N(1,2)andBuckley,C(3)andChessels,J(1)
1. Hearing-Impaired Children’s Therapies Inc, Brisbane, Queensland, Australia2. Griffith University, Gold Coast, Queensland, Australia3. Yeerongpilly Early Childhood Development Program, Brisbane, Queensland, Australia
Torealisethebenefitofearlyidentificationofhearingloss,concomitantqualityearlyinterventionisparamount(Kumaretal.,2009).
In synchrony with research evidence and expert opinion, a consultative and flexible family-centred approach which engages
familiesbyincorporatingtheirneeds,valuesandchoices,buildsthefoundationforbestpracticeinearlyintervention(ASHA,2001).
Parentsofchildrenwithpermanenthearing lossplayakeyrole intheirchildren’shabilitation.Althougharangeofstudieshave
providedevidenceofthisinter-relationshipacrossvariouschildoutcomemeasures,thedirectcorrelationsbetweenparentalinput
andchildoutcomesremainpoorlyunderstood(forasummary,seeKumaretal.,2009).Theprimaryaimofthecurrentprojectwasto
informpracticesandservicedeliveryoptionsthroughparentconsultationinordertobettermeetfamilies’needsandsecureoptimal
outcomesforchildrenwithpermanenthearingloss.
TheParentConsultationQuestionnaire(PCQ)wasdevelopedtoinformtheconsultationprocess.Thissurveyincludedbothopen
questionssuchas“Whathelpedtobuildyourconfidenceinlearningtomeetyourchild’sneeds?”andclosedquestionsinvestigating
targetedareas.Thequestionnairewascomprisedofthreesections:Aboutyourchild,AboutyourfamilyandAbouttheservice.The
PCQwasdistributedtoallfamilieswhosechildrenattendedtheservicein2012(N=96),withareturnrateof34%.Serviceevaluation
wasratedonbothimportanceandsatisfactionoftargetedareas,withparentsratingallareasexaminedbetweenimportant(2)and
veryimportant(3)(Range=2.18,2.91).Despitesatisfactionconsistentlybeingreportedbetweensatisfied(2)andverysatisfied(3)
(Range=2.0,2.91),importanceandsatisfactionratingsweresignificantlydifferent,t(17)=4.52,p<.05,withameandifferencescore
of0.16(SD=0.04,N=18).Discussionwillfocusontheareasofprimaryimportanceandneedidentifiedbyparentsandsubsequent
changesinservicedelivery.
NOTES
28
O R A L A B S T R A C T S F R I D A Y
Concurrent Session 1A: Supporting families – Part I1315-1330
Caregivers’ experiences with the diagnosis of hearing loss
Röhrs,EandKathard,HandTaljaard,D
University of Cape Town, Cape Town, Western Cape, South Africa
Knowledgeoftheimpactoncaregiverswithchildrenwithahearinglossandtheirrelationshipswithprofessionalsinvolvedintheir
lives,emotional,socialaswellastheperceptualimpactofthenewsonthecaregivers,especiallyinSouthAfrica,isinadequateor
lacking.Thepurposeofthisstudyisknowledgegenerationbasedontheexperiencesandperceptionsofcaregivers.Aqualitative,
retrospective,narrativeinquiryresearchdesignwasusedconsistingoftwophases.Inthefirstphaseparticipantswereinterviewed
usingasemi-structuredinterviewscheduleandinthesecondphasearesponsiveinterviewingapproachwillbeused.Participants
forthefirstphasewerepurposefullyselectedconsistingofonecoupleand12caregivers.
Fivethemesemergedfromthefirstphase’sdata:
1) Time:asenseofurgencyoftendroveparentstoobtainhelp,butalsotoexpressaneedforearlieridentification.Theyoftenalso
expressedaneedtohavemoretimetoletthenewssinkinafterdiagnosis.
2) Themostsignificantemotionspresentfrombefore,atandafterdiagnosisincludeddenial,shock,worry,andhope.
3) Communication:expressingtheneedtoobtaininformationatdiagnosiswhichwasoftenlackingordeniedandexpressingthe
needforgentleyethonestlanguageusebytheprofessionalatdiagnosis.
4) Resources: all participants expressed gratitude and a sense of hope when integrated into a school system. Families and
communities that labelled their child or didn’t support or understand their chosen communication mode was voiced as
challenging.
5) Inherentand learntattitudesandbeliefs:Themeaningof thenewswasperceiveddifferentlyunderdifferentcircumstances.
Increased professional insight should generate more refined counselling strategies and should become an integral part of
diagnosisofhearinglossinchildrensoastobetterservefamiliesthatarecomingtotermswithit.
NOTES
29
O R A L A B S T R A C T S F R I D A Y
Concurrent Session 1A: Supporting families – Part I1330-1345
“How early is too early?”The outcomes of cochlear implantation in infants under 6 months, 7-9 months and 10-12 months
Davis,A(1,2)andAbrahams,Y(1)
1. The Shepherd Centre, Sydney, NSW, Australia2. Macquarie University, Sydney, NSW, Australia
Thisongoingstudyaimstodetermineiftherearesignificantdifferencesintheaudition,receptiveandexpressivelanguageskills
ofchildrenwhoreceivedatleastonecochlearimplantat6monthsofageoryounger,comparedwiththoseimplantedbetween
7-9monthsofage,andthoseimplantedbetween10and12monthsofage.Thetypicalprofileforchildrenineachgroupisalso
reviewed.
ArangeofauditorytoolsincludingtheCategoriesofAuditoryPerformance-Revised,Auditoryhierarchyandfunctionalaccessto
theLing6soundswereusedtoassessthelisteningskillsandthePreschoolLanguageScaleswereusedtoassessthereceptiveand
expressivelanguageabilitiesof30childrenwhoreceivedatleastonecochlearimplantpriorto12monthsofage.Childrenwere
allocatedtooneofthreegroups:Group1(firstCI6monthsofageoryounger),Group2(firstCIbetween7and9monthsofage)and
Group3(firstCIbetween10and12monthsofage).Otherfactorsincludingparentalattitudes,familyengagementlevels,device
usageandmedicalandaudiologicalfactorswereexamined.
Nosignificant issueswereseen foranychildrenreceivingCIasyoung infants.Withacombinationofobjectiveandbehavioural
MAPpingtechniquestheywereabletoaccesssoundsacrossthespeechrange. By3yearsofagetheperformanceofthecochlear
implantuserswhoreceived theirfirstcochlear implantbefore12monthsoutperformedthosewhoreceived theirfirstcochlear
implantafter12monthsandwascomparabletotheirhearingpeers.Forinfants,thosewhowereimplantedattheearliestages
showedbetterperformancethanthoseimplantedbetween7-12months.
Outcomesforchildrenimplanted6monthsofageandunderindicatethatwithfull-timedeviceuseandengagementinanAuditory-
VerbalTherapyearlyinterventionprogramageappropriatevocabularyandlanguagecanbereachedby3yearsofage.Avarietyof
factorsinfluenceageofimplantandalsoinfluencelonger-termoutcomes.
NOTES
30
O R A L A B S T R A C T S F R I D A Y
Concurrent Session 1A: Supporting families – Part I1345-1400
Adapting a coordinated early intervention service to best support the families of babies screened under UNHS – a New Zealand perspective.
O’Connor,LandLin,R
The Hearing House, Provider to the Northern Cochlear Implant Programme, Auckland, New Zealand
TheHearingHouseistheprovidertotheNorthernCochlearImplantProgramme,providingaudiologyservicesfrom0-19years,and
habilitationservicesfrom0-6years.Habilitationisalsoprovidedforafewchildrenwhousehearingaids,onacasebycasebasis.
SinceUNHSwasrolledoutacrossNewZealand,wehaveseentheageofchildrenenrollingonTheHearingHouseprogrammelower
fromanaverageageof1year,10monthsto6months.Thishaspresentedtheteamwithsomeinterestingchallenges,andasaresult
wehavehadtoadaptouraudiologyandhabilitationprogrammestobestmeettheneedsoftheseyoungbabiesandtheirparents.
Thispresentationwilldiscusshowaudiologyandtherapysessionshavebeenadapted,andthedevelopmentofapilottwoday
workshopforthesefamilies.Professionalshavebeenupskilledtomeettheuniquedynamicsofworkingwithbabiesunderone.The
roleofthehabilitationist,whilealwaysincludingacounsellingrole,hasshiftedevenmoretowardsthisrole,asweencounterthese
newparentswhoaregrievingfortheirbaby’shearingloss.Fromanaudiologicalperspectivethechallengeshaveinvolvedtesting
thebabiesandamplifyingthemappropriately.Therehavealsobeendiscussionsarounddeterminingcochlearimplantcandidacy
andtheoptimalagefor implantingtheseyoungbabies. Wehavefoundthatmeetingotherparentsinsimilarsituationsplaysa
significantfactortofamilies’commitmentandparticipationtotheprogramme,andthisisfacilitatedthroughthevariousinitiatives,
inparticularthetwodayworkshop.
NOTES
31
O R A L A B S T R A C T S F R I D A Y
Concurrent Session 1A: Supporting families – Part I1400-1415
Bilateral cochlear implantation in children identified in newborn hearing screening: Why the rush?
McTaggart,MandChisholm,K
Sydney Cochlear Implant Centre, Australia
Thispaperexplorestheoutcomesofthreegroupsofchildrenidentifiedascochlearimplantcandidatessoonafternewbornhearing
screening.
Weaimtoidentifytheimpactonreceptiveandexpressivelanguageaswellasfunctionalandperceptuallisteningabilitieswhen
receivingjustoneortwocochlearimplantsand,iftwo,theimpactofsimultaneousorsequentialbilateralcochlearimplantation.
Method:
Speech,language,perceptualandfunctionalmeasuresat6,12andthen2yearspostcochlearimplantationandthenagainat5
yearsofage,weremeasured.
Group1.bilateralsimultaneouscochlearimplants
Group2.bilateralsequentialcochlearimplants(secondCIbefore2yrs)
Group3.unilateralcochlearimplant(withhearingaiduseintheircontralateralear-bimodal)
Datawasanalysedfor45childrengroupedaccordingtotheintervalandnumberofcochlearimplants:
Results:
Therewasnosignificantdifferencebetweenoutcomesofthethreegroupsinthefirsttwoyearsfollowingcochlearimplantation.
Resultsforthefollowingdataintervalwasmorevariable.
Howeveratrendwasobservedinthedatathatdemonstratedtheinfluenceofparentalsupportandengagementonoutcomes.
Conclusion:
Thesefindingsdemonstrategoodoutcomescanbeattainedifthechildisimplantedwithinthefirst12monthsoflife,albeitbilateral
orunilateral.Theimportanceofparentinvolvementindefiningtheoutcomeoftheirchildwillbeaddressed.
NOTES
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O R A L A B S T R A C T S F R I D A Y
Concurrent Session 1A: Supporting families – Part I1415-1430
Journey to a cochlear implant following a hearing loss
Jardine,J
Mater Cochlear Implant Clinic ,Brisbane QLD ,Australia
FollowingabirthinQueenslandsince2004ithasbecomeroutinetohaveahearingscreen.Thesescreensaremostlycarriedout
priortoleavinghospital.Medicaltechnologyhasallowedtheearlyidentificationofdetectionofhearinglossinnewborns.Ithas
becomeacceptedthatearlydetectionandinterventionenhancesthechild’sabilitytoachievebetteroutcomeswithcommunication.
Yoshinaga-Itanoandcolleaguesrecognisedthoseinfantswhosehearinglosswasidentifiedbeforetheageof6monthshadstronger
expressivelanguagethanlaterdiscovery.
Whatdoesthismeanforthefamily?Howearlyarethesefamiliesenteringamedicalmodelwheretheyembarkonajourneyof
interventionandmanagementofhearingloss?Alotofchoicesmaybepredeterminedbytheprocessremovingthedecisionmaking
fromtheparents.Therearemanyindividualsinvolvedintheprocessmakingthejourneysmoothforsome,butstillcomplicatedfor
many.Whatdoesitfeellikeforthosechildrenandtheirfamiliesthathaveslippedthroughthegapsorwerelatediagnosis,havea
progressivehearinglosswithlittleornofollowup?
TheaimofthispresentationistotellthestoryofafewofthechildrenthathavebeenreferredtotheMaterCochlearImplantClinic.For
someofthesefamiliestheyhavebeendiagnosedwithin4-6weeksandstartthejourneyofappointmentsandanacceptancethata
CochlearImplantisthebestchoice.Forothersitisaperiodofanxietytryingtonavigatethemyriadofappointmentsanddecisions.
Inadditiontothisequationintothemixcomesdifferentlanguages,culturalopinions,socialproblems,makingthedecisionmaking
verydifficult.Eachfamilyneedstobetreatedindividuallyandallaspectstakenintoconsiderationtohelpthisfamilyreachadecision
thatwillallowthechildtoreachtheirpotential.
Thisjourneyinvolvesmanyprofessionalsalongtheroute.
NOTES
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O R A L A B S T R A C T S F R I D A Y
Concurrent Session 1A: Supporting families – Part I1430-1445
‘No discipline is an island’:Working together to support families who need it the most
Davis,A(1,2)andBeresford,S(1)andSouthgate,M(1)andAbrahams,Y(1)
1. The Shepherd Centre, Sydney, NSW, Australia2. Macquarie University, Sydney, NSW, Australia
Oneofthefrequentlyreportedchallengesfrombothprogramandstafflevelsinservicesprovidingsupporttofamiliesofchildren
withhearinglossisaddressinghowtoensurethatvulnerablechildrenandfamilieswithminimalsupportnetworksarenotexcluded
fromfollowupprograms,butratheractivelyengagedinthemtogaintheirtruebenefits.Thereisagrowingbodyofresearchto
supportthatitistheseparents,particularlywithoutinformalsupports,whopotentiallyhavethemosttogainfromfollowupservices
andaretheleastlikelytoactuallyaccessthem(Katzetal,2007).
Thispaperwillexplorehowbarrierstoinclusionandengagementinearlychildhoodinterventionservicescanbeovercomeforsuch
familiesafteridentificationofahearinglossthroughtheframeworkofinterdisciplinaryteamsandbuildinginclusivecommunities
andsupportstructures.
Thejourneytowardsthisframeworkwillbediscussedthroughtheexperiencesofalargenot-for-profitearlyinterventionservice
inAustraliaasitworkstowardsasystemofintegratedservicesandcommunityinclusion,drawingfromtheexperiencesoffamilies
andnetworkserviceproviders.Casestudieswillbeusedtoexaminehowthiscanresultinenhancedoutcomesforfamilies,reduced
disincentivesforfamiliestoaccessservicesandcreativeservicedeliverymodelswhichcanbeadaptedforprovidersatallpoints
alongthehearingdiagnosispathway.Challengestothismodelofcrosscollaborativeservicefororganisationsandfamiliesandwill
beidentifiedanddiscussed.
NOTES
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O R A L A B S T R A C T S F R I D A Y
Concurrent Session 1A: Supporting families – Part I1445-1500
Newborn hearing screening facilitates early diagnosis of congenital CMV infection
Cottier,C(1,3)andWilkinson,M(1,4)andHall,B(2)andRawlinson,W(2,3)andPalasanthiran,P(1,3)
1. S ydney Children’s Hospital, Randwick, N.S.W., Australia 2. Virology Research, Department of Microbiology, SEALS, Randwick, N.S.W., Australia3. University of NSW, Kensington, N.S.W., Australia 4. Macquarie University, North Ryde, N.S.W., Australia
Introduction
CongenitalCMV(cCMV)isanaetiologicalfactorinupto20%ofcasesofsignificantsensorineuralhearingloss(SNHL).Twothirds
ofbabieswithcCMVwillhaveSNHLasasolemanifestationoftheinfectionTimelytreatmentofcCMVwithintravenousganciclovir
andpossiblyoralvalganciclovirintheneonatalperiodmaypreventhearingdeterioration.RoutinetestingforcCMVisnotcurrently
standardpracticeinN.S.W.
Method
In2009,analgorithmfortestingurineforCMVPCRwasintroducedintheAudiologyDepartmentatSydneyChildren’sHospital(SCH)
forbabieswithaconfirmedSNHL.SalivaswabCMVPCRwasaddedin2011.Afactsheetwasgiventoparents/carersatthetimeof
testing.AllbabieswithCMVPCRpositiveurineand/orsalivawerereferredtotheDepartmentofInfectiousDiseasesforanurgent
assessmentforcongenitalCMVstatusandconsiderationoftreatment.AllbabieswerefollowedupwithAudiologyandtheHearing
SupportService.
Results
Ofthe224babiesreferredfromSWISHinwhomadiagnosisofhearinglosswasconfirmed,sevendefiniteandoneprobablecCMV
infantswereidentified.Meanageoftestingwas4weeks(range2-6weeks).Onefamilyproceededwithoralvalganciclovirtreatment.
Conclusion
NewbornHearingScreeningwithCMVtestingprovidesauniqueopportunitytomakeanearlydiagnosisofcCMV,allowingfamilies
toaccesstimelytreatmentandmonitoring.
NOTES
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O R A L A B S T R A C T S F R I D A Y
Concurrent Session 1B: Maintaining motivation and quality assurance in newborn hearing screening programmes – Part I1300-1315
Natural disasters and a newborn hearing screening programme: maintaining services, quality and sanity
Deken,A
Canterbury District Health Board, Christchurch, New Zealand
TheCanterburyregionexperiencedtwonaturaldisastersoverasixmonthperiodwiththemostsignificantbeingonFebruary22nd
2011anearthquakeofsignificantstrength.Itwasakintoanaturaldisasterofthescaleonlyreadaboutorseenontheworldnews.
AsindividualswithinNewZealandweareencouragedtoprepareforanaturaldisasterwithinthehomeandworkenvironment.
ThisearthquakehasgiventheopportunityfortheCanterburyDistrictHealthBoardto“test”itspoliciesarounddisasters’.Employees
includingnewbornhearingscreenersareguidedbytheiremployertomeetcertainobligationsduringeventssuchasthese.
This presentation describes the impact of the earthquake on the screening staff and programme outcomes. It will include a
descriptionoftheimmediateimpact,theeventsasthedisasterunfoldedandtheongoingeffectthathasfollowedforstaffand
families.
The presentation will also focus on the supports that were made available to assist with coping through a disaster, initiatives
established,practicalapplicationandanoutlineofkeydocumentsandpolicesthatguideascreenerspracticewhenfacedwitha
naturaldisaster.
NOTES
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O R A L A B S T R A C T S F R I D A Y
Concurrent Session 1B: Maintaining motivation and quality assurance in newborn hearing screening programmes – Part I1315-1330
Implementation of an early hearing detection management and information system to improve quality and standardisation in Queensland
Beswick,R
Health Services Support Agency, Queensland Health, Queensland Government, Queensland, Australia
Newbornhearingscreeningprogramshavebecomestandardpracticeinmostdevelopednations,withanabundanceofliterature
availableonthebenefitsof theseprograms.Programsrequirethat infantsarescreenedearlyandaccurately inordertoachieve
timely identification of the hearing loss, streamlined referrals, and appropriate intervention. A breakdown at any point in this
processmaycausesignificantlong-termnegativeeffectsonthechild.Largepopulationscreeningwithcrucialtimelimitsimposes
manychallengesonhearingscreeningprogramsincluding(1)managementofmassdata,(2)deliveringahighqualityofservice,
and(3)ensuringconsistencyismaintainedacrossallpartsoftheprogram.Inaddition,thereisanincreasingdemandtoprovide
standards-basedreportingonallaspectsofnewbornhearingscreeningprogramsatbothastateandfederallevel.Toovercome
thesechallenges,QueenslandHealth’sHealthyHearingProgramdevelopedanewclinical,management,andinformationsystem:
QChild.Thissystemincorporatesdetailedinformationfrombirth,newbornhearingscreening,audiology,earlyintervention,family
support,andmedicalappointments.Thesystemincludesautomaticprocessessuchasdailyimportofallhospitalbirthsstatewide,
populationofteamscreeninglists,infantandscreeningresultmatchinganderrordetection,andreferralstoaudiology.Theopen-
endednatureofthedatastructureinthesystemallowsforincorporationoffuturemodulestoexpandbeyondhearingscreening.
Linkagesor interfaceswithotherdatasourceswillalsobepossible.Asmisinterpretationofaudiologyreportsmaybeashighas
29.2%inchildrenwithabnormaloutcomes(Ramachandranetal.,2011),audiogramsanddiagnosticlettersaregeneratedwithinthe
systemtohelpstandardiseaudiologyreportingacrosssites.Thispresentationwilldemonstratethegenerationofaudiogramsand
letters,aswellasdetailedmanagementandqualityassuranceonallaspectsofthecontinuumofcarethatisapartoftheHealthy
HearingProgram.
Ramachandran, V., Lewis, J. D., Mosstaghimi-Tehrani, M., Stach, B. A., & Yaremchuk, K. L. (2011). Communication outcomes in audiologic
reporting. J Am Acad Audiol, 22(4), 231-241.
NOTES
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O R A L A B S T R A C T S F R I D A Y
Concurrent Session 1B: Maintaining motivation and quality assurance in newborn hearing screening programmes – Part I1330-1345
Reflections on an investigation into reported changes in rates of referral from screening to diagnostic assessment
Catherine,LandFizzell,JandMurphy,E
NSW Ministry of Health, NSW Government, Sydney, New South Wales, Australia
The NSW Statewide Infant Screening- Hearing (SWISH) Program was established in December 2002.The Program consistently
performsatalevelsuperiortotheinternationalnewbornscreeningbenchmarks,includingscreeningmorethan99%oflivebirths
usingAutomatedAuditoryBrainstemResponse(AABR)technology.
AreviewoftherecentSWISHProgramactivitydatawasundertakenbyNSWHealthin2012toinvestigatereportedchangesinrates
ofreferralfromSWISHuniversalnewbornhearingscreeningtodiagnosticaudiologyassessment.
The limitations of the existing SWISH Data Collection (which consists of monthly aggregated reports prepared manually and
correctedovera6monthperiod)presentedvariousdataandresourcerelatedchallengestotheepidemiologistsandpolicyofficers
involvedinthereview.
Variousfactorswhichmaypotentiallyimpactonreferralrateswereidentifiedincludingequipmenttypeandmodificationaswellas
changesinstaffing,birthrateandreferralpathways.
DetailedactivitydatawassoughtfromLocalHealthDistrictsfortheperiodfromJuly2011toApril2012,duringwhichmorethan
72,000babieswerescreened.
Analysisofthisdatawascompletedtosubstantiateanychangeinratesofreferralanddiagnosis,andtoenableconsiderationofthe
abovefactors.ThefindingsofthereviewrelatedtobothrecentandhistoricaltrendsinSWISHProgramactivityandsupportedthe
valueofearlyobservationsmadebySWISHclinicians.
Arangeofadditionalquality-focusedSWISHprojectswere initiated inresponsetothefindings includingthedevelopmentofa
QualityFramework.
Theresultsofthereviewandinitiativesundertakensincewillbediscussed.
NOTES
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O R A L A B S T R A C T S F R I D A Y
Concurrent Session 1B: Maintaining motivation and quality assurance in newborn hearing screening programmes – Part I1345-1400
Screening infants who are young and too young: An analysis of gestational age at screening in Victoria
Kavanagh,GandPoulakis,ZandBarker,MandClarke,J
Royal Children’s Hospital, Melbourne, Victoria, Australia
ScreeningprogramssuchastheVictorianInfantHearingScreeningProgram(VIHSP)mustberegularlymonitoredandreviewedto
ensuredataareofahighquality,patientsarenottestedunnecessarily,staffareworkingtoacceptablestandardsandparticipants
arereceivingthebestpossibleservice.
Gestationalageatscreeningdatafromthefinancialyear1July2011–30June2012wereexamined,withaparticularfocusoninfants
screenedyoung–priorto36weekscorrectedgestationalage(CGA),andthosescreenedtooyoung-priortotheeligibilityof34
weeksCGA.
Dataindicatedthat0.08%ofinfantsscreenedwerescreenedbeforetheywere34weeksCGA,and2.85%ofinfantswerescreened
withCGAbelow36weeks.
Recordsofinfantsscreenedbefore34GCAindicatedthatthemajorityoftheseinfantswerescreenedat33weeksand5daysor33
weeksand6days.ThemethodusedbytheVIHSPdatabasetoascertainCGA,andreadinesstoscreen,roundsCGAattwopoints,
whichresultedininfantsappearingtohavereached34weeksofageafewdaysearly.Forinfantsscreenedbetween34and36weeks
CGA,investigationsrevealedpossiblecausestobeveryshortstaysandSpecialCareNurseryinfantsbeingdischargedwithinhours
ofcompletionoftreatment.Notscreeningtheseinfantswhentheopportunityarises,andwaitinguntiltheseinfantsaregreaterthan
34weeksCGAmayresultinthemmissingtheirscreenwhileinpatients.
AnenhancementtotheVIHSPdatabaseisduetobeimplementedtoremovebothpointswherethegestationalageisrounded.
VIHSPisconfidentthatthisdatabasechangewillensurethatstaffdonotinadvertentlyscreeninfantswhoaretooyoungtoscreen.
FurthermonitoringofCGAatscreeningwillcontinue.
NOTES
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O R A L A B S T R A C T S F R I D A Y
Concurrent Session 1B: Maintaining motivation and quality assurance in newborn hearing screening programmes – Part I1400-1415
How a hearing screening programme database can result in both quality improvements and cost savings.
Deken,AandCraig,BandAnthony,JandWilson,J
Canterbury District Health Board, Christchurch, New Zealand
OfferinganewbornhearingscreeningprogrammeinalargeDistrictHealthBoard(DHB)inNewZealandforupto7000babiesper
yearwithoutelectronicsupportleadstoinherentqualityandprocessrisksfromthescreeningoffertoaudiologyreferrals.Therewas
nonationaldatabasein2009whentheCanterburyDHB(CDHB)commencedtheUniversalNewbornHearingScreeningProgramme.
Astheprogrammerolledouttheneedforadatabasewasclear,sotheCDHBcreatedacustomiseddatabase.Thisdatabasehas
significantlyimprovedthequalityofthescreeningservicebyfacilitatingidentificationandtrackingofbabies,screensandoutcomes.
Italsosavesscreenerandcoordinatortime,resultinginannualDHBsavingsof$48,000.TheNationalScreeningUnit(NSU)alsosaves
costsinreduceddataentrytime.
Every CDHB hospital birth is automatically populated into the database daily. The database collates screening and audiology
informationwhichiselectronicallyaccessibletoDHBcliniciansandlocalGPs.Itsendselectronicdataforscreeningandaudiology
outcomestotheNSUandflagsdataentryerrors. Italsohasanappointmenttrackingsystem.Monthlyandquarterlyreportsare
generated,whichsupportanalysisoftheserviceandenabletheinstigationofqualityinitiatives.Screenerperformanceforyearly
appraisalsisalsoreportedfromthedatabase.
Thenextdatabasedevelopmentproposedisforbabieswhoarediagnosedwithhearinglossandwillincludetheirfullclinicaldetails
anddevelopmentalmilestones,toenableassessmentofinterventioneffectiveness.Wearealsocurrentlyexploringtheoptionofa
directdailydownloadofscreeningdata,toimprovescreeningqualityauditingfacilityandtosavetime.
Thedevelopmentofthisdatabasehassignificantlyimprovedthequalityoftheserviceandmitigatedmanyofitsriskstooptimise
patientsafetyandtheprogramme’sefficacy.
NOTES
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O R A L A B S T R A C T S F R I D A Y
Concurrent Session 1B: Maintaining motivation and quality assurance in newborn hearing screening programmes – Part I1415-1430
When a unilateral refer reveals a bilateral loss on diagnosis: cause for concern?
Douglas,R
Children’s Hospital at Westmead ,NSW, Australia
Ithasbeen reported that inmanynewbornhearingscreeningprogramsmoreattentionhasbeenplacedon infantswho refer
bilaterallythanthosewhoreferunilaterally. Infactsomeprogramsonlyreportbilateralrefers(Chang,KWetal2009).Atthesame
time,thetrade-offsmostprogramsmakeonscreeningsignalcharacteristicstomaintainspecificitymeanthatunilateralreferscan
sometimesresultinbilaterallossatdiagnosis.
Overthelastdecade,theAudiologyClinicatChildren’sHospitalWestmeadhasassessedmorethan2,000infantsviatheStateWide
InfantScreeningHearing(SWISH)program.Over600ofthesewereunilateralrefersandofthose,121werediagnosedwithhearing
lossinboththereferringandpassear :closeto1in5.Offurtherconcern,closetoonequarterofthis lattergrouphadbilateral
sensori-neuralhearingloss.
Thispaperwillexamineboththetypeanddegreeofhearing lossdetected,aswellas report relevant risk-factors, includingthe
possiblebias inoursample.Acasestudywill thenexaminethepotentialpsycho-socialeffectsresultingfromtheseunexpected
cases.
Future opportunities will then be explored for fine-tuning the support our program provides, to ensure these infants receive
optimumqualitycare.
Chang,KW,et al.J Med Screen 2009;16:17-21
NOTES
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O R A L A B S T R A C T S F R I D A Y
Concurrent Session 1B: Maintaining motivation and quality assurance in newborn hearing screening programmes – Part I1430-1445
VicCHILD: establishment of the world’s first population-based childhood hearing impairment longitudinal databank
Wake,M(1,2,3)andPoulakis,Z(1,2)andMcMillan,L(1)andHampton,A(1)andTobinS(1)andMueller,K(1)andBurt,R(1)andStevens,L(1)andHalliday,J(1)
1. Murdoch Children’s Research Institute, Melbourne, VIC, Australia2. Royal Children’s Hospital, Melbourne, VIC, Australia3. The University of Melbourne, Melbourne, VIC, Australia
Context:
Inaneraofbetter lifechancesthaneverbeforefordeafchildren,congenitalhearinglossescontinuetoexertmajor impactson
speechandlanguage,incurringlifelongsocial,educationalandeconomiccosts.
Objective:
(1)Toestablishtheworld’sfirstpopulation-basedlongitudinaldatabankforchildrenwithcongenitalhearinglossand(2)facilitate
collaborative population-based research to: (i) describe secular trends in outcomes; (ii) support population-based quality
improvementactivities; (iii) identifyandquantify factors thatpredictoutcomes;and(iv) facilitaterandomisedcontrolledtrialsof
interventions.
Design:
Established in late2011 toprospectively recruitchildren indefinitelyand follow them fromsoonafterbirth throughadulthood,
VicCHILDcombines(1)questionnaireandassessmentdatacollectedapproximately5-yearlyfromVicCHILDfamiliesandchildren;(2)
linkagetodeafness-specificandgenericpopulation-basedhealthandeducationaldatabases;and(3)salivarysamplesforgenetic,
epigeneticandviralstudies.
Setting:
CurrentlythestateofVictoria,Australia,butwithcapacityforfuturenational/internationalfederatedmembership.
Participants:
189childrenasofJanuary2013,prospectivelytargetingallchildrenborninthestateofVictoriasince2011withbilateralorunilateral
congenitalhearingimpairment,identifiedthroughtheVictorianInfantHearingScreeningprogram(VIHSP),plusone-offretrospective
re-recruitmentfromtwopopulation-basedstudiesandchildrenbornduringVIHSP’sroll-out(2005-10).
Main outcome measures:
TheREDCapweb-basedservercanbetailoredtoresearcheraccessrequirements.Datainclude:hearingdiagnosis(type,degree,age
atdiagnosis);birthandfamilyhistorydata;demographics;childoutcomes(eg language,academicachievement,mentalhealth,
HRQoL);parentoutcomes(egmentalhealth,HRQoL);treatment;serviceutilisation,includinglifetimeMedicaredata;buccalsamples
extractedandstored.
Implications:
VicCHILDrespondstoaclearly-identifiedinternationalneedfornewapproachestocoordinated,collaborative,population-based
research.AstheVicCHILDrepositorygrows,wehopeitwillstimulateandsupportnovellocalandinternationalcollaborationsand
capacityincongenitalhearingimpairmentresearch.
NOTES
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O R A L A B S T R A C T S F R I D A Y
Concurrent Session 1B: Maintaining motivation and quality assurance in newborn hearing screening programmes – Part I1445-1500
Screening anomalies in newborn hearing screening programmes in NZ
Kelly,A(1)andWoodward,J(1)
1. Auckland District Health Board, Auckland, New Zealand
Recently,revelationsofdeviationsfromthenationalscreeningprotocolbyindividualnewbornhearingscreenershavemademedia
headlinesinNewZealand.Thispresentationwilldiscusstheidentificationoftheanomaliesinthedataandcontrastdatafromtwo
verydifferentheathboards inNewZealand.Onehealthboard isbased inthe largestmetropolitanareaofNZandemploysthe
largestnumberofscreenersinthecountryandthesecondissmallurbanhealthboardthathasoneofsmallestscreeningworkforces
inthecountry.
Datawillbepresentedtoshowthepatternandtypesofanomaliesidentified,thetechniquesdevelopedtoanalysedataforprompt
datascreening,andmeasuresputinplacetoattempttopreventfutureoccurrences.Causalfactorsidentifiedbythetwoscreening
programmeswillbediscussed.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 2A: Effective evidence based ways of delivering early intervention programmes0900-0915
Nga Kohungahunga Turi: envisioning a whanau-centred approach to early intervention
Smiler,K(1,2)
1. Health Services Research Centre, Victoria University of Wellington, Wellington, New Zealand.2. Deaf Studies Research Unit, Victoria University of Wellington, Wellington, New Zealand.
This presentation will report on a study that investigated the early intervention experiences of whanau (family) of Maori deaf
children.Basedonfivecasestudies, the researchaimedtodocumentMaoriperspectiveson interactionwithearly intervention
services and to explore what other information and ideas shaped their perception of deafness and influenced their decisions
aroundcommunication,language,andparenting.Thefeaturesofawhanau-centredmodelofinterventionareexploredbetween
theresearcherandwhanauparticipants inordertoprovideanunderstandingofhowearly interventionservicescouldbemore
effectivefromMaoriperspectives.
Whanauinthestudyreportedthattheir initialencounterswithprofessionalsfocusedonmedicalperspectivesandresponsesto
hearing loss. As the child entered developmental stages whereby language acquisition and social acculturation process began
however, whanau needed more social and linguistic support to ensure participation in home and educational contexts. Early
interventionserviceswereseenbysomeparticipantstoconstrain,ortoconflictwith,theirsocial-culturalaspirationsforthechild,
bya focusonacquiringspokenEnglishandparticipation inmainstreameducationalcontexts.Whanauexpressed frustrationat
thecompromise they feltandwished foramodelof support thatengagedwithwhanauaspirationsandrelational stylesmore
effectively.Potentialfeaturesofawhanau-centredmodelofearlyinterventionwereidentifiedbetweentheresearcherandwhanau
duringawananga(forum)heldasapartoftheresearch.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 2A: Effective evidence based ways of delivering early intervention programmes0915-0930
Developing a blended service model to deliver family-centred early intervention
McCarthy,M
Royal Institute for Deaf and Blind Children, Sydney, New South Wales, Australia
TheimplementationofUniversalNewbornHearingScreeninghasresultedinearlieridentificationofhearinglossformanychildren
andtheirfamilies.Whilethisisasignificantachievement,thefullpotentialofscreeningprogrammesisonlyrealisedwhenthose
programmesarecomplementedbyearlyamplification,ongoingaudiologicalmanagementandearlyinterventionservices.
TheRoyalInstituteforDeafandBlindChildren(RIDBC)furtherstheobjectivesofscreeningprogrammesbyprovidingaudiological
management and early intervention services to families throughout Australia. RIDBC uses a family-centred approach focusing
on coaching and guiding families to be the primary facilitator of their child’s language and communication development. In
metropolitanareas,individualandgroupearlyinterventionservicesaredelivered‘in-person’throughhome-basedorcentre-based
sessions. Families in regional and remote areas access similar early intervention services through home-based or centre-based
‘telepractice’sessionsusingvideoconferencingtechnology.
Data is regularly collected from families regarding their satisfaction with both types of service delivery. Feedback from families
indicates that both in-person and telepractice sessions are valued and each adds a different component to the families’ early
intervention experience. In response to this feedback, RIDBC has developed a blended approach to service delivery, which
incorporates the benefits of both types of sessions.The blended model uses a combination of in-person sessions, telepractice
sessions,andasynchronousweb-basedlearningtoaddresstheindividualneedsofeachfamily.
Thispresentationwillexaminethedevelopmentofablendedservicemodeltodeliverfamily-centredearlyinterventionandthe
rationalefor implementingablendedapproachinmetropolitanareasaswellasremoteareas.Casestudieswillbepresentedto
explicatetheblendedservicemodelandthewaysinwhichtechnologycanbeusedtofosterafamily-centredapproach.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 2A: Effective evidence based ways of delivering early intervention programmes0930-0945
Barriers to early intervention service delivery for children with hearing loss – the Queensland experience
Usher,H
Health Services Support Agency, Queensland Health, Queensland Government, Queensland, Australia
Sinceitsinceptionin2004,theQueenslandHealthHealthyHearingProgramhasestablishedahighqualityscreeningprogram.In
additiontoearlyidentificationofahearingloss,itiswidelyacknowledgedthatchildrenneedtimelyengagementinappropriate
earlyinterventionprogramstorealisetheirbestoutcomes.
Feedbackfromparentsandearlyinterventionprovidershaveindicatedthatparentsofchildrenwithahearinglossfindaccessto
appropriate early intervention services to be problematic in some areas of Queensland. Between October 2010 and December
2011theHealthyHearingprogramconductedaprojectaimingto1)identifyanddescribetherangeandlocationofmajorearly
interventionservicesforQueenslandchildren,aged0to5yearswithapermanenthearinglossand2)suggestpracticalstrategiesto
improveaccesstoearlyinterventionservicesforthesechildren.
AseriesofinterviewswasconductedwithstaffacrossQueenslandandinNewSouthWaleswithconsultationsrevealinganumber
ofbarrierstoservicedelivery.Thesewereclassifiedunderthefollowingheadings: (1)accesstospecialisedhearing lossservices,
(2) proximity to services, (3) inequity of services for children with hearing loss, (4) referral pathways and case management, (5)
informationgapsand(6)familyissues.
To overcome the barriers, this project developed some practical strategies to target the limitations in current service delivery
including(1)theformationofanEarlyInterventionWorkingGrouptodevelopstandardearlyinterventionguidelinesandpromote
professionaldevelopmentopportunities;(2)promotingtheincreaseduseofvideoteleconferenceserviceswhereappropriate;and(3)
thedevelopmentofanearlyinterventionmoduleinthenewEarlyHearingDetectionManagementandInformationSystem,which
canfacilitatebettercommunicationacrossagencies,storeclinicalandmedicalinformationandmonitorchildren’sengagementand
progressinearlyinterventionservices.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 2A: Effective evidence based ways of delivering early intervention programmes0945-1000
“Learning to listen to a baby who cannot hear” infant hearing loss and attachment
Green,V
Queensland Hearing Loss Family Support Service, Queensland Health, Australia
TheQueenslandHearingLossFamilySupportServicewasestablished in2007,asapartoftheHealthyHearingProgram(which
conductsnewbornhearingscreening,aswellassurveillancescreeningofolderchildren).
Thisstatewideteamoffamilysupportfacilitatorsprovidesfamily-centredcounsellingandsupporttofamiliesofchildrendiagnosed
withapermanenthearingloss.
Thisincludesemotionalsupportandcounsellingwhererequired,withregardtoparentaladjustmenttodiagnosis,aswellasensuring
familiesgaininformationabouttheirchild’shearingloss andthefullrangeofhabilitationoptionsavailabletosupporttheirchild’s
communication,development andhealthneeds.Advocacyonbehalfofchildrenwithapermanenthearingloss(PHL) andtheir
families,withinrelevantservicesandsystems,andcontributingtothedevelopmentofresearch andbestpracticeinthisfieldare
additionalfocalpointsforourservice.
Thispresentationwill focusontheeffectof thediagnosisof infanthearing lossonearlyParent-Child interaction,andhowthe
therapeuticrelationship,aswellasprovisionofinformationandadvocacy,canamelioratethisimpactandmaintainparentalcapacity
tomeetthechild’sneeds,bothemotionallyandwithregardtoearlycommunicationandeducationalneeds.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 2A: Effective evidence based ways of delivering early intervention programmes1000-1015
Impact of the presence of auditory neuropathy spectrum disorder on outcomes at 3 years of age
Ching,TYC(1,2)andDay,J(1,2)andDillonH(1,2)andGardner-Berry,K(1,2)andHouS(1,2)andSeetoM(1,2)andWongA(1,2)andZhang,V(1,2)
1. National Acoustic Laboratories, Sydney Australia2. The Hearing CRC, Melbourne Australia3. Australian Hearing, Sydney Australia
Thereislimitedliteratureonspeechandlanguagedevelopmentinchildrenwithauditoryneuropathyspectrumdisorder(ANSD),
with the majority of publications restricted to measures of speech perception and functional auditory behaviour. There is also
considerablecontroversyaboutthemostappropriateearlyinterventiontorecommendforthisgroup,andtheincreasedneedfor
cochlearimplantsregardlessofthedegreeofthehearingloss. Theaimofthisstudywastoinvestigatetheimpactofthepresence
ofANSDonspeech,languageandpsycho-socialdevelopmentofchildrenat3yearsofage,andtocomparetheseoutcomesto
childrenwithoutANSD.
Methods: FortysevenchildrenwithANSDwhoparticipatedintheLongitudinalOutcomesofHearingImpairment(LOCHI)study
wereassessedusingstandardizedmeasuresofspeechproduction,receptivelanguageandexpressivelanguage.Performancewas
comparedtothatofchildrenwithoutANSDintheLOCHIstudy.
Results: Sixty-fourpercenthavehearingsensitivity loss ranging frommildtoseveredegrees,andtheremaininghadprofound
hearingloss.At3years,27childrenusedhearingaids,19usedcochlearimplantsandonechilddidnotuseanyhearingdevice.Thirty
percentofchildrenhavedisabilitiesinadditiontohearingloss.Onaverage,therewerenosignificantdifferencesinperformance
levelbetweenchildrenwithandwithoutANSDonspeechproductionorlanguagedevelopment.Also,thevariabilityofscoreswas
notsignificantlydifferentbetweenthosewithandwithoutANSD.
Conclusions:Therewasnosignificantdifference inperformance levelsorvariabilitybetweenchildrenwithandwithoutANSD.
Therewasalsonodifferencebetweenchildrenwhousehearingaids,andthoseusingcochlearimplants.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 2A: Effective evidence based ways of delivering early intervention programmes1015-1030
Responding to the needs of families of children with unaidable mild and borderline hearing losses
Britton,LandGold,TandHodgson,FandTer-Horst,K
Royal Institute for Deaf and Blind Children, Sydney, NSW, Australia
UniversalNeonatalHearingScreeningidentifieshearinglossesacrossawiderange,fromborderlinetoprofound.Whileintervention
pathways for children with significant bilateral aidable hearing losses are typically well established, the pathways for children
withmilder lossesare lesswelldefined.Nevertheless, theneed for families to receivesupportand information in regard to the
consequencesofhearinglosses,whichareunlikelytobenefitfromthefittingofhearingaids,remainsevident.
This paper reports on the development and implementation of a family-centred early intervention program for the families of
childrenidentifiedwithmildhearingloss.TheprogramdevelopedbytheRoyalInstituteforDeafandBlindChildrenoffersindividually
and group-delivered information sessions, as well as audiological monitoring and speech/language assessment. Families are
encouragedtotakeanactiveinterestintheirchild’slanguagedevelopmentand,wheredelaysbecameapparent,theservicesof
speechtherapistsandteachersofthedeafaremadeavailable.Therationalefortheprogramaswellasanoverviewofthecontent
oftheinformationcomponentoftheprogramwillbepresented,togetherwithfeedbackfromparticipatingfamilies.Implicationsfor
screeningprogramsmorebroadlywillbediscussed.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 2A: Effective evidence based ways of delivering early intervention programmes1030-1045
Tele-practice: delivering early intervention and audiology services to families in rural and remote areas
Brown,JandRushbrooke,EandRyan,MandConstantinescu,G
Hear and Say, Brisbane, Queensland, Australia
Advancesintechnologyarechangingthewayhealthandeducationalpractitionersareabletoprovidequalityservicestochildren
withhearingloss.Inordertobenefitfromtheearlydiagnosisofhearingloss,professionalsneedtoseekinnovativewaysofproviding
effectiveAudiologyandAuditory-VerbalTherapyforallchildren,regardlessofgeographicallocation.
Tele-Practiceisprovidingprofessionalswithexcitingandrewardingopportunitiestodisseminatetheirservicestoallclients,wherever
theymaybethroughouttheworld.ItischangingthefaceofhowprofessionalsatHearandSayinteractwithchildrenwithhearing
lossandtheirfamilies.
ThispresentationwilldescribetwoaspectsoftheHearandSayeMPOWERmodelofTele-Practice:earlyinterventionusingAuditory-
VerbalTherapy (eAVT) and remote MAPping (programming) of cochlear implants using videoconferencing (eAudiology).Video
footagewillbeusedtodemonstratethesetwoprograms.
Researchoutcomeswillbetabledfrom
• AvalidationstudyoftheeAudiologyprogram,conductedwith40children
• AsurveyofparentandprofessionalsatisfactionwiththeeAVTprogram
• A pilot study, showing the feasibility of the eAVT program, comparing a group of seven children in the eAVT program
matchedwithsevenchildrenintheface-to-faceprogram.Thisisthefirstcomparisonstudyofitskindworldwide.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 2A: Effective evidence based ways of delivering early intervention programmes1045-1100
A home based model of cochlear implantation: the role of telepractice
Psarros,CandMcCarthy,M
Royal Institute for Deaf and Blind Children, Sydney, Australia
The nature of support for cochlear implant (CI) recipients is rapidly evolving due primarily to the exponential growth of the CI
populationandtechnologicaladvances.Expandingselectioncriteria,bilateralcochlearimplantationandtheincreasingevidence
oftheefficacyofearlyimplantationforchildrenidentifiedthroughnewbornhearingscreeninghavebeenastrongimpetusforthe
growthinthepopulationofCIrecipients.Asaresult,CIclinicsmustreconsidertheirtraditionalservicemodelstoensurethatthey
meettheneedsofadiverseandgrowingclientbase,whilstpreservingahighstandardofservicedelivery.
Further,ahighproportionofcochlearimplantrecipientsresideoutsideoftheirmetropolitanarea,henceaccesstoservicescanbe
difficult.
RemotemappingofcochlearimplantsthroughtheuseofteleaudiologywasfirstdocumentedbyFrank,PengellyandZerfossin
2006.FollowingrecentstudiesbytheHearingCRCthefeasibilityandthevalidityofthisprocedurehasbeenestablished(Psarros,van
Wanrooy,&Rushbrooke2012).Inover70cochlearimplantmapsthatwereperformed,allbut3werefoundtoachieveallessential
criteriafora“successful”mappingsession.Questionnairedatarevealedthatparentandrecipientsatisfactionwashigh.
Themethodologyandfeasibilityofimplementingremotemanagementofcochlearimplantsusingtelecommunicationsforaudiology
andhabilitationwillbereportedinthispaper.Further,acasestudywillbepresentedwherebytheentirecochlearimplantprocess
hasbeenmanagedusingtelecommunications.Themultidisciplinaryteamsengagementofthefamilyinthisprocesshasensured
minimaldisruptiontothefamiliesroutineandinclusionoflocalprofessionalstomaximizeoutcomesinongoingmanagement.
Plansandproceduresforfuturedevelopmentofthishomebasedmodelinkeepingwithtechnologicaladvancesandfamilyneeds
willbediscussedwithparticularreferencetotheneedsofchildrenandfamiliesidentifiedthroughnewbornhearingscreening.
References:
Frank, K., Pengelly, M., & Zerfoss, S. (2006). Telemedicine offers remote cochlear implant programming. Voices, 13(1), 16 – 19. Psarros, C., Van
Wanrooy, E., & Rushbrooke, E. (2012). Telemedicine in Audiology: Cochlear Implant Mapping. Workshop presented at Audiology Australia
Conference, Adelaide.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 2B: Maintaining motivation and quality assurance in newborn hearing screening programmes - Part II0900-0915
The pieces of the jigsaw puzzle: a range of tools and resources required to deliver a quality newborn hearing screening programme in New Zealand
McLeod,MandMaxwell,AandBadkar,JandGreensmith,S
Antenatal and Newborn Screening, National Screening Unit, Ministry of Health, New Zealand
Wikipediadescribesajigsawasa“tiling puzzle that requires the assembly of numerous small, often oddly shaped, interlocking pieces. Each
piece usually has a small part of a picture on it; when complete, a jigsaw puzzle produces a complete picture”.
The Universal Newborn Hearing Screening and Early Intervention Programme can be likened to a jigsaw puzzle with many
interlockingcomponentsrequiredtobuildaqualityscreeningprogramme.
Evaluation and monitoring activities in screening programmes aim to generate the information needed to confirm whether or
notaprogrammeissafeandeffective.TheNationalScreeningUnitdrawsonasuiteofresourcesandtoolstoprovidenewborn
hearingscreeningserviceproviderswiththetoolstoassistwithhighqualityserviceprovision.Thepiecesofthepuzzlethatbuild
acompletepictureofaqualitynewbornhearingscreeningprogrammeincludeNationalPolicy&QualityStandards(NPQS); the
screenercompetencyframework;consumerresourcesandprovideraudits.
Thethree-yearauditshaveaquality/performanceimprovementfocusandassesstheserviceproviderproceduresandoperations
relatingtothenewbornhearingscreeningprogrammeagainsttheNPQSandcontractrequirements.Theauditshaveidentifiedareas
ofpartialornon-complianceandalsopotentialopportunitiestoimproveprovisionofthenewbornhearingscreeningprogramme.
This presentation will include recommendations from the audits that contribute towards producing a complete jigsaw puzzle
pictureofahighqualitysustainablenewbornhearingscreeningprogrammeinNewZealand.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 2B: Maintaining motivation and quality assurance in newborn hearing screening programmes – Part II0915-0930
Identifying ethically important scenarios in newborn hearing screening
Kavanagh,G(1)andDelany,C(1,2)andPoulakis,Z(1)andBarker,M(1)andHood,F(1)andClarke,J(1)
1. Royal Children’s Hospital, Melbourne, Victoria, Australia2. University of Melbourne, Melbourne, Victoria, Australia
TheVictorianInfantHearingScreeningProgram(VIHSP)aimstopromoteearlyidentificationofpermanentcongenitalhearingloss
throughahighqualitynewbornhearingscreeningprogram.VIHSPstaffworkasprimaryhealthpractitionersto:
• Informfamiliesaboutthescreeningprogramandengagetheminthescreeningsteps
• Competentlyconductscreening
• Informfamiliesandotherhealthprofessionalsofscreenresults
• Createarelationshipoftrustwithfamiliesofanewbornwhenpositivescreeningresultsarisetoensureappropriatesupportfor
outcomes
• Followupfamilieswhorequireongoingassessment,supportandmanagement.
Theeffectivenessofuniversalnewbornhearingscreening(UNHS) inpromotingearly identification iswellestablished.However,
individualfamiliesorfamilymembersmaynotalwaysagreewithorwishtoparticipateinscreeningprogramsand/orattendfurther
consultations.Inthesetypesofsituations,therolesofVIHSPstafftoobtainconsentforscreening,toeducate,motivate,supportand
monitorfamiliesbecomeethicallycomplex.Howmuchinformationshouldbegiventofamilies?Whatisthebestwaytopresent
screeningresults?Aretherelimitstofollowingupfamilieswhoareunwillingtoattendfutureappointmentsfortheirchild?
Thesequestionsraisespecificanduniqueethicalissuesthathavereceivedlittleattentioninhealthethicsliterature.Specificcase
studiesandnarrativesabouthearingscreeningpracticewereusedinaseriesofclinicalethicsworkshopstofacilitatediscussion,
debate and education about ethical issues arising in and from our screening program. Through supported ethics analysis and
reflection, staffgainedan increasedunderstandingof thedimensionsofethical issues inscreeningprograms.Thispresentation
willshareaclinicalethicseducationapproachandprovideinsightintotheethicalguidelinesdevelopedbyVIHSPtoassistothers
involvedinUNHStoanalyzeandreflectontheirpractice.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 2B: Maintaining motivation and quality assurance in newborn hearing screening programmes – Part II0930-0945
Overcoming challenges of delivering a newborn hearing screening program in a tertiary care hospital in India
Nallamuthu,AandGanapathy,HSandSeethapathy,JandNagarajan,RandNinan,B
Sri Ramachandra University,Chennai, Tamil Nadu, India
OneofthechallengesofNewbornHearingScreening(NHS)programislosttofollowup(LFU)atvariousstagesoftheprogram.
NewstrategiesneedtobeadoptedtoknowthehearingstatusofthebabieswhoLFU.Thisstudydocumentshowchallengeswere
overcomeindeliveringNHSprogram.Inthisretrospectivestudy,dataof1135babiesbornbetweenSeptember2011andAugust
2012wereextractedandpercentageanalysiswasdone.
Firstscreeningwasdonebefore1monthofageandforbabieswithNICUstaybefore1monthofdischarge.OAEScreeningwasdone
forallexceptforbabieswithNICUstay(>4days)andhyperbilirubemeniaforwhomABRscreeningwasdone.Secondscreeningwas
recommendedforbabieswhogotreferredinfirstscreening.Whenbabiesarereferredinsecondscreening,immediatefirstdetailed
evaluation was done. Based on the results, follow up evaluation after three months (for maturational delay) or intervention (if
diagnosedhearingloss)wasrecommended.Forbabieswholosttofollow-up(LFU)inscreeningordiagnosticevaluation,telephone
follow-up (TFU) was done. Reasons for LFU were documented and hearing screening checklist (Northern & Downs, 2002) was
administeredtoknowthehearingstatusofbabies.
Usingtwostepscreening,thereferralratewas2.2%.Immediatediagnosticevaluationreducedtherequirementforfollow-up.Babies
whoLFUwherecontactedtelephonically.Twoparentsshowedconcernandwereurgedtocomeback.Onexploringthereasons
forLFU,57%ofparentswereconvincedthatchildcanhearand13%reportedthatchild’shearingwasscreenedelsewhere.The
remaining30%expressedtheirinabilitytobringthechildbecauseofdistanceproblem,preoccupiedwork&personalissues.This
indicatesthatNHSprotocolshouldbefinetunedandadaptedtoculturalneeds.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 2B: Maintaining motivation and quality assurance in newborn hearing screening programmes – Part II0945-1000
Are we screening the correct baby?
Clarke,JandPoulakis,ZandBarker,MandKavanagh,G
Royal Children’s Hospital, Victoria, Australia
The Australian National Safety and Quality Health Service Standards mandates that all patients be identified by at least three
approvedpatientidentifierspriortoundergoinganyprocedure.Babiesarenotabletoverballyidentifythemselvesandrelianceon
acotcardisnotsufficient,asbabieshavebeenplacedintothewrongcots.Thereareknowninstancesoftheincorrectnewborn
undergoingaprocedure.Newbornhearingscreeningservicesarevulnerabletothesamechallenges–relyingoncheckingacot
cardalonehasresultedintheincorrectbabybeingscreened.Additionally,thehearingscreenmayhavebeenundertakenwithout
theparentorguardianprovidinginformedconsent.
AnalysisofdatafromtheVictorianInfantHearingScreeningProgram(VIHSP) identifiedthatthereareoccasionswhenahearing
screenhasbeenperformedonan incorrectly identifiedbaby,oran incorrectly identifiedtwin.Therearesignificant implications
whenthisoccurs includingunnecessarystressandanxiety forparents, thecorrect infantnotundergoingscreening (while their
recorderroneouslyindicatestheyhave),requirementsforcall-backofinfantsforscreening,andreductioninstakeholderandpublic
confidenceinthescreeningprocess.
Followingatrialofmandatorycheckingofthreeapprovedidentifierspriortocompletingahearingscreen,VIHSPhasnowamended
thescreeningproceduremakingitmandatorythatallin-patientshavetheiridentificationbandcheckedforfullname,dateofbirth
andaddressbeforecompletingahearingscreen.
Compliancewiththeamendedprocedurehasbeenvalidatedthroughobservationalaudits.Manuallyuploadedscreeningresult
datahasalsobeenreviewedtoverifytheresultsbelongtothecorrectbaby.
The VIHSP hearing screening procedure is now compliant with the ACSQHC (Australian Commission for Safety and Quality in
Healthcare)NationalStandardsforpatientidentificationwhichisarequirementforhospitalaccreditationundertheACHS(Australian
CouncilonHealthcareStandards).
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 2B: Maintaining motivation and quality assurance in newborn hearing screening programmes – Part II1000-1015
Rescreening infants in Victoria 2011-2012
Kavanagh,GandBarker,MandPoulakis,ZandClarke,J
Royal Children’s Hospital, Melbourne, Victoria, Australia
Screeningprogramsmustberegularlymonitoredandreviewedtoensurereportabledataisofahighquality,patientsarenotbeing
unnecessarilyreferredforfurthertesting,staffinvolvedareworkingtoacceptablestandardsandparticipantsarewellinformedand
receivingthebestpossibleservice.
TheVictorianInfantHearingScreeningProgram(VIHSP)recentlyundertookareviewofdatafromthefinancialyear1July2011–30
June2012toinvestigatetherateofre-screeningofnewborns.Ratesofre-screeningareimportantconsiderationsinthequalityof
screeningprovided,minimisingfalsenegativeresults,andresourcingofscreeningservices.
AnalysisofdatafromthisperiodindicatedthattheVIHSPrescreenrateisapproximately10%.Whiledatawerebeinganalysed,a
numberofinterestingsubsetsofinformationcametotheattentionofthemonitoringteam.VIHSPthenundertookanin-depth
reviewofparticularsetsofthisdata,focusingprimarilyonrescreensindicatedtohavebeenundertakenwithintwentyminutesof
thepreviousscreen.Thisrevealedsomeerrorsandscreeningpracticesspecifictosomescreeningsitesthatwerenotconsistent
withthemajorityofVIHSPservices.Practicessuchasrescreeninginpatientsimmediatelyfollowingareferresultanddataentryerrors
oftenrelatedtothescreeningofmultiplebirthinfants.
ThroughthisanalysisVIHSPhasbeenabletocreateandimplementaguidelineforrescreeninginfants.Ithasalsoundertakenan
educationprogramforallstaffdeliveringscreeningacrossVictoriatoraiseawarenesstotheimportanceoffollowingprocedures
andattendingtodetail.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 2B: Maintaining motivation and quality assurance in newborn hearing screening programmes – Part II1015-1030
Cultural issues in hearing screening
Geddes,TandBaker,D
Osborne Park Hospital, WA, Australia
OsborneParkHospitalprovidescareforthehighestnumberofCALDwomen(pertotalbirths)inWesternAustralia.Culturalissuesare
arealityintoday’ssocietyandonethatalsoneedstobeaddressedandevaluatedwithinthenewbornhearingscreeningprogram.
OnemainissuethathasbeenobservedinasmallWAhospitallocatedinalargemulticulturalareaisthelanguagebarrierandhow
informationinrelationtothenewbornhearingprogramisbeingdisseminatedtothesefamilies.
Althoughconsentformsaresignedattheirinitialclinicappointment,thehearingscreenerisoftenfacedwiththefactthatthese
familiesarestillunsureofwhatthehearingscreenerisdoing,thereforeraisingthequestions,aretheyunderstandingwhattheyare
signinginthefirstplaceandhowisthisprogrammeinitiallyexplainedtothem,sotheyareabletocomprehendwhatwillhappen
inthetest?
WiththemajorityofmigrantsspeakinglittleornoEnglishandtheuseofInterpretersanexpensiveexerciseandunfortunatelyaren’t
alwaysavailableatthetimeofthescreen,canattimes,bedifficulttoascertaintheinformationrequiredinrelationtofamilyhistory,
orexplainingresultsofahearingtest,especiallywhenit’sareferredresultcanposeproblems.
Sohowdoweovercomethesebarrierstocontinuetoimprovethestandardsofdeliveringahearingprogrammethatenrichesthe
livesofallinfants?
BearinginmindthattheEnglishlanguageisadifficultonetounderstand,weneedtolearntosimplifyoursentencestoenable
migrantstotryandunderstand,soonesuggestionisatrialofsmallcuecardstranslatedintoavarietyoflanguageswithaverysimple
questionandanswertypecard.Bytriallingsomethingassimpleasthiscardmayinfact,assistwiththelanguagebarrierandhelpto
continueimprovingtheHearingScreeningProgram.
Osborne Park Hospital Newborn Hearing Program has developed a set of cue cards both written and pictorial to improve the
collectionofnewbornhearingfamilyhistoryandinformedconsentfromCALDwomen.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 2B: Maintaining motivation and quality assurance in newborn hearing screening programmes – Part II1030-1045
Maintaining and retaining a competent screener workforce
Woodward,J
Auckland, New Zealand
ForNewZealandandinternationallypartoftheinitialdevelopmentandimplementationofaNewbornHearingscreeningprogramme
hasbeentomonitorthesuccessorfailureofaprogrammeperformanceonthe1-3-6goals.Giventherecentincidentswithinboth
theUKandNZscreeningprogrammesitisevidentthatthereisaneedforcloserscrutinizingofindividualscreenerperformanceand
atamuchlowerlevelofscreeningprotocol,thiswillhelptoidentifyanyanomaliesofeitherloworhighperformancethatareout
ofinternationallyrecognisedlevels.Howevertherealsoneedstobeincreasedeffortstoimprovestaffengagementtotheidealsof
theprogramme.
Toachievethisweneededtolookatsomeoftoolsavailableinternationallyinboththehealthandcorporatesectorsformaintaining
andretainingaqualityworkforce.Supportingevidenceprovesthatbydevelopingfeasible,costeffectivetoolstoassessindividual
competency,ensuringaprogrammeofregularanddetailedinternalandexternalaudittoolsandensuringthattheyareefficiently
andconsistentlymanagedcanimproveeffectiveness,productivityandservicequality.
Theadditionalexpansionofanaccessibleandachievablecareerstructureforscreeners,includeeducationpackagesforcoaching
andmentorshipprogrammes,LeadscreenerandCoordinatortrainingandTrainerdevelopmentwouldassistinthefutureproofingof
theprogramme.Thebenefitofthisistocreateaninteractiveandself-supportingscreeningcommunity.Ifalloftheseimprovements
areappliedtogethertheaimwouldbetoincreasetheretentionrateofgoodstaff,therebyincreasingservicequalityandreducing
staffturnover.ForNewZealandgovernmentavailabledatasubstantiatesthatthiswouldbringconsiderablecostsavingstoboth
therecruitmentandtrainingofnewstaff.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 2B: Maintaining motivation and quality assurance in newborn hearing screening programmes – Part II1045-1100
Holding onto the tail of the tiger: education and training of the newborn screening workforce in New Zealand
Burgess,SandGreensmith,SandvanAsten,H
Antenatal and Newborn Screening, National Screening Unit, Ministry of Health, New Zealand
In2007NewZealandintroduceduniversalnewbornhearingscreeningtoimprovetheoutcomeforbabiesbornwithpermanent
congenital hearing loss.The implementation of a high quality programme presented a workforce development challenge as it
requiredanewscreeningworkforcetobecreated.
Astherewasnonationalqualificationortrainingprogrammefornewbornhearingscreeners,theNationalScreeningUnit(NSU)
undertookthedevelopmentofcompetencies,atrainingprogrammeandqualificationfornewbornhearingscreeners.
Two trainers, an audiologist and a midwife who had skills in adult learning and assessment, delivered a programme based on
internationalmodelstoabout110people.Itconsistedoftechnicalandpracticalsessionsandhands-onexperiencefollowedbyan
onsitevisitforfurtherassessmentandsign-off.
In2010theNSUdevelopedtheNationalCertificate inHealth,DisabilityandAgedSupport (NewbornHearingScreening)which
isonNationalQualificationsFramework.Theoriginalcohortofscreenerswasgivenanopportunitytocompletethequalification
throughaRecognitionofCurrentCompetency(RCC)process.Forscreenersjoiningtheprogrammelater,theNSUexpectsthatall
willcompletethequalificationwithinayearofcommencingemployment.Todate,52screenershavegainedthequalificationand38
screenersareactivelyworkingtowardcompletion,bothRCCandscreenerstrainedbytheDHB.Toaddresstheissuesofreplenishing
thescreenerworkforceaftertrainingtheinitialcohort,theNSUdevelopedatrainthetrainermodel.Expertscreenersweretrained
astrainers;todeliverthefoundationtraining,andtodate33newscreenershavebeentrained.Anevaluationofthetrainingwillbe
presented,whichfoundthattherewerebothbenefitsforthetraineeandtrainer.
Thepresentationwill includethecompetencyframeworkthathasbeendevelopedalongsideanonlinetooltosupporttheon-
goingcompetencyofscreenersonanannualbasisoncetheyhavecompletedtheNZQAqualification.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 3A: Mixed session. Targeted surveillance, late-onset hearing loss and cochlear implantation1300-1315
Recommendations for monitoring hearing in children using a risk factor registry
Beswick,R(1,2)andDriscoll,C(1),Kei,J(1)andGlennon,S(2)
1. School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia2. Health Services Support Agency, Queensland Health, Queensland Government, Queensland, Australia
The Joint Committee on Infant Hearing (JCIH) recommend targeted surveillance of at-risk infants using a risk factor registry, in
conjunction with parent and/or professional monitoring to detect hearing loss that develops post newborn hearing screening.
However,criticismsoftheserecommendationsareemergingastargetedsurveillanceprogramsarecostly,resourceintensive,have
poorfollow-uprates,andlackevidenceofbestpractice.Thepurposeofthispresentationistoproviderecommendationsforrisk
factor registries incorporatedwithin targetedsurveillanceprograms.These recommendationsweredevelopdbycombiningthe
resultsofpreviousresearchincludingasystematicreviewoftheliteratureandacomprehensiveevaluationofatargetedsurveillance
programinQueensland.Recommendationsareasfollows.Childrenwiththeriskfactorsoffamilyhistoryorcraniofacialanomalies
shouldhavetheirhearingmonitored,whereas,childrenwiththeriskfactoroflowbirthweightshouldnot.Childrenwiththerisk
factors of syndrome or prolonged ventilation should potentially have their hearing monitored, however, the evidence was not
definitive.Equally,childrenwithbacterialmeningitis,hyperbilirubinemia,orprofessionalconcernasa risk factormaypotentially
notneedtheirhearingmonitoredbutagain,theevidencewasnotdefinitive.Fortheriskfactorsofsevereasphyxiaandcongenital
infection,theevidencewasinconclusiveand/orconflictingsonorecommendationswereabletobemade.Moreresearchisneeded
tofurtherinformevidence-basedclinicalpolicyrecommendationsforhearinglossdetectioninearlychildhood.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 3A: Mixed session. Targeted surveillance, late-onset hearing loss and cochlear implantation1315-1330
Success of risk indicators for detecting late onset and progressive hearing loss: an analysis of the New Zealand protocol
Kelly,A(1)andPurdy,S(2)andBrown,C(1)
1. Auckland District Health Board, Auckland, New Zealand2. University of Auckland, Auckland, New Zealand
Itiswidelyrecognisedthatauniversalnewbornhearingscreeningprogrammewillonlydetectaproportionofchildhoodhearing
loss.Theremaininghearinglosseswillbediagnosedpredominantlyinthepreschoolyears.Theimportanceofearlyinterventionis
alsoacknowledgedasintegraltonewbornhearingscreeningprogrammestoenableinfantsandyoungchildrenaccesstosound
andtheopportunitytodeveloplanguage.
Techniquesusedtodetecthearinglossesthatarenotidentifiedinnewborninfantstypicallyconsistofacombinationofapproaches
includingtheidentificationofriskindicatorsforlateonsetorprogressivehearinglossthatwerepresentasanewborninfantand
therecallandtestingofthesechildrenatsomeolderageandtheuseofafurtheruniversalhearingscreeningprogrammeforolder
children.Bothapproachescanbecostlyandtheefficacyofeachapproachcanbedifficulttomonitorduetoincompletecoverage
anddifficultieswithmaintainingaccuratedatabasesovertime.
NewZealandusesbothapproachesbyrecallingchildrenidentifiedbytheuniversalnewbornhearingscreeningprogrammewith
riskindictorsforhearinglossandauniversalhearingscreeningprogrammeatagefourtofiveyears(B4SchoolCheck).Ananalysis
ofthedatathathasbeencollectedbyalargemetropolitandistricthealthboardusingtheuniqueNewZealandriskindicatorswillbe
presentedandcontrastedtoriskindicatorsthatareusedinternationally.Additionallydatawillbepresentedontheefficacyofthe
B4Schoolcheckinidentifyinglateonsetandprogressivehearinglossesandcontrastedtotheuseofmonitoringbyriskindicators.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 3A: Mixed session. Targeted surveillance, late-onset hearing loss and cochlear implantation1330-1345
Weaving the tapestry: working with geographic and cultural diversity
Harris,S(1)andSavage,J(2)andPrice,H(4)andGiust,C(4)
1. Queensland Hearing Loss Family Support Service, Brisbane, Australia2. Queensland Hearing Loss Family Support Service, Brisbane, Australia
TheQueenslandHearingLossFamilySupportService(QHLFSS)providesservicestofamiliesidentifiedwithapermanenthearingloss
throughUniversalNewbornHearingScreening.Queenslandisageographicallydiversestate–nearly1.7millionsquarekilometres.
Populationcentresareconcentratedinthesoutheastcornerandalongthecoastline.
Providing specialist hearing loss services to this diverse area brings many challenges including coordination and collaboration
betweenservices.Withgeographicdiversitythereisanaddeddemographicofculturaldiversity-tothenorthofthestateahigh
proportionoffamiliesareofindigenousorigins,whileinotherareasrefugeeandimmigrantfamiliesbringculturalandreligious
complexitiestoserviceprovision.
Withlimitedclinicalresources,extensivegeographicareasandculturaldiversitytoweaveintothetapestrytheQHLFSShasdeveloped
uniquewaysofworking.Atacommunitylevelanextensivecommunitydevelopmentapproachtobuildingsectorcapacityandat
afamilyclinicallevel-acasemanagementapproachtoservicedeliveryforcomplexfamilysituations.
Thispresentationwilldescribethejourneyfor3familiesfromnewbornhearingscreeningtoEarly Intervention.Thestudieswill
identifypathwaysandroadblocks,andhighlighttheimportanceofworkingcloselywithourfamiliesandsectorpartnerstoachieve
goodoutcomes.
Theconceptof“goodoutcomes”willbeexploredtogeneratethoughtsonwhatisdesired,whatisidealandwhatareagreedgoals
forfamiliesbasedontheprinciplesoffamilycentredcare.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 3A: Mixed session. Targeted surveillance, late-onset hearing loss and cochlear implantation1345-1400
Universal, risk factor and opportunistic screening for congenital hearing loss: 5-6 year old population outcomes
Wake,M(1,2,3),andChing,T(4,5)andWirth,K(1)andPoulakis,Z(1,2)andMensah,F(1,23)andGold,L(6)andKing,A(7)andBryson,H(1)andReilly,S(1,2,3)andRickards,F(3)
1. Murdoch Childrens Research Institute, Melbourne, VIC, Australia2. Royal Children’s Hospital, Melbourne, VIC, Australia3. The University of Melbourne, Melbourne, VIC, Australia4. National Acoustic Laboratories, Australian Hearing, Sydney, NSW, Australia5. The HEARing Cooperative Research Centre, The University of Melbourne, Melbourne, VIC, Australia6. Deakin Health Economics, Deakin University, Melbourne, VIC, Australia7. Australian Hearing, Melbourne, VIC, Australia
Objective:
Tocomparepopulationoutcomesofuniversalnewbornandriskfactorscreeningwithopportunisticdetectionadecadeearlier.
Design, Interventions and Setting:
Population-based follow-up of (1) 5-6 year olds born 2003-5 in New SouthWales (NSW) andVictoria (VIC), when NSW offered
universalnewbornandVICriskfactorscreening(neonatalintensivecarescreening+universalriskfactorreferral),withbothoffering
similareducationalandpost-diagnosticservices;and(2)7-8yearoldsborn1991-3,whendetectionwaslargelyopportunistic.
Participants:
ChildreninthenationalregisterwithbilateralcongenitalHL>25dBHLinthebetterear,aidedby4years;the1991-3cohortexcluded
childrenwithintellectualdisability.
Main Outcome Measures:
Age of diagnosis; directly-assessed language, receptive vocabulary and letter knowledge; and parent-reported behaviour and
health-relatedqualityoflife,comparedbetweenstatesusingadjustedlinearregression.
Results:
69childrenbornNSWand65bornVictoria2003-5;86bornVictoria1991-3.Forallchildren,UNHSshowedtrendstowardsbetter
language, receptive vocabulary and letter knowledge compared to risk factor screening. Among children without intellectual
disability,outcomesimprovedincrementallyfromopportunistictoriskfactortouniversalscreeningforageofdiagnosis(22.5vs.16.2
vs.8.1months,p<0.001),receptivelanguage(81.8vs.83.0vs.88.9,p=0.05),expressivelanguage(74.9vs.80.7vs.89.3,p<0.001)and
receptivevocabulary(79.4vs.83.8vs.91.5,p<0.001);nonetheless,allremainedwellbelowpopulationmeans.Benefitsofuniversal
screeningweremaximal in themild-moderate range for letterknowledge,severe range for receptivevocabulary,andprofound
rangeforreceptivelanguage.Behaviourandparentandchildhealth-relatedqualityoflifewerelargelyindependentofbothseverity
andscreeningprogram.
Conclusions:
UNHSimprovesoutcomes,butrealisingitsfullbenefitwillrequirerigorousoptimizationofearlypathways,plusresearchtoadvance
thescienceofintervention,amplificationandhearingrestoration.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 3A: Mixed session. Targeted surveillance, late-onset hearing loss and cochlear implantation1400-1415
Sequential cochlear implantation in children – does age at second implant matter
Tuohy,P
Chief Advisor, Child and Youth Health, Ministry of Health, New Zealand
Asensitiveperiod for thenormaldevelopmentofhearingexists inhumans,althoughtheexact lengthof thisperiod isunclear.A
significantbodyofresearchsuggeststhattheauditorycortexofchildrenwithsevere/profoundSensorineuralHearingloss(SNHL)is
poorlyresponsivetoauditorystimulationbytheageofseventoeightyearsifadequateauditoryfunctionisnotdevelopedbythisage.
The recognition of this critical period for the acquisition of hearing in the early years has led to worldwide implementation of
newbornhearingscreeningprogrammes,whichaimtoscreen,diagnoseandtreatcongenitallydeafchildrenbytheageof6months.
Thereisconsiderableevidencethattheseprogrammesprovidebetterspeechandlanguageoutcomesforchildrenwithsevereand
profoundSNHL,andtheearlierchildrenreceivecochlearimplants(CI)themorerapidlyandcloselytheimplantedchildrenapproach
thespeechandlanguagecapabilitiesoftheirnormallyhearingpeers.
ThereisongoingpressuretoprovidebilateralCIsinchildrenwithcongenitalSNHL,andmostAustralianstateshaveadoptedthis
approach. In New Zealand the Ministry of Health funds bilateral electrode insertion for eligible children with profound post-
meningiticdeafness.Thiswasjustifiedasaninsurancepolicyforthesechildren,becauseinthepresenceofacontralateralossified
cochlea,aunilateralelectrodefailureislikelytomeanthatnofurthersurgicaltherapeuticoptionsareavailable.HowevertheMinistry
doesnotfundprovisionoftheexternalprocessorormappingandhabilitationforthecontralateralear.
Thispolicy led theauthor to reviewthemedical literature todetermine themaximumsafewaitingperiodafter thefirstCIand
contralateralelectrode is inserteduntilachildwithbilateral severeprofoundSNHLshouldbeofferedasecondprocessor? The
resultsofthisreviewarepresentedanddiscussed.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 3A: Mixed session. Targeted surveillance, late-onset hearing loss and cochlear implantation1415-1430
Pathways to cochlear implantation following identification of hearing loss from newborn hearing screening
Atkinson,B
Hear & Say Centre, Brisbane, Queensland, Australia
The introduction of Universal Newborn Hearing Screening has resulted in an increased number of families accessing early
intervention services with their very young children.This presentation will describe the multidisciplinary team involved in the
careofthesechildren. Casestudiesofchildren identifiedthroughscreeningwillbediscussed. Wewill lookatthepathwayto
cochlear implantation for thesechildrenand theirparentsandprofessionals involved in their care. These includeababywho
receivedsimultaneousbilateralcochlear implantationat8monthsofageandunilateral implantation ina toddlerwithauditory
dys-synchrony.Videoclipswillbeusedduringthepresentationtodemonstratetheprogressthesechildrenhavemadefollowing
adevelopmentalapproachtotheirspeechandlanguagedevelopmentinanAuditory-VerbaltherapyEarlyInterventionProgram.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 3A: Mixed session. Targeted surveillance, late-onset hearing loss and cochlear implantation1430-1445
Creating a baseline
Harris,S
Queensland Hearing Loss Family Support Service, Brisbane, Australia
TheQueenslandHearingLossFamilySupportService(QHLFSS)providesservicestofamiliesidentifiedwithapermanenthearing
lossthroughUniversalNewbornHearingScreening.TheQHLFSScommencedservicein2008withavisionto“supportfamiliesto
optimizethequalityoflifeandpotentialofchildrenwithapermanenthearingloss.”
Developingaqualityserviceinasectorrichwithvariedandsensitiveculturalandcommunicationnormshasnotbeenwithoutits
challenges.Aspecialisedservicehasemergedthatisseenastheuniqueinprovidingsupportservicestofamilieswhosechildren
haveapermanenthearingloss.
WiththefollowingfoundingprinciplesintheQHLFSSMissionstatementto-
“Workinpartnershipwithfamiliesandprofessionals.Facilitateaccessandengagementtoserviceswhichwillpromotehealthand
wellbeingforchildrenand.Utiliseafamilycentredphilosophybasedonthedeliveryofcomprehensive,unbiasedaccesstoobjective
information”.
Whilealsoprovidinghighqualityservicestofamilies,theQHLFSShasengagedinarigorousprocessofservicedevelopmentand
qualitymanagement.
In2011theQHLFSSServiceModelwascreatedtoarticulatethemodelofcareandlayafoundationforfuturegoalsoftheservice.The
ServiceModelhascreatedatemplateagainstwhichtheservicecanbemeasuredandevaluated,enablinganinformedapproach
toservicedevelopment.
AqualityClinicalAuditwascarriedoutin2012tomeasuretheserviceagainstsetcriteriaasdescribedbyAustralianHealthCare
standards,theQHLFSSModelofServiceandproposedNationalNewbornHearingScreeningStandards.Theauditalsoidentified
servicecomponentsrelatingtoconsumer/familyengagement.
ThispresentationdescribesthisClinicalAuditprocessandidentifiesemergingissuesandstrategiesforthefuturedevelopmentof
theserviceanditsclinicalpractice.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 3B: Supporting families – Part II1300-1315
Parents and deaf and hard of hearing adults: supporting families in screening programs
Ewing,S(1)andCarter,T(1)andKeenan,R(2)
1. Deaf Children Australia, Brisbane, Queensland, Australia2. Deaf Children Australia, Melbourne, Victoria, Australia
Tworecentlyestablishedprogramsareprovidingfamilieswithnewlydiagnosedchildrenvaluablesupportfrombothparentswho
haveexperienceraisingachildwithahearingloss,andadultswhohavegrownupwithahearingloss.Theseprogramsarehelping
families broaden their understanding of deafness while gaining support, inspiration and encouragement from those with lived
experience. Families are able to talk to parents who have an older child with a hearing loss, as well as meet adults who have
hadahearinglosssincechildhoodandarenowlivingfulfillinglives,working,travelling,studying,orraisingfamiliesoftheirown.
Theseadultscomefromdifferentwalksoflife,andusedifferenttechnologiesandcommunicationmethodsincludingspeech,sign
language,oracombinationofboth.
Thefeedbackfromparticipantsinbothprogramshasbeenoverwhelminglypositive,withfamiliesreportingsuchimpactsasfeeling
morereassuredandconfidentabouttheirchild’sfuture,feelingthattheyhaveabetterunderstandingofdeafnessandwhattheir
childmightgothrough,feelinginspiredbymeetingsuchpositivepeople,andfeelinglessalone.Whilststillintheirearlydays,both
programsareprovingtobevaluableandworthwhilecomplementstotheprofessionalservicesnewlydiagnosedfamiliesreceive.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 3B: Supporting families – Part II1315-1330
The experiences of hearing siblings when there is a deaf child in the family
Ray,L(1)andSutherland,D(2)andO’Steen,B(3)
1. Doctoral Candidate, University of Canterbury, Christchurch, New Zealand2. University of Canterbury, Christchurch, New Zealand3. University of Canterbury, Christchurch, New Zealand
Whenachildisidentifiedasdeaf,interventionservicestypicallyfocusonparentsandthedeafchild.InNewZealandandinternationally
littlehasbeenwrittenabouttheexperiencesofhearingsiblingswhenthereisadeafchildinthefamily.Marschark(1997)suggests
thatweknowverylittleabouthowsiblingrelationshipsmightbeaffectedwhenonechildisdeaf.Itisstillunclearwhetherhearing
siblingsexperiencenegativeaffectswhenthereisadeafchildinthefamilyorwhetherrelationshipswithdeafsiblingsarewarmand
closewithaspecialunderstanding.
This presentation will describe a current New Zealand study investigating the experiences of hearing siblings of deaf children.
Preliminary findings to be presented include: Information on specific approaches and strategies parents use to ensure sibling
experiencesaretypicalandaffirming.Understandingtheexperiencesofdeafandhearingsiblingswillbetterinformtheservices
thatprofessionalsprovidetohearingsiblingsandfamilieswhenachildisidentifiedasdeaf.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 3B: Supporting families – Part II1330-1345
The Victorian infant hearing screening program early support service
Gillespie,J(1)andBreit,S(1)andMcMillan,L(2)andPoulakis,Z(1,2)
1. Royal Children’s Hospital, Melbourne, Victoria, Australia,2. Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
TheVictorianInfantHearingScreeningProgram(VIHSP)EarlySupportServiceprovidessupportandinformationtofamilieswhose
childwasreferredforfurtherhearingtestingfollowingareferresultontheVIHSPhearingscreen.Ongoingsupportisprovidedto
familieswhosebabyhasasubsequentdiagnosisofhearingloss.Thephilosophyoftheserviceistoprovideindependent,unbiased,
family-centredandchild-focussedsupportandassistance.Facilitatingfamiliestomakeinformedandtimelydecisionsthatprovide
foroptimumcommunicationoutcomesfortheirchildisapriorityoftheservice.
An independent evaluation was carried out to assess the performance of the service in the first year of operation (September
2010-August2011).Datawascollectedfromthreemainsources:stakeholder feedbackcollectedbyonlinequestionnaire; family
feedbackcollectedbymailquestionnaire;andservicedatabaseaudit.Aspartoftheevaluation,familiesdescribedtheroletheEarly
SupportServiceplayedinnavigatingthepathwayfromscreentodiagnosis,throughtoengagingearlyinterventionservices(for
whomthoseserviceswereapplicable).
While the feedback from families was largely positive, families were able to offer recommendations for improving the service.
Additionalrecommendationswerealsomadeasaresultofstakeholderfeedback,andtheservicedatabaseaudit,manyofwhich
havenowbeenimplemented.Commonthemesincludingtheinfluenceofthefamily’sculturalperspective,readinesstoengage
withservices,andtheimportanceofcrosscollaborationwithstakeholders,willbeexplored.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 3B: Supporting families – Part II1345-1400
Coordinated tertiary care: childhood hearing clinics Queensland
Adamson,K
Childrens Health Services QLD Hospitals, Brisbane, QLD, Australia
InQueenslandapproximately120childrenarediagnosedeachyearwithapermanenthearinglossthroughtheHealthyHearing
Program(UNHS).Thedegreeofhearinglossisnotthesinglefactorindeterminingfunctionaloutcomesforthesechildren.Accessto
earlyinterventionwhenthechildisveryyoungisidealsothechildcanutilisethebrain’ssensitivitytoauditoryinput.Withafocuson
earlyinterventiontheestablishmentoftheChildhoodHearingClinics(CHC)inQueenslandinAugust2011hasenabledtheparent
earlyaccesstoamultitudeofhealthprofessionals.CurrentlythreemultidisciplinaryCHCclinicsexistwithtwoinBrisbaneatthe
RoyalChildren’sHospitalandMaterChildren’sHospitalandoneinfarNorthQueenslandinTownsville.Theclinicsprovidetheinitial
medicalinvestigationsandconsultations,developmentalassessment,earlyamplificationandopportunitiesforearlyintervention
fromalliedhealthandotherexternalagenciesaswellasreferraltootherSpecialistsasrequired.Theseservicesareprovidedina
seriesofthreetofoursessionsforinfantslessthan12monthsofage.Benefitsoftheclinicinclude:reductionsintheappointment
attendance requiredof families; streamlinedcare; consistent information for families; andenhancing theparent’scapabilities to
addresstheirchild’semergingneedsinaholistictimelymanner. WaitinglistforadmissiontoCHCisminimalwithappointment
timesachievedwithin2to4weeksfrompointofdiagnosisconfirmationandreferral.Themajorityofchildrenfirstaccesstheclinic
at2to4monthsofagewithmostreferralsseenby6monthsofage.Withover140familiesthroughtheBrisbaneclinicsalonesince
clinicinception,thecoordinatedTertiarycareinamultifacetedapproachisprovingtobebothvaluedandpopular.Multidisciplinary
clinicscanprovideamodelofcarethatisbestpracticeinprovidingoptimalqualitycareforchildrenwithapermanenthearingloss.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 3B: Supporting families – Part II1400-1415
Cultural issues in hearing screening
KumSing,S(1)andHarris,S(2)
1. Queensland Hearing Loss Family Support Service, Townsville, Queensland, Australia2. Queensland Hearing Loss Family Support Service, Brisbane, Queensland, Australia
AustralianIndigenouschildren,bothAboriginalandTorresStrait Islander,whoarebetweenbirthandthreeyearsofagehavean
incidenceofhearinglossthatisthreetimesgreaterthanthatofnon-Indigenouschildren.
TheQueenslandHearingLossFamilySupportService(QHLFSS)sinceitsinceptionin2008hasplayedanactiveroleinregionalareas
developingsustainablecommunitynetworksacrossthehearinglosssectorinparticularforserviceslinkedwithIndigenousfamilies.
Throughthecollaborationandworkonesuchcommunitynetwork-theNorthernPartnershipGrouptheneedforanIndigenous
CommunityDevelopmentworkerwasidentifiedandabusinesscasewasputforwardforitsestablishment.
In2011theQHLFSSsuccessfullyengagedan IndigenousCommunityDevelopmentWorker (ICDW).The purposeof therole to
effectivelyengageAboriginalandTorresStraitIslanderhearing-impairedchildrenandtheirfamiliesinatimelymannertomitigate
the impactsofhearing lossonspeechand languagedevelopment,school readiness,educationalachievement,social inclusion,
mentalhealthandsubsequentwholeoflifeoutcomes.
This presentation will highlight the work of the ICDW through the Community Development Framework. This Framework is
describedthroughthecommunitydevelopmentworkcurrentlybeingundertakenbytheICDWwiththecommitmentofLockhart
RiverAboriginalCommunity.LockhartRiver is located535kmnorthofCairns,Queensland,Australia.Providingspecialisthearing
loss services, to this remote area brings many challenges including coordination and collaboration between services against a
backgroundofculturalvalues,traditionsandsensitivityinaremotelocation.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 3B: Supporting families – Part II1415-1430
The evaluation of a 2000Hz auditory steady state response newborn hearing screening protocol
VanDerMerwe,K(1)andTaljaard,D(2)andPetersen,L(1)
1. University of Cape Town, Cape Town, South Africa 2. Ear Science Institute Australia/ Ear Science Centre, School of Surgery, University of Western Australia, W.A., Australia
Achieving the recommended referral rate of <4% in newborn hearing screening programmes, current screening techniques,
namelyAABRandScreeningOAE(sOAE),haveattained100%sensitivityand95%specificityratesinhearinglossdetection(JCIH,
2007).However,currenttechniquesremaintopresentwithlimitations,suchasfailingtodetectsinglefrequencyhearinglossesand
markersforprogressivehearinglosses, implyingthattheidentificationofcongenitalhearinglossescanstillbe improved(Leigh,
Schmulian-Taljaard&Poulakis,2009;Nortonetal.,2000).
Over the last decade, clinical findings have validated the potential application of Auditory Steady State Responses (ASSRs) in
newbornhearingscreening(Rance,2008;Perez-Abaloetal.,2001).Duetothetechnique’sobjective,frequencyspecificandrapid
hearingthresholddetectionabilities(JCIH,2007),thepurposeofthestudywastogenerateknowledgeona2000HzASSRscreening
protocol’ssensitivity,specificityandscreeningtimebyfollowingaquantitative,comparative-descriptiveresearchdesign.
The performance characteristics of a 2000Hz ASSR protocol presented at 30dB nHL, 40dB nHL, 50dB nHL and 60dB nHL were
comparedtothatofAABRandsOAEwhenallthreemethodswereperformedonhealthyneonatesbetween2-28daysofage(n=52
ears).ResultsconcludedthatallfourASSRintensitylevelsachieved100%sensitivityand25%,55%,88%and94%specificityrates,
respectively.AABRpresentedwith100%sensitivityand80%specificityrates,whereassOAEpresentedwith100%sensitivityand65%
specificityratesinhearinglossidentification.Additionally,ASSRobtainedthelowestmediantesttimeof1:05minutes,followedby
sOAE’s1:24minutesandAABR’s2:32minutes.
AlthoughASSRpresentedwiththelowestmediantesttimes,earlyresultsconcludethatitssensitivityandspecificityvalueswere
comparabletothoseofAABRandsOAEwhenpresentedat50dBnHLand60dBnHL.Itthereforecomparesequivalenttothecurrent
techniques,asitisnotabletoreliablydetectmildhearinglossesinthenewbornpopulation.
NOTES
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O R A L A B S T R A C T S S A T U R D A Y
Concurrent Session 3B: Supporting families – Part II1430-1445
Workshops for parents of children with unilateral/mild hearing loss identified through UNHSEIP programme
Sivaraj,S(1)andUpton,L(2)andWinward,C(2)andMcLaren,S(3)
1. Department of Audiology, Wellington and Kenepuru hospitals, CCDHB, Wellington, New Zealand2. Ministry of Education, Wellington, New Zealand3. Institute of Acoustics, Massey University, Wellington, New Zealand
Thelevelsofincidenceforhearinglossinnewbornchildrenrangefrom0.36to1.30per1,000formidbilateralhearinglossand0.8
to2.7per1,000forunilateralhearingloss.(Dalzell,etal.,2000;Johnsonetal.,2005;WatkinandBaldwin,1999;Whiteetal.,1994).
Manychildrenwithunilateralandmildhearinglossesare identifiedfewmonthsafterbirththroughUniversalNewbornHearing
ScreeningandEarlyInterventionProgramme(UNHSEIP).Therearenumberofcompellingevidencestoshowthatearlyidentification
andinterventionofhearinglossresultsinveryfavourableoutcomesandwiththeintroductionofUNHSEIP,wehaveanopportunity
tointerveneearlierforchildrenwithUnilateralHearingLoss(UHL)andmildhearingloss(MHL)andalleviate/reducetheimpacton
speechandlanguagedevelopment,learningandpsychosocialissues.
Thisworkshopwasheldon26Feb2012inordertoeducateandsupporttheparentsofinfants/childrenwithunilateralandmild
hearinglossintheCapitalandCoastDistrictHealthboard(C&CDHB)region,bymakingthemawareoftherisksandthedifficulties
associatedwithunilaterialandmildhearinglosses.Theparentsof7affectedchildrenattendedtheworkshop.Theinformationwas
presentedbytheAudiologist,Advisorondeafchildren,SpeechandLanguagetherapistandanAcoustician.Thisinformationwas
alsosharedwithhearingscreenershighlightingtheirroleinidentificationofhearinglossandfacilitatingbetteroutcome.
Thisworkshopcoveredvarioustopicsondifficultiesexperiencedbythechildrenwithunilateralandmildhearingloss,effectsof
child’shearinglossonspeech-languagedevelopment,bilingualism,andpotentiallearningissues.Theinformationwasalsoprovided
onfacilitatingbetterlearningathome,crèche/preschool, includingstrategiestoenableamore“listeningfriendly”environment.
Theavailabletreatmentoptionssuchasconventionalhearingaids,FrequencyModulating(FM)System,OsseointegratedAuditory
Device,ContralateralRoutingofSignal(CROS)aidwerediscussed.Theparentswerealsoprovidedwithinformationpackconsisting
ofspeechandhearingchecklist,glueearandprevention,speechandlanguagestimulationathomeandmethodsofmakinghome
a“listeningfriendly”environment.Aftertheworkshop,theparentswouldliketohaveasupportgroupforchildrenwithunilateral/
mildhearinglossinthisregion.
NOTES
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P O S T E R S
Are we on track? An effective early intervention programme by using a trans-disciplinary approach to universal newborn hearing screening and early intervention programme (UNBHSEIP)
Upton,L(1)andSivaraj,S(2)
1. Ministry of Education, Wellington, New Zealand 2. Department of Audiology, Wellington and Kenepuru hospitals, CCDHB, Wellington, New Zealand
Introduction:
TheUNHSEIPaimstoidentifynewbornswithhearinglossearlysotheycanaccesstoappropriateassistanceassoonaspossible,
leading to better outcomes for these children as well as their families/whānau and society.The age at when children begin to
haveaccesstolanguageandcommunicationandthecharacteristicsoftheinterventionaretheprimarycauseofbetteroutcomes.
Screeningistheavenuethroughwhichaccesstoqualityinterventionismadeavailable.[Yoshinaga-Itano(2004)].Therearenumber
ofcompellingscientificevidencesshowthatageofidentificationofhearinglossisreduced,thatageofinterventioninitiationis
lowered,andthattheoutcomesofinterventionarebetterbecauseoftheestablishmentofaNew-bornhearingscreeningandEarly
Interventionprogrammes
Aim:
TheaimofthisdataanalysisistoanalysetheeffectivenessofhearingscreeningandearlyidentificationprogrammeinCCDHBregion.
Methods:
ThestudywouldinvolvethecollectionofdatafromCapitalCoastDistrictHealthandTheMinistryofEducationonthenumberof
babiesbornbetweenJuly2009andJuly2012,numberofbabiesscreened,numberofbabiesnotscreened,thenumberofbabies
identifiedwithSNHL/AN,thetimebetweenscreeningandidentificationandthetimebetweenidentificationandinterventionfrom
anAODC.Comparativeanalysiswasalsoperformedonasimilarsizeregion.
Results:
1)Itisimportanttohaveacoordinatedteamapproachtohearingscreening,diagnosisandearlyinterventionstrategiestoproduce
betteroutcomesforallchildren.2)HighlightstheimportanceoftheroleofAdvisorondeafchildren(ADOC)andthespeechand
languagetherapistintranslatingaudiologyintoauditoryapproachforthechildrenandtheparentsofthechildrenidentifiedwith
hearingloss.
Conclusion:
Awell-coordinatedtrans-disciplinaryapproachisnecessaryforbetteroutcomesforallchildrenidentifiedwithhearinglossthrough
UNBHSEIP.
NOTES
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P O S T E R S
Association of high risk factor for hearing loss and initial hearing screening result in a tertiary care hospital at South India
Seethapathy,JandGanapathy,HSandNallamuthu,AandNagarajan,RandNinan,B
Sri Ramachandra University,Chennai, Tamil Nadu, India
Referresult infirstscreeningoftenheightenstheanxietyinparents. IthasbeenreportedbyPereiraetal(2007)thatspecificrisk
factorsaremorelikelytobeassociatedwith‘Refer’resultininitialNewbornHearingScreening(NHS).However,theassociationofrisk
factorvarieswithdifferentcountriesandavailablemedicaltechnology.Hence,itisimportanttostudythisassociationatatertiary
carehospitalwherelargeproportionsofbabiesarefromNICUreferrals.
ThecurrentstudyanalysestheassociationofhighriskfactorswiththeinitialresultsofNHSinatertiarycarehospital.Datafrom1653
babiesscreenedfromApril2011-August2012wereextractedfromthemedicalrecords.Initialhearingscreeningwasdonebetween
10daysand1monthofage.Informationonriskfactorswascollectedasapartoftheprotocol.DPOAEwastheprimaryscreening
tooltoscreenallbabies.BERAscreeningwasdoneonlyforbabieswithhyperbilirubinemia(>13mg/dl)andNICUstayfor>5days.
Among1653babiesscreened,753arewithriskfactorsand900babiesarewithoutriskfactors.147babiesobtained‘Refer’result
ofwhich85hadriskfactorsforhearingloss.Onanalysis,thepresenceofoneormoreriskfactorshavesignificantassociationwith
‘Refer’ results (OR of 2;CI=1.12,1.51;p=0.002). Risk factors such as craniofacial anomalies, preterm birth, LBW and NICU stay were
thesignificantfactorsrelatedtothepossibilityof‘Refer’result.CombinationofpretermandLBWhastwotimesmorechancesof
obtaining‘Refer’result.Resultsofthecurrentstudycanbeusedtosensitizethemedicalprofessionalsandparentsaboutthehigh
possibilityof‘Refer’resultsandthereforeprepareparentadequatelyforfollowupifnecessary.
NOTES
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P O S T E R S
It all starts with screening: Long term audiological, speech, language and pragmatics outcomes after early intervention
Davis,A.(1,2)andAbrahams,Y.(1)
1. The Shepherd Centre, Sydney, NSW, Australia2. Macquarie University, Sydney, NSW, Australia
Ongoingresearchonthelongitudinaleducationalandsocialoutcomesofchildrenwithhearinglossinschoolsystemsisnecessary
forprofessionalsworkingwithchildreninthesesettingstodeterminetheoptimaltypeandamountofsupportrequired.Empirical
dataonperformancebythispopulationalsoprovidesanevidencebasetoguidegovernmentlobbyingandpolicydevelopment
andfacilitatescontinuousqualityimprovementinearlyinterventionprograms.
Agroupofover150childrenbetweentheagesofbirthandtwelveyearsofagewereassessedonarangeofstandardizedspeech,
languageandpragmaticdevelopmenttoolsmeasuresovera10yearperiod.AllofthegroupattendedthesameAuditory-Verbal
EarlyInterventionPrograminSydney,Australiabeforetransitioningtomainstreamschool.
The outcomes indicate the long-term listening, speech, language and pragmatics skills for children transitioning to school are
varied. Individualtrajectoriesofchildren’srateofprogressshowedthatforchildrenenteringthemainstreamschoolingenvironment
withaboveaveragescoresinlanguagecontinuedtodowell,howeverasagroup,childrenwithstandardscoresofunderthetypical
meanstruggled tomaintainageappropriate levels.A rangeof factorswere investigatedand their complex interaction, impact
andpossibleinfluenceonthisgroupwillbediscussed. Inaddition,thepragmaticlevelsofagroupof30childrenwithhearingloss
graduatingfromearlyinterventionin2012willbediscussed.Reviewoftheseoutcomesandvariancesprovidestheevidencebase
forfocussingandplanningeffectivesupportservicesforchildrenwithhearinglossinthelongterm.
Attendeeswillgainanunderstandingofthelongtermoutcomesforchildrenwithhearinglossdevelopingspokenlanguagein
Australiaandanunderstandingofthefactorsthatimpactontheseoutcomes,soastobeabletoapplythisinthedevelopmentof
supportsystemsthatfacilitateoptimaleducationaloutcomesforchildrenidentifiedwithahearingloss.
NOTES
76
P O S T E R S
NOTES
77
W O R K S H O P S
Concurrent 1C: The DHB Newborn Hearing Screening workshopFriday 17 May
1215-1230 LunchinWorkshopRoom
1230-1400 Roleplayineverydaysituations:
•Screeningunderpressure
•Givingresults
•Workingwithotherhealthprofessionals
1400-1415 Shortbreak
1415-1515 Gettingitrightfromthestart:theroleofscreenersincontributingtopositiveoutcomesforchildrenandfamilies
•ScreeningintheUK
•Videosofreal-lifeexperiences
1515-1530 Afternoontea
NOTES
78
W O R K S H O P S
Concurrent 2C: Paediatric Audiology Professional Development WorkshopSaturday 18 May
0830-0850 IntroductionandupdateonchangesincludingLittleEars,issueswiththeUNHSprogramme
0850-0935 UpdateonUKprogrammeandmeasuresputinplaceforareasofweaknesse.gABR
0935-0955 Managementissuesforcomplexpopulationse.gdownsyndrome,cleftpalateanddraftofanationalprotocolfor
audiologicalassessment
0955-1105 Caseexamplesanddevelopmentofnationalprotocols
1105-1110 Wrapup
1110-1130 Morningtea
NOTES
79
W O R K S H O P S
Concurrent 3C: Early Intervention WorkshopSaturday 18 May
1300-1500 ThephilosophicalframeworkofInformedChoice:fromtheoryintopracticeinEarlyIntervention
Thissessionwillexplorethetheoreticalframeworkandprinciplesofinformedchoiceandthechallengesoftranslatingphilosophy
intopracticeinearlyinterventionandsupportforfamilies.
Decisionmakinghasbeenremarkeduponasanenduringexperienceofparentingadeafchild(DesGeorges2003)andwiththe
adventofnewbornhearingscreening,choiceanddecisionmakinghavebecomepartofparents’earliestexperienceswiththeir
deafchild.Thecompressedtimeframenowencounteredbyparentsfromscreeningthroughtodiagnostics,medicalinvestigations
andontoearlyinterventionmeansthatfamiliesmeetanarrayofprofessionalsfromavarietyofdifferentdisciplinesandinarange
ofcontexts, sometimeswithpolarisedorpotentiallyconflictingadvicetogive.Howcanprofessionalsensurethat theirpractice
facilitatesandsupportsfamiliesinmakinginformedchoicesfortheirchildandforthemselves?
Drawingonthewiderresearchoninformedchoiceanddecisionmaking,andthefindingsofatwoyearresearchanddevelopment
project funded by the English Government which culminated in published guidance for professionals and a comprehensive
handbookforparents,thesessionwilldiscussandinteractivelyexploretheunderpinningelementsofInformedChoicetofocuson
howearlyinterventionprofessionalscanworktomakeInformedChoicearealityforfamiliesofdeafchildren.
NOTES
80
General Information Accommodation
Delegates who have booked accommodation via the
ConferenceManagers(ConferenceInnovators)shouldensure
youraccountissettledinfullpriortoyourdeparture.
Airport Transfers
There are a number of companies that provide transport to
theairport.Shouldyouwishtopre-book,contactoneofthe
companieslistedinthetelephonedirectoryorseethestaffat
theregistrationdeskwhowillbepleasedtoassist.
Banking and ATM Machines
Central city banks are open Monday to Friday 0900-1700.
ThenearestATMtotheRendezvousGrandHotelisASBBank
Limited,68VictoriaStreetWest,AucklandCentral1010.
Car Parking
Pleasenoteallcarparkingissubjecttoavailability.
RendezvousGrandHotelCarpark,MayoralDrive
$12.00percarperday
CivicCarPark,GreysAvenue&MayoralDrive
2-3hours$15 4-5hours$24
3-4hours$19 5+hours$29
Conference Catering
Morningtea,lunchandafternoonteaisincludedindelegates’
registration fees. All catering breaks will be held amongst
the industry exhibition. If you have advised the Conference
Innovators regarding special dietary requirements you will
receivespecialinstructionsinyourregistrationpack.
Conference Evaluation
To assist us in meeting your conference expectations in the
future,pleasetakeamomenttofilloutouronlinesurvey.
Youcanaccessthisviatheinternet:
www.surveymonkey.com/s/anhs
Alternatively you can scan the code with
your smart device which will take you
directlytothesurvey.
Hearing Loop and CaptioningIndividual hearing loop units are available from the AVtechniciandesklocatedintheballroom.Theseareavailableforkeynotesessionsonly.Pleaseseethetechnicianforassistance.
Live captioning will be provided for keynote sessions.Captioning can be viewed on the large screens or can bestreameddirectlytoiPadsandtablets.
Captioning kindly sponsored by Ai Media.
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Name Badges
Pleasewearyournamebadgeatallconferencesessionsand
at the social function. Tickets are required for entry to the
conferencedinner.
New Zealand Sign Language
Interpreters will be signing the plenary and concurrent
sessions throughout the conference. Please note workshops
willnotbesigned.
Registration and Information Desk
RendezvousGrandHotel,AtriumLounge,Level1
Telephone:0212233575
Thedeskwillbeopenatthefollowingtimes:
Friday17May 0800-1800
Saturday18May 0800-1530
Smoking
Smokingisnotpermittedinthemeetingvenuesorexhibition
areas.
Telephone Directory
RegistrationandInformationDesk 0212233575
Conference Hotel
RendezvousGrandHotel 093663000
71MayoralDr,Auckland,1010
Airlines
AirNewZealand 0800737000
Qantas 0800808767
Jetstar 0800800995
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CorporateCabs 093770773
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GN Otometrics | Freephone: 0800 900 126 | www.otometrics.com
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