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what also helps get better outcomes when paired with EI
nonverbal cognitive abilities, less severe HL, absence of additional disabilities, higher maternal education level, and use of speech in therapy
ultimate goal of NBHS is
improve long term outcomes of child with PHL through early detection and EI to reduce the cost of HL to individual and society
why continue evaluation with aids
to trigger CI candidacy, to track progress
LOCHI study
gain info about management of HL in children
early fitting improves spoken language
CI improves ^ as well
ANSD doesn't influence outcomes
use of nonlinear frequency compression doesn't influence audibility/outcomes
how many children are fitted with HA or CI by school entry for a permanent childhood HL
evidence based management for LOCHI
ensure streamlined clinical pathway from screening to diagnosis to intervention
updated recently to cover evidence
there are key milestones post diagnosis for 18 mos
presence of permanent childhood HL (PCHL) impacts
speech and language
literacy
mental health
social and cognitive functioning
educational achievement
employment
socioeconomic opportunity
key milestones
1. HAs match target 6-8 wks after diagnosis. HA use REM. audibility via prescription evaluated by aided cortical AEPs
2. PEACH questionnaire by 3 mos after fitting (or around 6 mos old) to know hearing in real world
3. monitor progress by administering PEACH regularly. get ear specific info using VRA and REM. goal is typically developing progress.
lifetime cost of all care in US per birth cohort of 80k children
117 million
current best practice
fit HA timely, verify with prescriptive targets, give objective cortical measures and PEACH