Birth to Three corner: Accessing Services for Infants and Toddlers

By Arlene Stredler Brown
Coordinator, Early Education Services at CSDB

Babies are being screened for hearing loss before hospital discharge! Many people in our state have wanted to say this for years. Planning, commitment from many people in many agencies, and relentless support from parents has made hearing screening a reality. As of September 2001, we are screening 94% of the children born in Colorado 's hospitals before they leave the hospital.

In December 2000, Colorado 's Infant Hearing Advisory Committee published guidelines for hearing screening, audiologic assessment, and intervention. Read on for an overview of these guidelines.

Screening Guidelines: There are two procedures currently being used to screen a baby's hearing. These procedures are automated auditory brainstem response (AABR) and otoacoustic emissions (OAE). If a baby "fails" a screening test, the parents should arrange for a second screening test or a diagnostic evaluation. Parents can educate their physicians about hearing loss by telling them the results of the baby's screening test. Audiologic Assessment Guidelines: The referral rate from the screening process in our State is less than 3%. If a baby fails a hearing screening, there is a one-in-five chance the child has a hearing loss. Our goal is to diagnose hearing loss by the time a child is 3-4 months of age. Certified clinical audiologists are trained to conduct diagnostic tests on very young children. When a hearing loss is diagnosed, the audiologist refers the family to the Colorado Hearing Resource (CO-Hear) Coordinator. These Coordinators have expertise in hearing loss. They share information with the family about funding sources for amplification, funding for early intervention, the names of intervention programs that work specifically with children with hearing loss, the Part C system in the family's county of residence, and the local Community Centered Board.

Amplification Guidelines: Amplification is appropriate for the majority of children with hearing loss. Hearing aids should be fit to accommodate a child's audiologic profile. Funding for hearing aids can be a challenge and the system can be difficult to navigate. There is currently an organized effort in Colorado to pass legislation requiring insurance companies to cover the cost of hearing aids. Help from parents will make passage of this legislation more likely. If you would like to help, contact Janet DesGeorges at (303) 492-6283 or by e-mail: mdnc@colorado.edu.

Early Intervention Guidelines: There are nine CO-Hear Coordinators in Colorado . Each is a specialist in hearing loss. These Coordinators are also experts in Colorado 's early intervention system (a.k.a.; Part C). The CO-Hear Coordinator can meet with a family on the phone or, more typically, in the family's home to explain the early intervention system in our State. The CO-Hear Coordinator describes different programs and demonstrates the various communication methods appropriate for children with hearing loss. CO-Hear Coordinators share objective, unbiased information and give the family a copy of the Colorado Resource Guide for Families of Children Who are Deaf/Hard of Hearing in Colorado . This Guide provides contact information for state and national agencies serving children with hearing loss. Websites and publishers are listed in the Resource Guide.

There are many stakeholders in this system and a lot needs to happen in a very short time. There are prescribed timelines for conducting a multi-disciplinary evaluation and creating an Individual Family Service Plan (IFSP). Our system continues to evolve and will continue to change until we meet our goals.

We are committed to identifying children with hearing loss and enrolling them in early intervention by six months of age. We are committed to help families understand the implications of a hearing loss on their baby's development. And, we are committed to maintaining age-appropriate communication and language skills for all children. Copies of Colorado 's guidelines are available on the internet at: http://cdphe.state.co.us/ps/mch/hcp/completechiac.pdf