Early Hearing Detection and Intervention (EHDI)
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Early Hearing Detection and Intervention
Specialty Care
Role of specialty care providers
All children identified as deaf and hard of hearing should receive evaluations from the following specialty care providers:
- Otolaryngology/Ear, Nose and Throat (ENT)
ENTs perform a full medical diagnostic evaluation of the ears, head and neck and related structures. The ENT physician should have expertise in childhood hearing loss. The ENT physician is responsible for investigating the etiology of hearing loss and for determining whether medical or surgical intervention may be an appropriate option. In addition, the ENT physician provides information about and participates in the assessment of the options for amplification, assistive listening devices, and cochlear implantation. - Ophthalmologist
Children who are deaf and hard of hearing often have vision problems. The role of the ophthalmologist in EHDI is to assess for the presence of syndromic visual loss associated with hearing loss, such as in Usher's syndrome. Evaluation for more common types of visual impairment, including refractive error, is essential for children who will likely be strong visual learners. If a child is found to have combined vision and hearing loss, they should be referred to the Minnesota DeafBlind Project. - Geneticist
According to the CDC, 4 out of 5 babies with a hearing loss have a genetic cause, while the rest will have a non-genetic cause or a combination of factors. The purpose of the evaluation performed by a clinical geneticist is to help determine the cause of hearing loss, identify other medical issues that are associated with hearing loss, and develop long-term medical management plans based on associated conditions.
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For ENTs
For all providers
- For combined hearing and vision loss, connect families with Minnesota DeafBlind Project.
Refer to early intervention and connect to parent support
- Connect families with early intervention through Help Me Grow.
- Connect with parent support: Minnesota Hands and Voices.
Specialty care resources
- There are many resources available to families with a child identified as DHH. Visit Resources for Families for additional information.
- MDH mails an EHDI parent resource binder (PDF) to families in Minnesota with a child recently identified as deaf and hard of hearing (DHH). The binder features the EHDI roadmap (PDF), which offers information for families to make a care plan after identification.
- Several resources are available for audiologists to order for free on the Early Hearing Detection and Intervention Free Resources Order Form.
- EHDI roadmap
- Unilateral Hearing Loss Brochure
- Transient Hearing Loss Follow-up Postcard (available in English, Hmong, Somali, Spanish)
- Beginnings Book (available in English and Spanish)
- 2019 Joint Committee on Infant Hearing Position Statement
- Supplement to the JCIH 2007 Position Statement: Principles and Guidelines for Early Intervention After Confirmation That a Child Is Deaf or Hard of Hearing
- Congenital Cytomegalovirus - MN Dept. of Health (state.mn.us)
- CMV Information for Health Professionals - MN Dept. of Health (state.mn.us)
- Section 4: Audiology Guidelines For Infants With Congenital Cytomegalovirus (state.mn.us)
- Congenital Cytomegalovirus Infection in Pregnancy and the Neonate: Consensus Recommendations for Prevention, Diagnosis, and Therapy (2017)
Clinical Practice Guideline: Otitis Media with Effusion (Update) 2016
Guideline with recommendations to manage otitis media with effusion (the presence of fluid in the middle ear without signs or symptoms of acute ear infection).
Clinical Practice Guideline: Tympanostomy Tubes in Children (Update)
Guideline intended for clinicians involved in managing children (six months to 12 years) with tympanostomy tubes, or being considered for tympanostomy tubes, as an intervention for otitis media of any type.
Ophthalmologists are in a position to be one of the first providers to tell a family that their child has vision loss in addition to hearing loss. Children with combined sensory loss, or deafblindness, have varying types and degrees of hearing and vision loss. For example, a child might have cortical visual impairment (CVI) and a hearing loss. Very few children are totally deaf and totally blind. According to the NCDB, identification and referral to state deafblind projects is essential so families can receive the support they need.
Range of Combined Vision and Hearing Loss in Deaf-Blindness
Chart showing which children would likely qualify as DeafBlind according to degree of hearing and vision loss.
Minnesota DeafBlind Project Home
Refer families of children with combined sensory loss to the Minnesota DeafBlind Project. The project provides technical assistance to families, education teams, and service providers to support children (birth–21 years) who have a combined vision and hearing loss or are highly suspect of having both vision and hearing losses. Mild losses may qualify. Services are in addition to those provided by schools and other state and local agencies.
- National Center on Deafblindness (NCDB)
Programs serving Minnesotans who are deafblind
A list of programs for Minnesotans with combined sensory loss, compiled by Minnesota Department of Human Services.
Below are some common misconceptions about hearing loss and newborn hearing screening that clinicians might encounter. For additional information, please see Myths vs. Clinical Facts of Newborn Hearing Screening and Early Diagnosis (PDF).
Misconception: Abnormal OAE's along with flat tympanograms (normal volume) confirms a conductive hearing loss.
Clinical Fact: Diagnostic ABR including bone conduction testing is needed in combination with OAE's and tympanograms for a complete diagnosis of type and degree of hearing loss in each ear.
Misconception: Infants who need diagnostic testing with an audiologist must be sedated.
Clinical Fact: Younger infants (ideally between four to eight weeks of age) can typically be tested without need for sedation.