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A Medical Home for Children with Hearing Loss

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A Medical Home for Children with Hearing Loss Julia L. Hecht, M.D., Deaf Access Program Albuquerque, New Mexico The Medical Home Model Accessible Continuous ... – PowerPoint PPT presentation

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Title: A Medical Home for Children with Hearing Loss


1
A Medical Home for Children with Hearing Loss
  • Julia L. Hecht, M.D.,
  • Deaf Access Program
  • Albuquerque, New Mexico

2
The Medical Home Model
  • Accessible
  • Continuous
  • Comprehensive
  • Coordinated
  • Family-centered
  • Compassionate
  • Culturally competent

3
Linking EHDI to the Medical Home
  • Physician is key
  • 8 visits between birth and 18 months
  • Assess NBHS status
  • Negotiate the system
  • Help families with grief and acceptance

4
Life after Deaf
  • Focus on language access and development
  • Eye contact
  • Facial expressions and gestures
  • Sign language
  • Spoken language

5
Comprehensive Care
  • Referrals for infants / children who are
    newly-diagnosed with hearing loss
  • Audiologist
  • Hearing Aid Provider
  • Early Intervention / StepHi
  • Appropriate School placement
  • Other families
  • Deaf adult role models
  • Medical Specialists Genetics / Dysmorphology,
    ENT, Ophthalmology, Others as needed

6
Physician as Safety Net
  • Coordination of services
  • Parent satisfaction with services / advocacy
  • Are parents lost in the politics of deafness?
  • Risk for additional health problems including
    developmental delays
  • Ongoing evaluation of language development
  • Impact on the family

7
Developing a Vision
  • Encounters with a community of deaf adults are
    important for understanding the deaf world and
    the tremendous potential that babies with hearing
    loss possess.

8
Tremendous Potential
9
A Typical Deaf Family
10
Cultural Competence
  • Sociocultural model of deafness
  • Recognize the value of learning ASL
  • Emphasize communication, not necessarily speech

11
Family-centered Care
  • Recognize the range of options for intervention
    for hearing loss
  • Reinforce development of the whole child
  • Support family through the grief and acceptance
    process throughout the childs lifetime
  • Support family choices and encourage openness to
    change

12
Linking EHDI to the Medical Home Using Telehealth
13
Goals
  • Support families of child who refers through
    the NBHS process
  • Support the primary physician in developing a
    medical home for the child with hearing loss
  • Educate physicians about the components of a
    medical home for deaf
  • Link physician with community resources
  • Enhance relationships between members of the
    multidisciplinary team

14
UNIVERSAL NEWBORN HEARING SCREENING
AABR 1
Refer
coordinator
AABR 2
No Hearing Loss
Refer
coordinator
Dx ABR
Family with deaf child
VIA
CONSULTANT
PCP
TELEHEALTH
15
TELEHEALTH CONNECTIONS
FAMILY WITH EI
PCP
FAMILY WITH PCP
DEAFNESS CONSULTANT MD
OTHER FAMILY
FAMILY WITH EI
SCHOOL
PCP
16
RELATIONSHIPS ENHANCED BY TELEHEALTH
ENT
GENETICS
FAMILY WITH DEAF CHILD
OTHER FAMILY
AUDIOLOGY
OTHER FAMILY
PCP
SCHOOL
STEP HI -- EARLY INTERVENTION
COORDINATED TELEHEALTH CONNECTION
17
Juan
  • Spanish speaking family
  • Diagnosed early
  • Deaf sister
  • In total communication preschool
  • Behavorial problems, tantrums
  • Referred to medical home
  • Revealed sister has progressive visual impairment
  • Family education
  • Usher syndrome
  • Behavior and family dynamic / communication
  • Preparation for future vision loss
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