hearing and vision screening who, when, and why

Hearing and Vision ScreeningWho, When, and Why

Hearing & Vision

• For the newborn, hearing his/her parents voices started as a fetus in the uterus. After birth, the newborn now gets to put a face on those familiar voices.

• This is where the communication initiates.• It all starts at the top.

Hearing & Vision

• Who receives Hearing & Vision Screening?

• When do children receive Hearing & Vision Screenings?

• Why do children receive Hearing & Vision Screenings?

WHO

• NEWBORNS

• On January 1, 2003 the universal newborn screening for hearing loss program began in Illinois. The goals of the program include detection of hearing loss in infants before 3 months of age and the initiation of appropriate intervention no later than 6 months of age.

State Programs

• States have taken a variety of approaches to address this issue: some mandate that all hospitals or birthing centers screen infants for hearing loss before they are discharged; some mandate that insurance policies cover the cost of the screening; others use state dollars to fund screening programs.

THE ILLINOIS NEWBORN HEARING PROGRAM

• IDPH is charged with maintaining a registry of infants in need of follow-up. In addition, IDPH is required to refer children with confirmed hearing losses for services to minimize problems caused by the impairment.

• For further information about the Illinois Newborn Hearing Program, contact the IDPH Newborn Hearing Program team at (voice) 217-782-4733 or (TTY) 800-547-0466.

THE ILLINOIS NEWBORN HEARING PROGRAM

• The Illinois Newborn Hearing Screening Program maintains the registry of infants in need of follow-up testing through three stages:

Screening;Audiologic evaluation of those with an

abnormal result (confirmation); andEarly intervention for those with confirmed

hearing impairment

Who

• In addition to newborn screenings routine screenings are also required.

Who

• According to the IDPH Vision and Hearing Screening Codes (77 Ill. Adm. Code 675 and 685), vision and hearing screening services "shall be provided annually for all preschool children three years of age or older in any public or private educational program or licensed child care facility."

http://www.idph.state.il.us/rulesregs/rules-index.htm

http://www.idph.state.il.us/rulesregs/rules-index.htm

WHO• Department of Children Services also require routine hearing

and vision screenings.

• Part 407.310, Health Requirements for Children: "D). The center shall ensure that hearing and vision screening services are provided annually in accordance with Illinois Department of Public Health’s Hearing and Vision Screening Codes (77 Ill. Adm. Code 675 and 685) and the Illinois Child Vision and Hearing Test Act (410 ILCS 205)."

http://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1538&ChapAct=410%20ILCS%20205/&ChapterID=35&ChapterName=PUBLIC+HEALTH&ActName=Child+Vision+and+Hearing+Test+Act.

Who

• Can perform hearing and vision screenings:

• Certification by the State of Illinois as a licensed Vision Screening Technician and Hearing Screening Technician is required for individuals performing hearing and vision screenings.

When

• According to both DCFS and Illinois Department of Public health, screenings are to be obtained annually.

Hearing & Vision

• As the infant grows his/her body systems grow and develop.

• Hearing and vision interventions are required for the infants and children to reach developmental milestones.

• It is of utmost importance that with hearing and vision screenings infants and children can successfully grow and develop.

WHY

• The first three years of life are the most important for language and speech development.

• Consequently, for many infants and young children with unidentified hearing impairment, much of the crucial period for language and speech development may be lost.

• This in turn leads to lower reading abilities, poorer academic achievement and fewer career opportunities (Task Force on Newborn and Infant Hearing).

•

State Programs

With early intervention in mind, states have taken action to ensure children are screened and treated

early for hearing loss.

Screening programs are typically cost-effective.

WHY

• According to the American Academy of Pediatrics, hearing loss is one of the most frequently occurring birth defects; approximately 3 infants per 1,000 are born with moderate, profound or severe hearing loss. Hearing loss is even more common in infants admitted to intensive care units at birth.

http://www.medicalhomeinfo.org/how/clinical_care/hearing_screening/

Why• According to the Centers for Disease Control and Prevention, of

the nearly 4 million infants born in the United States in 2005, 91.5 percent were screened for hearing loss. States have taken a variety of approaches to this issue: some mandate that all hospitals or birthing centers screen infants for hearing loss before they are discharged; some mandate that insurance policies cover the cost of the screening; others use state dollars to fund screening programs. Still other states require that information on hearing screening be available to parents before they leave the hospital. Fourteen states allow newborns to be exempt from universal hearing screening programs if a parent objects to the testing.

http://www.cdc.gov/ncbddd/ehdi/documents/Screen_Summ_05__B.pdf

Why

• If hearing loss is not detected and treated early, it can impede speech, language and cognitive development. Over time, such a delay can lead to significant educational costs and learning difficulties.

Why

• With early intervention in mind, states have taken action to ensure children are screened and treated early for hearing loss.

• Screening programs are typically cost-effective and amount to about $10-$50 per baby, according to NCHAM. National Center for Hearing Assessment and Management

http://www.infanthearing.org/resources/fact.pdf


Why

• The National Center for Hearing Assessment and Management (NCHAM) reports that detecting and treating hearing loss at birth for one child saves $400,000 in special education costs by the time that child graduates from high school.



State Programs

• The hospital are required to maintain written documentation in the infant’s clinical record.

• Such documentation shall include: Procedures used for hearing screening Time and location for the screening Individual administering the screening test Screening results per ear, for each and every

screening or screening attempt and recommendations for further testing.

State Programs

• Vision and hearing screening services shall be administered to all children as early as possible, but no later than their first year in any public or private education program, licensed day care center or residential facility for handicapped children; and periodically thereafter, to identify those children with vision or hearing impairments or both so that such conditions can be managed or treated. 410 ILCS 205/3)

How the Ear Works

• A baby's hearing, is fully mature by the end of his first month outside the womb.

• Hearing system is based solely on physical movement.

• Your ears are one of the most incredible parts of your body!

Hearing

• To hear sound, your ear has to do three basic things:

• Direct the sound waves into the hearing part of the ear

• Sense the fluctuations in air pressure • Translate these fluctuations into an electrical

signal that your brain can understand

The Ear

The Ear

Pinna/Outer Ear• The outer structure of the

ear.• Funnel and focus sound

waves on their way to the middle ear and auditory canal.

Sound Waves

The Ear

Middle Ear• The middle ear contains the

auditory canal / ear drum

The Ear

Inner Ear• The inner ear functions for

purposes of equilibrium

Infections of The Ear

• An ear infection, or otitis media, is the most common cause of earaches.

• Can affect children and adults.


• It very often accompanies a common cold, the flu, or other types of respiratory infections. This is because the middle ear is connected to the upper respiratory tract by a tiny channel known as the eustachian tube.

• Germs that are growing in the nose or sinus cavities can climb up the eustachian tube and enter the middle ear to start growing.


• In children and infants, the eustachian tube is often too soft or immature and has a harder time staying open.

• Allergies, post nasal drainage, sinus infections, and adenoid problems can all interfere with the eustachian tube’s ability to let air pass into the middle ear.


• When the doctor looks at the ear drum, he or she will see that it is red, often bulging, and be able to make the diagnosis of an ear infection.


• Ear infections occur in various patterns. A single, isolated case is called an acute ear infection (acute otitis media).

• If the condition clears up but comes back as many as three times in a six-month period (or four times in a single year), the person is said to have recurrent ear infections (recurrent acute otitis media).


• Recurrent acute otitis media usually indicates the eustachian tube isn't working well.

• A fluid buildup in the middle ear without infection is a condition where fluid stays in the ear because it is not well ventilated, but germs have not started to grow.

Infections of The EarIn recent years, scientists have identified the characteristics of people most likely to suffer recurrent middle ear infections:

• Males• Individuals with a family history of ear infections

• Babies who are bottle-fed (breastfed babies get fewer ear infections)• Children in day care centers

• People living in households with tobacco smokers• People with abnormalities of the palate, such as a cleft palate• People with poor or damaged immune systems or chronic

respiratory diseases such as cystic fibrosis and asthma

Complications of Ear infections

• Chronic or recurrent middle ear infections can have long-term complications. These include scarring of the eardrum with hearing loss, speech and language developmental problems, and meningitis.

Complications of Ear infections

• A hearing test may be needed if you child suffers from chronic or frequent ear infections.

Ear Tubes

• If your child has recurrent ear infections or fluid that just won’t go away, hearing loss and a delay in speech may be a real concern. One solution is for your doctor to insert small tubes through the eardrum.

Ear Tubes

• Ear tubes let fluid drain out of the middle ear and prevent fluid from building back up. This can decrease pressure and pain, while restoring hearing. The tubes are usually left in for 8 to 18 months and most often fall out on their own.

Preventing Ear Infections

• The biggest cause of ear infections is the common cold, so one strategy for prevention is to keep cold viruses at bay. The most effective way to do this is frequent and meticulous hand washing.

Preventing Ear Infections

• Other lines of defense against ear infections include avoiding secondhand smoke, vaccinating your children, and breastfeeding your baby for at least six months.

Allergies and Ear Infections

• Like colds, allergies can irritate the Eustachian tubes and contribute to middle ear infections. Getting allergies under control can help reduce the risk of ear infections.

Eyes

• Communication Starts at The Top

Eyes

• As any mom will tell you, a newborn baby always looks at the face of the person holding them.

• The baby will stare and not make a sound as if he or she is studying the object in front of them.

Eyes

• Newborns have all the eye structures necessary to see when they are born, still a newborn has to learn how to utilize his/her eyes.

• Development of vision begin at birth.

Eyes

• While your newborn's eyes are physically capable of seeing just fine at birth, his brain isn't ready to process all that visual information, so things are not clear, they are fuzzy for a while.

Eyes

• As the newborn’s brain develops, so does his/her ability to see clearly, giving him/her the tools he/she needs to understand and manage his/her environment.

Eyes

• Babies spend much of their early weeks and months of life developing skills such as focusing, teaming their eye movements, recognizing depth, developing eye-hand coordination, and making spatial judgments.

Eyes

• As the child grows, more complex skills are developed, such as visual perception and visual motor integration.

• These skills are needed to meet the child’s growing need to understand and interpret their world.

Eye Anatomy

Eye Anatomy

• Pupil• Sclera• Iris• Retina• Lens• Optic Nerve• Eye Lid

Eye Anatomy

• The white outer part of the eye is called the sclera.

• The sclera is a tough, fibrous tissue that extends from the cornea (the clear front section of the eye).

• The cornea helps the eye focus as light makes its way through. It is a very important part of the eye, but you can hardly see it because it's made of clear tissue.

Eye Anatomy

• The iris (say: eye-riss) is the colorful part of the eye. When we say a person has blue eyes, we really mean the person has blue irises! The iris has muscles attached to it that change the size of the pupil.

Eye Anatomy

• The pupil is the black circle in the center of the iris, which is really an opening in the iris, and it lets light enter the eye.

Eye Anatomy

• Your retina is in the very back of the eye. It holds millions of cells that are sensitive to light.

• Think of the retina or optic nerve as the great messenger in the back of your eye.

Eye Anatomy

• The optic nerve serves as a high-speed telephone line connecting the eye to the brain. When you see an image, your eye "telephones" your brain to trigger images.

Eye Anatomy

• The many parts of the eye work together to transform light rays passing through your pupil into information that your brain can interpret. The final result is an awareness of the objects around you based on the information sent to the brain.

Eye Anatomy

How Eyes Work

• The human eye is like a camera. Light comes in through the cornea, a clear cover that is like the glass of a camera's aperture.

• The amount of light coming in is controlled by the pupil, an opening that opens and closes a little like a camera shutter.

How Eyes Work

• The light focuses on the retina, a series of light-sensitive cells lining the back of the eye.

• The retina acts like camera film, reacting to the incoming light and sending a record of it via the optic nerve to the brain.

Infants Vision Development

• Healthy eyes and good vision play a critical role in how infants and children learn to see.

• Their eyes are providing information and stimulation important for their development.

• It is important to detect any problems early to ensure babies have the opportunity to develop the visual abilities they need to grow and learn.

Vision Birth to Four Months • When babies are born, they see in black and white and

shades of gray. Newborns can only focus eight to twelve inches away, thus most of their vision is blurred.

• Babies first start to learn to focus their eyes by looking at faces and then gradually moving out to bright objects of interest brought near them.

• Newborns should be able to momentarily hold their gaze on an object for a few seconds, but by 8-12 weeks they should start to follow people or moving objects with their eyes.

Vision Birth to Four Months • At first, infants have to move their entire head to follow

objects, but by two to four months they should start to follow with their eyes more independently with much less head movement.

• When infants start to follow moving objects with their eyes they begin to develop tracking and eye teaming skills. Young infants haven't learned to use their eyes together; they haven't developed enough neuromuscular control yet to keep their eyes from crossing.

Vision Birth to Four Months

This will alarm most parents, but by four or five months, babies usually will have learned to coordinate their eye movements as a team, and the crossed-eyes should stop. (If you're seeing your infant's eyes cross after this time, this could indicate a problem, and you should seek the advice of your family optometrist.)

Vision Birth to Four Months

By four months, babies start to reach for objects, the beginning of eye-hand coordination. Also by four months of age, babies' visual systems will have developed the ability to see in full color, and they're exposed to an exciting new world!

Vision Four to Six Months

• As babies learn to push themselves up, roll over, sit, and scoot, eye-body coordination develops as they learn to control their own movements and space.

• Likewise, four- to six-month-old babies become quite skillful with their eye-hand coordination, able to direct a bottle into the mouth or grasp at objects freely.


• Their hands become their most important tool--they reach for almost everything they see! This is also the time they start to work on remembering things they see.


• By the fourth or fifth month, babies' brains have finished learning how to fuse the pictures coming in from both their right and left eyes into a single image for full binocularity, or "two-eyed" vision with strong depth perception. Spatial and dimensional awareness continue to improve as the baby learns to aim accurately when reaching for objects of interest.


• Likewise, they refine their eye teaming and focusing skills as they learn to look quickly and accurately between near and far distances. Normal visual acuities, or a child's sharpness of vision, has usually developed to 20/20 by the time the child reaches six months

Vision Six to Eight Months

• By the sixth month, babies acquire fairly

accurate eye movement control. Some experts caution that early walkers may not learn to use their eyes together as well as babies who have crawled a great deal and teamed their eyes more when looking at close-up objects.

•


• The sense of sight develops gradually over 6 to 8 months, While your newborn's eyes are physically capable of seeing just fine at birth, his brain isn't ready to process all that visual information, so things stay pretty fuzzy for a while.


• As his brain develops, so does his ability to see clearly, giving him the tools he needs to understand and manage his environment. Though a baby starts out life being able to see only as far as your face when you hold him, his range of clarity grows steadily, month by month.

Vision Eight to Twelve Months

• Babies can now judge distances well. Eye/hand/body coordination allows them to grasp and throw objects fairly accurately.

• Perception skills such as visual memory and visual discrimination help babies make sense of their exciting new world.

Vision Eight to Twelve Months

• The integration of their vision and fine motor coordination allows babies to manipulate smaller objects, and many begin feeding themselves with finger foods.

• Most babies start crawling during this time, further developing eye-body coordination.

Vision Eight to Twelve Months• They learn to judge distances and set visual goals, seeing

something and moving to get it. Their sudden freedom allows for many new experiences and the rapid development of visual perception skills as babies experience their own bodies in relation to other objects and notice differences in size, shape, and position.

• Once children start walking, they learn to use their eyes to direct and coordinate their bodies' large muscle groups to guide their whole body movements.

Vision Toddlers and Preschoolers

A child’s vision will continue to develop throughout their preschool years. As toddlers, it is important for them to continue development of eye/hand/body coordination, eye teaming, and depth perception.


• Stacking building blocks, rolling a ball back and forth, coloring, drawing, cutting, or assembling lock-together toys all help improve these important skills.


• Also, reading to young children is also important. They develop strong visualization skills as they "picture" the story in their minds.


• Per DCFS, Illinois Department of Public Health, a child should have his first eye screening by age three. In early Childcare programs, children can receive vision screenings as young as 6 months.

Vision School-Aged Children

• It is important for some children to have a

complete eye examination before starting school. The optometrist needs to determine if a child’s vision system is adequately prepared to handle reading, writing and other close work.

• The demands of schoolwork can put too much stress on a child’s visual system, causing problems even if none existed before.


• Whereas toddlers use their eyes mostly for looking at distance, school requires children's eyes to focus on very close, small work, for hours every day. This can cause vision problems to arise.


• Children don’t often realize that their eyes are under strain, and they rarely report vision problems. Because their vision is "normal" to them, they think everyone sees the way they do.


• School vision screenings provide a valuable service, but children can pass a school eye chart test and still have undetected vision problems which are affecting their school work.

• The eye chart just checks a child’s sharpness of vision, but reading requires many other visual skills.


• The eye chart test can’t tell if a child’s eyes are healthy, or if he can track a line of print without losing his place, focus his eyes comfortably, or use his two eyes together for long periods of time.


• Remember a vision screen is just a screen.

• School vision screenings are no substitute for a complete eye examination by your family optometrist.

Hearing & Vision Screenings

• According to the Illinois Department of Healthcare and Family Services,” the purpose of hearing and vision screening is to identify children who may have a visual or a hearing impairment”


• Impairment in either hearing or vision may prevent a child from obtaining full benefit from their educational opportunities.

• Defects can be difficult to defects. Without specific screening tests a problem may not be found until your child develops significant educational or medical problems.


• Hearing and Vision screening enables unrecognized conditions to be detected as early as possible.

• This allows prompt treatment and resolution to any hearing and vision problems.

Hearing & Vision Screenings• Healthcare and Family Services covers:

• Vision: • Vision screenings for preschool age children, including screening for amblyopia, also known as "lazy

eye.“ • Vision screenings for school age children • Eye exams • Eyeglasses • A second pair of eyeglasses, if glasses are lost, broken or medically necessary • • Hearing: • Hearing screenings – at newborn with follow-up as needed, for preschool age children, and school

age children • Referrals for hearing tests • Hearing aids


• Hearing and vision deficient's have been acknowledge as a impediment to healthy growth and development.

• To prevent complication hearing and vision screenings are mandatory.


• Children who are unsuccessful at passing the hearing and vision screenings are referred to their pediatrician, an eye doctor or an audiologist.


• All referrals are followed up and must be provided after the hearing and vision screening has occurred.


• All hearing and vision screenings are reported annually to the Illinois Department of Public health.


• The goal with hearing and vision screening is prevention.

7234 W. North Ave., Suite 408 Elmwood Park, IL 60707

Telephone (708) 395.5519 Fax (708) 395.5795Email: [email protected]

Website: www.livinghealthyinc.com

hearing and vision screening who, when, and why

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