Disaggregation: The data will be presented by the following stratifications: Jurisdiction Sex Remoteness Socio-economic status Aboriginal and Torres Strait Islander status CALD Preterm birth Age completed screen – disaggregated as <1 month, 1–3 months, 3–6 months, >6 months corrected age Issues for consideration: Infants who do not enter the screening pathway before being discharged from hospital may be at a higher risk of not completing a hearing screen. To ensure equitable access for all infants, those who do not enter the screening pathway by receiving at least their first screen prior to discharge should be followed-up to ensure they complete their hearing screen. It is noted that this is a jurisdictional issue best monitored at the jurisdictional level. The denominator should be the number of live births. The National Perinatal Data Collection (NPDC) provides a comprehensive validated dataset of all live births in Australia, but is only is available a two-year delay. State/territory neonatal screening programs are able to provide a suitable and timely alternative. While the aim of neonatal hearing screening is for all infants to be screened for congenital PCHI by 4 weeks of (corrected) age, the Draft National Framework (NHSWG 2010) restricts this to eligible infants. Infants who are not eligible for screening include infants deemed to be medically unfit for screening. It is anticipated that this subgroup of infants will be very small and best monitored at the jurisdictional level. Indicator 2 Screening Indicator 2.1 Positivity rate of the screening test Definition: The proportion of infants who are screened and test positive for potential permanent childhood hearing impairment National Framework Objective 2.7: To ensure that the number of infants referred for assessment and subsequently diagnosed with the target condition is appropriate for the population and is consistent with international standards
New Zealand Ministry of Health Ms Jan MacLean West Australian Newborn Hearing Screening Programme Ms Renee Garuccio NT Hearing Services NT Department of Health and Families Ms Chris Sturrock Unit Head Health Registers and Cancer Monitoring Unit Australian and Welfare Ms Alison King Principal Audiologist, Paediatric Services Australian Hearing Ms Tina Carter and Parents of Deaf Children (ANZPOD) representative Secretariat Mr Alan Director, Screening Section Population Health Programs Branch Department of Health and Ageing Ms Karen Granton A/g Assistant Director, Screening Section Population Health Programs Branch Department of Health and Ageing
2. Screening Objective Standard Target Performance Indicators 2.1 Parents are able to make an informed decision on hearing screening and diagnostic services 2.1.1 All parents are provided with sufficient information in a culturally and linguistically appropriate format to allow informed decision making. 2.1.2 Easily accessible written information is provided for families throughout the pathway, from screening to engagement with early intervention services. 2.1.3 Consent is provided by parents/guardians to perform the screen. Written parental consent is obtained to perform a screen. All parents who decline screening have been provided with sufficient information to make an informed decision. A decline form is signed by all parents who choose to decline a screen. A decline to participate in screening is recorded appropriately in the infant’s medical file. Written consent is obtained to collect data for those babies with a refer (positive) result on the screen. 2.2 All eligible newborns complete a hearing screen. 2.2.1 >97% eligible newborns are screened before one month of corrected age. >97% eligible babies complete a hearing screen before one month corrected age. All babies with a ‘refer’ (positive) result are referred for audiological assessment. 2.3 All babies in Neonatal Intensive Care Units (NICU) and Special Care Units are screened with technology capable of identifying Auditory Neuropathy Spectrum Disorder. 2.3.1 All babies admitted to NICU and Special Care for more than five days are screened using AABR based protocol. All babies admitted to NICU are screened according to NICU protocols. 2.4 Results of screening processes are communicated to families accurately, effectively and considerately 2.4.1 Communication of screening outcomes is conveyed to families in a culturally appropriate, sensitive and effective manner. 2.4.2 Communications regarding results of screening for babies referred to diagnostic audiology clearly indicate the possibility that the baby may have hearing loss. All results are provided verbally and in written form. Outcomes are recorded.
Habilitation 5.3 All families are informed about the range and nature of early intervention service options in order to facilitate timely engagement with early intervention. 5.3.1 All families have timely and coordinated access to high quality services. 5.3.2 Support and advocacy services facilitate engagement with early intervention services at the earliest possible time. 5.3.3 Services provide families with unbiased information on all options regarding approaches to communication to assist informed decision making. 5.3.4 Early intervention services are commenced by four months of age and no later than six months of age. 5.3.5 Services are responsive to cultural and language differences to allow first language development in a language other than English. 5.3.6 Engagement with specialist early intervention specific to hearing impairment should be facilitated in cases where hearing impairment is not the primary disabling condition. Age of initiation of formal early intervention is recorded centrally in the program for all children diagnosed with permanent hearing impairment. >97% of babies with permanent hearing impairment are engaged in formal intervention by four months of age. Families who do not attend audiology or early intervention services are notified to the family’s GP and/or Maternity and Child Health Nurse for follow-up within four weeks. Habilitation 5.4 All intervention programs assess language skills, cognitive skills, auditory skills, speech, vocabulary, and development of all children with hearing impairment. 5.4.1 Services comprise professionals with appropriate expertise and qualifications specific to hearing impairment, including teachers of the deaf, pathologists, and audiologists. 5.4.2 All early intervention programs provide coordinated, ongoing measurement of outcomes for children in oral or visual language. 5.4.3 All parents are provided with information on the status of their child’s development. 5.4.4 All assessments are completed using a common standardised assessment instrument (to be determined) at six-month intervals during the first three years of life. Services demonstrate that all professional staff members have the skills/qualifications that are necessary for providing families with the highest quality of service specific to children with hearing impairment. Services have a comprehensive orientation and training program for involved in the delivery of services to children and their families. >97% of babies with confirmed hearing impairment receive a full developmental assessment with standardised assessment protocols (not criterion reference checklists) for language, speech, and nonverbal cognitive development by 12 months of age.
>97% of babies with confirmed hearing impairment in early intervention programs receive a language, cognitive skills, auditory skills, speech, vocabulary, and assessment at six-month intervals during the first three years of life. Audiological 5.5 Babies who have a permanent, moderate or greater bilateral sensorineural hearing loss are provided with amplification/implants in an appropriate time frame for optimal speech and language development. 5.5.1 All babies and families have access to amplification devices of high quality technology, including hearing aids by six months of age in accordance with best practice. 5.5.2 All babies and families have access to high quality cochlear implant technology, as appropriate to hearing loss by 12 months of age. >97% babies diagnosed with a permanent hearing loss are referred to Australian Hearing 100% of referrals received by Australian Hearing are confirmed to the referral agency within 5 days >97% of families attend appointment within three weeks of the referral. Australian Hearing confirms attendance at initial appointment of all referred newborns. >85% of children diagnosed with bilateral hearing loss >40 dBHL are fitted with amplification by six months of age. >95% of children diagnosed with a bilateral hearing loss >40 dBHL are fitted with amplification by 12 months of age. >97% of children with 3FAHL of ≥90 dBHL at the initial diagnostic audiology appointment are offered referral for cochlear implant candidacy Other children are offered a cochlear implant referral when appropriate to the family’s program. Audiological 5.6 To ensure hearing aids and/or other devices are programmed to optimise functional auditory capacity. 5.6.1 Audiologists who fit hearing aids to babies abide by Australian Hearing’s standards and protocols for services to children. 5.6.2 Audiologists who assess children with cochlear implants abide by documented clinical protocols. All amplification devices are fitted according to Australian Hearing protocols and standards. All cochlear implant speech processors are fitted within documented clinical protocols.
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