Trifold Brochure Front cover: Photo of Woman holding towards her and smiling at infant daughter who is glancing towards the photographer. Brochure title: 2015 Guam EHDI Progress Report Newborn Hearing Screening At-A-Glance Guam EHDI and the University of Guam, CEDDERS logos below the brochure title. Inside page: Article title: About Guam EHDI Article: The Guam EHDI Project was established in 2002 through a federal grant awarded to the University of Guam Center for Excellence in Developmental Disabilities Education, Research, & Service (Guam CEDDERS). The grant was awarded by the U.S. Health and Human Services (HHS), Health Resources and Services Administration (HRSA) to establish GuamÕs Newborn Hearing Screening and Intervention Program. In 2003, Guam CEDDERS also applied for and received funding through a Cooperative Agreement with the U.S. HHS, Centers for Disease Control and Prevention (CDC) to establish an integrated data, tracking, and surveillance system to support the Guam EHDI Project. To support this initiative, Guam received training and technical assistance from the University of Maine to develop the data system, known as Guam ChildLink. Guam CEDDERS continues to submit applications to the U.S. HHS HRSA and CDC for continued funding support for the Guam EHDI Project. Through the efforts of the Guam EHDI Project, Universal Newborn Hearing Screening and Intervention is a public law on Guam. The Universal Newborn Hearing Screening and Intervention Act Public Law 27-150 became law in December 2004. GuamÕs local legislation aligns with national goals and assures an upgraded standard of care for all babies born on Guam. The goal of the Guam EHDI Project is to assure that all babies born on Guam are screened for hearing loss by 1 month of age, that those with hearing loss are diagnosed by 3 months of age, and that quality early intervention services they need are initiated by 6 months of age (known as the Ò1-3-6 PlanÓ). Statistic title: Types of Hearing Loss Identified from 2002-Present Conductive1 56 Sensorineural2 22 Mixed3 7 Total: 85 Footnotes: 1Conductive Hearing Loss - Type of hearing loss where sound is not conducted efficiently through the outer ear canal to the eardrum and can often be medically or surgically corrected. 2Sensorineural Hearing Loss - Type of hearing loss when there is damage to the inner ear or to the nerve pathways from the inner ear to the brain. 3Mixed Hearing Loss - Type of hearing loss that is a combination of conductive hearing loss and sensorineural hearing loss. Note: Data is from 2 of 3 birthing sites: Guam Memorial Hospital Authority (GMHA) and Sagua Ma–agu Birthing Center. Center page: Two bar graphs Top Bar Graph title: Initial Screening Percent Screened (blue bar): 2011: 99 percent 2012: 99 percent 2013: 99 percent 2014: 99 percent Benchmark (red bar): 2011: 95 percent 2012: 98 percent 2013: 98 percent 2014: 98 percent Text under bar graph: The Guam EHDI project has maintained a 99% initial hearing screening rate at Guam Memorial Hospital Authority and Sagua Managu Birthing Facility. Bottom Bar Graph title: Percent Lost to Follow Up (LFU) Outpatient Rescreen Percent LFU for Outpatient Rescreened (blue bar): 2011: 8 percent 2012: 30 percent 2013: 27 percent 2014: 8 percent Benchmark (red bar): 2011: 10 percent 2012: 10 percent 2013: 10 percent 2014: 10 percent Text under bar graph: The Lost to Follow Up (LFU) rate for outpatient rescreens increased to 30% in 2012, and decreased to 27% in 2013. However, the rate decreased to 8% in 2014, which exceeded the established Guam EHDI benchmark. Page 3 Ð Bar graph and table Bar Graph title: High Risk Rescreen Percent LFU for High Risk Rescreened (blue bar): 2011: 10 percent 2012: 33 percent 2013: 35 percent 2014: 20 percent Benchmark (red bar): 2011: 20 percent 2012: 20 percent 2013: 20 percent 2014: 20 percent The Lost to Follow Up (LFU) rate for High Risk Rescreens increased to 33%in 2012, and 35% in 2013. In 2014, the Guam EHDI benchmark was met with 20% LFU for High Risk Rescreens. New section: Table with 11 columns, 5 rows Section title: Diagnostic Audiological Evaluation (DAE) 1st column header title: Total Referred for DAE 1st row: 2011 - 22 2nd row: 2012 - 40 3rd row: 2013 - 26 4th row: 2014 - 33 2nd column, 1st row header title: Total with Normal Hearing 1st row: 2011 - 5 2nd row: 2012 - 13 3rd row: 2013 - 3 4th row: 2014 - 5 3rd column header title: Total with Hearing Loss 1st row: 2011 - 3 2nd row: 2012 - 4 3rd row: 2013 - 8 4th row: 2014 - 8 4th column header title: Total with DAE before 3 months 1st row: 2011 - 1 2nd row: 2012 - 13 3rd row: 2013 - 11 4th row: 2014 - 15 5th column header title: Total DAE via Tele-audiology 1st row: 2011 - 2 2nd row: 2012 - 11 3rd row: 2013 - 2 4th row: 2014 - 0 6th column header title: Total receiving EI Services 1st row: 2011 - 4 2nd row: 2012 - 12 3rd row: 2013 - 4 4th row: 2014 - 8 7th column header title: Total Receiving EI Services before 6 months 1st row: 2011 - 2 2nd row: 2012 - 10 3rd row: 2013 - 4 4th row: 2014 - 7 8th column header title: Total Pending DAE 1st row: 2011 - 5 2nd row: 2012 Ð 3 3rd row: 2013 - 7 4th row: 2014 - 6 9th column header title: Total Deceased 1st row: 2011 - 0 2nd row: 2012 - 1 3rd row: 2013 - 1 4th row: 2014 - 1 10th column header title: Total Relocating/ Refusing Services 1st row: 2011 - 7 2nd row: 2012 - 10 3rd row: 2013 Ð 3 4th row: 2014 - 2 11th column header title: Total LFU 1st row: 2011 - 2 2nd row: 2012 - 0 3rd row: 2013 - 0 4th row: 2014 - 3 In 2012 and 2013, there were no infants LFU for a Diagnostic Audiological Evaluation. This was due primarily to the implementation of the Teleaudiology project that began in November 2011 and ended in August 2013. This project involved the successful collaboration between Guam EHDI, The Childrens Hospital Ð Colorado, GEIS, and the DOE Audiology department. Photo of hearing screening device on the bottom right of the page. Page 4 There were 85 infants identified with a hearing loss since the Guam EHDI project began in 2002. These infants were all identified and offered early intervention services through the Guam Department of Education, Guam Early Intervention System (DOE-GEIS). Page 4 Article title: Project Achievements September 2014 to April 2015 The goal of the Guam EHDI project, in accordance with the national EHDI focus is to ensure that all babies born on Guam are screened for hearing loss before 1 month of age, that those with hearing loss are diagnosed before 3 months of age, and that quality early intervention services they need are initiated before 6 months of age (known as the Ò1-3-6 PlanÓ). Benchmarks were met for hearing screening performed on newborns at the civilian birthing sites before 1 month of age. All newborn infants identified with hearing loss were enrolled into early intervention services before 6 months of age. There was a reduction on the number of infants loss to follow-up who were born with risk factors for late-onset hearing loss. Successful strategies used to reduce loss to follow-up of high-risk infants include the following: 1. Offering alternate hearing screening appointment dates and sites; 2. Providing incentives for kept appointments; 3. Making calls about appointment date/time; 4. Giving hearing screening outpatient appointments from the birthing sites before discharge. Public awareness on the importance of early detection of hearing loss through the screening and evaluation processes was greatly enhanced by the ProjectÕs participation in numerous community outreach activities. Hearing screeners, physicians, parents and early intervention providers were surveyed to assess the ProjectÕs strengths and needs for quality improvement purposes. The findings of these surveys will identify future training and technical assistance needs that will be addressed. Guam EHDI is a stakeholder and participant in the Culturally and Linguistically Appropriate Service Partners (CLASP), a coalition of agencies working together to improve language access services (LAS). CLASP brought attention to the role of LAS through a public forum addressing health disparities. Members sit on an Advisory Board for Guam Community College in developing a curriculum for interpreter training. The projected focus of Guam EHDI will be to develop work groups for each Aim/Goal that will utilize the National Initiative on Child Health Quality (NICHQ) Learning Collaboratives using the Model for Improvement process in developing potential strategies that will reduce the loss to follow-up at all levels of the hearing continuum. Photo of male adult holding infant son whoÕs facing out. Page 5 Ð Back page Guam EHDI, University of Guam CEDDERS logos above text: For more information contact: Guam EHDI Phone: 735-2466 TTY: 734-6531 Email: nenehearing@guamehdi.org Website: www.guamehdi.org Office: Dean Circle House 22-23, University of Guam Office Hours: Monday - Friday, 8am - 12 noon/1pm - 5pm Produced by the Guam Early Hearing Detection and Intervention (Guam EHDI) Project with 100% funding support from the U.S. Department of Health & Human Services, Health Resources and Services Administration, Grant No. 5UR3DD000784-04 and facilitated by the University of Guam Center for Excellence in Developmental Disabilities Education, Research, & Service (Guam CEDDERS). The University of Guam is an Equal Opportunity Provider and Employer. End of brochure