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EHDITION COLORADO

Volume 2, Issue 6 January 1, 2022

From the EHDI Director

By Arlene Stredler Brown

A full body shot of a smiling slender fair-skinned woman in a forest.  She is wearing gray hiking pants with a zip up blue jacket and a light cap as well as hiking boots. She is on a wet hiking trail surrounded by slender aspens, fallen aspen trees, and knee high meadow grass. The sky is cloudy and there is a mountain and evergreen trees behind her.

As we usher in 2022, I send New Year’s greetings to one and all! This past year - 2021 - was certainly a unique year, and I can only wonder what is in store for us in 2022. One certainty is that our HRSA-funded EHDI grant will enter its third year beginning April. And, I am also certain that there are many projects that will launch as a result of the priorities that have been set in COEHDI task forces. I do wonder, though, just what is in store for the enhancement of our Colorado EHDI system. Whatever enhancements we make, they will reflect the guiding principles of our grant.

I want to recap some of those guiding principles. First, we were awarded a grant that promised to refresh our COEHDI system. I hope you have seen evidence of this in our use of data. We have also recognized, in addition to our premier Hands & Voices chapter, additional family supports that are offered by professionally-led organizations. Additionally, we have initiated regional collaborations by conducting virtual site visits (VSVs) with birthing facilities. Our VSV team represents the scope of our EHDI system and includes a parent, a pediatrician, a clinical audiologist, a CO-Hear Coordinator, an AuD student and yours truly.

Another principle guiding our work is to embrace a novel approach to system refresh. One example is our Ascent Program which connects families with adults who are deaf, hard of hearing, or deafblind. We created this program for two reasons: One reason is that HRSA, our grantor, has made this a new priority. The other reason is that it’s the right thing to do! Thank you to Heather Abraham for her leadership in fulfilling this HRSA initiative. Yet another novel initiative of COEHDI is enlisting educational audiologists to conduct screenings and rescreenings.

The third principle is collaboration. We hope each of you reading this newsletter knows that we have well over 100 people involved in our task forces, subcommittees and on the COEHDI Alliance. It is by working together that we can make changes that resonate with the majority of stakeholders. Thank you for your participation.


Personally speaking, I am in my element when there is an opportunity for change. I hope you are too. Happy New Year to all! I look forward to our continued collaboration to refresh our system in novel ways.

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Announcements

The Diagnostic/Identification Task Force meets on the 1st Thursday of each month. The next meeting will be January 6, 2022 from 4:00-5:00 pm.

The Screening Task Force meets on the 2nd Tuesday of each month. The next meeting will be January 11, 2022 from 11:00-12:00 pm.

The Early Intervention Task Force meets the 3rd Tuesday of each month. The next meeting will be January 18, 2022 from 2:00-3:00PM.

The DHHDB Adult Task Force meets quarterly. The next meeting will be February 14, 2022 from 1:00-2:00 pm.

The Families of DHH Children Task Force meets quarterly. The next meeting will be March 14, 2022 from 1:00-2:00 pm.

The Screening Task Force meets on the 2nd Tuesday of each month. The next meeting will be November 9, 2021 from 11:00-12:00 pm.

The COEHDI Alliance meets the 3rd Friday of each month from 10-11:30AM. The next meeting date is January 21, 2022. Contact a member of the Alliance and/or any of the task forces to obtain meeting access information. See our website for monthly meeting minutes (https://www.coehdi.org/alliance). Meetings are open to the public and members of the public are invited to submit a public comment. The public comment request form can be found at this link: Public Comment Request Form

CSDB is offering monthly professional development workshops. Kimberly Sanzo from Language First will be presenting on ASL-English Language Therapy and Research Based Treatment on Friday February 25, 2022 from 9:00 am - 12:00 pm. For questions or more information, contact Ashley Renslow at (719) 822-3537 or arenslow@csdb.org

If you would like your meetings included in our monthly newsletter, contact: info@coehdi.org.

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Spotlight on Marin Adkisson

A headshot of a fair-skinned woman with long curly brown hair with reddish hues. She has green eyes, green shirt, and is wearing a small necklace

This month’s spotlight highlights Dr. Marin Adkisson, Alliance member and audiologist who is passionate about improving the quality of life and physical, mental, and emotional health of people with hearing loss and tinnitus. She is co-owner of Mile High Hearing, a private audiology practice located in Lakewood. Prior to private practice, she worked in an otolaryngology office providing hearing and vestibular care. She also served veterans as a Compensation and Pension Audiologist at the Golden Veterans Affairs clinic from 2012-2019. She is credentialed as a Certificate Holder - Tinnitus Management (CH-TM) through the American Board of Audiology. It is her own experience with persistent tinnitus that motivated her to focus on a speciality in this area. Marin is currently serving as the Past President of the Colorado Academy of Audiology and represents the Academy on the Colorado EHDI Alliance. Marin is a Colorado native, an avid Denver Broncos fan, and believes that Disneyland really is the happiest place on earth.

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Educational Audiologists’ Involvement in Screening and Rescreening Efforts

by Lisa Cannon, AuD

Colorado is a state of contrasts; the I-25 corridor holds most of our higher populated regions and the western and eastern regions of the state are classified as rural. This rural designation means it can be difficult to find qualified and accessible services for families with children who are deaf or hard of hearing; this is especially true of medical services that are highly specialized such as pediatric audiology. Not every audiologist is equipped to perform tests on children, much less infants. Pediatric audiologists have more training, experience, skill, and comfort working with young children and their families.

While Colorado is fortunate to have a robust group of pediatric audiologists, most of them work in higher populated regions along major interstate corridors. This presents a challenge and often a “loss to follow-up” situation when children need a newborn hearing screening or rescreening; families in rural areas may be unable to access the services they need in their communities. This is one of a few reasons that Colorado EHDI, as a part of the system “refresh,” has initiated collaboration with educational audiologists throughout the state.

Educational audiologists are typically employed by the local education agency (LEA) which is usually a school district or cooperative group of districts known as BOCES. Educational audiologists are licensed through the Colorado Department of Education (CDE) to provide services to students age birth through 21 years. Colorado’s network of educational audiologists is nationally recognized as providing some of the most comprehensive coverage of LEAs compared to other states in the country. As a part of the education system, these audiologists support the LEA’s Child Find obligation to identify, locate, and evaluate children with disabilities in their community from ages birth through 21.

For families that are struggling to obtain a follow up hearing screening for their infant who has not passed or participated in a newborn screening, a local educational audiologist might just be the solution. The initiative works as follows:

  • Caregivers or others who reach out to the CDPHE newborn hearing screening coordinator on behalf of families looking for support may be matched with a local educational audiologist who can offer assistance. Assistance might include:

    • offering an OAE (otoacoustic emissions) hearing screening,

    • finding options for follow up screening in the community,

    • putting families in touch with local funding or medical resources to assist with follow up,

    • or connecting families with clinic-based pediatric audiologists who can offer diagnostic testing when needed.

A successful and effective newborn hearing screening program takes a village to implement and bringing educational audiologists into our Colorado EHDI system will strengthen this village so we can reach the ultimate 1-3-6 goal for all children. Educational audiologists are poised to fill gaps in rural areas. It's not just, "Oh how nice, educational audiologists as another resource", but rather it is, "The educational audiologists are addressing a crucial system gap.

Resources/Contacts

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CDPHE Corner

By Leanne Glenn

Tik Tok….. HIDS Data Entry needed before January 18th

CDPHE will be submitting 2020 data to the Centers for Disease Control and Prevention (CDC) on January 18, 2022. Please submit your HIDS data for 2020 in advance of this date so that your facility's data is there when we do our data pull.

Here are some hints if you need a reminder as to how to see your facility's outstanding data:

  • Pulling the “All Outstanding” worklist is a great way to start. Remember that worklists are pulled based on birthdate. (So 2020 data for CDC will incorporate birthdates from 1/1/2020 to 12/31/2020).

  • Please remember that the Worklist link is in the black header at the top of the page in the Newborn Hearing application.

  • For instructions on accessing the worklists, please see the training video in the How-To-Guide at: https://www.healthinformatics.dphe.state.co.us/Home/Training/1

You can email Leanne Glenn (Leanne.Glenn@state.co.us) with any questions.

You can access the CDPHE Monthly Newsletter for November/December at this link: https://drive.google.com/file/d/1SyxJwEjIQnF1i5x1EohN4Tc55OCCY-A1/view

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Task Force Updates

Families of DHHDB Children

In an effort to increase participation, task force members decided that the task force will change to quarterly meetings. These meetings will focus on topics about the EHDI system, and provide a forum for parents to ask questions and raise any concerns they have about the system. Parents are being encouraged to join other task forces, though some members shared that there are some barriers to parent participation in other task forces. These barriers include limited available time and lack of familiarity with statewide system issues.

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DHHDB Adults

This task force meets quarterly. At the November task force, the members discussed The Ascent Program and ways to promote utilization of it. Most requests for DHHDB adult visits are for events. Fewer requests are made for individual visits. To date, individual visits include families of children 6 months of age to 30 months of age. Most individual requests are for older children; this is relevant in that HRSA is documenting visits with a DHHDB adult by a targeted nine months of age. A suggestion was made to have a DHHDB adult join an early intervention provider on a home visit. This visit could be virtual or in-person. COEHDI staff have been messaging The Ascent Program and are exploring novel ways to familiarize stakeholders and parents about it.

Members of this task force are encouraged to participate in other task forces. The members of this task force reported that timing does not always allow for this and DHHDB adults reported that system complexity and terminology can make it challenging for them to participate in other task forces.

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Screening Task Force

NCHAM has a new training curriculum for hospital screeners. This curriculum is being recommended by the virtual site visit (VSV) team as they meet with birthing facilities.

Three VSVs have been conducted to date. Five more are planned before March 31, 2022. Our VSV team represents the 1-3-6 EHDI system and includes: a parent, the EHDI Director, a clinical audiologist, the Regional CO-Hear Coordinator, a PCP, and an ENT. By representing the full 1-3-6 system, we are addressing a long-standing recommendation to provide opportunities for regional collaborations throughout the EHDI system. We are fortunate to have University of Colorado-Boulder AuD students and LEND trainees participating in this initiative.

Going forward, the VSV team will look for diversity among birthing facilities who receive VSVs. We are seeking facilities with geographic diversity; those that do, and do not, contract for screening services; size diversity; and the presence, or not, of an onsite clinical audiologist. We aim to gather themes identifying common trends in birthing facilities’ practices.

As COEHDI conducts VSVs with birthing facilities, it remains unclear as to the roles COEHDI and/or CDPHE have for surveillance of all birthing facilities in the state. Leanne Glenn reported that the CDPHE’s definition of surveillance is to collect data and share it in HIPAA-compliant ways. A different definition of surveillance would be to observe in order to gather evidence. At this point in time, COEHDI is gathering themes to support the utilization of best practices in birthing facilities.

To access the November issue of the COEHDI Newborn Hearing Screening Monthly, click on this link: https://www.coehdi.org/wp-content/uploads/2021/11/Hearing-Screening-Monthly-Issue-11.pdf

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Diagnostic/Identification and Transition from Diagnostic/Identification to Early Intervention Task Force

This task force has been discussing identification and treatment of children with unilateral hearing loss (UHL). In general, this group of children is being underserved, as the majority of families do not choose to utilize the services that are offered. Available services include connecting with the Regional Colorado Hearing (CO-Hear) Resource Coordinator and using the progress monitoring tool that is available through CU-Boulder. The task force members are discussing ways to more effectively message the information about UHL. An infographic will be offered to diagnosing audiologists who can share it with families. And, task force members are also discussing messaging about UHL that is shared by PCPs. We have been given the opportunity to publish information about UHL in the bimonthly publication of the Colorado Chapter of the American Academy of Pediatrics.

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Intervention Task Force

For the past eight months, task force members have discussed the transition of children from Part C to Part B services. The task force members have a document with recommendations that is being shared with Early Intervention Colorado (aka; Part C) .

Christy Scott reported that Part C is in the final stages of creating an agreement between CDE and CDHS as Child Find services, for children birth to three years of age, move from one agency to another. There will be a longer transition period specifically for children with sensory disabilities (e.g., DHH, BVI, DB).

At the upcoming meeting in January, task force members will review and prioritize intervention topics.

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Alliance Meeting Brief

November’s Alliance meeting was attended by 14 of our 17 members. There were 11 additional attendees including COEHDI staff, task force members, members of the public, and those who provided accommodations. Agenda items and decisions made include the following: (a) COEHDI staff will be submitting Year 2 accomplishments and Year 3 plans to HRSA in December; (b) CDPHE will be reporting 2020 data to the CDC in January, 2022; (c) a professional development workshop, facilitated by Heather Abraham, was attended by 12 early interventionists, Part C service Coordinators, and some regional CO-Hear Coordinators; (d) federal reauthorization of EHDI legislation is being reviewed by Congress; (e) the December Alliance meeting was cancelled for the holidays; (f) a new Alliance member, representing the role of Part C Community Centered Boards (CCBs), will join the Alliance in January; and (g) updates on the activities of each task force were shared.

The next Alliance meeting will take place on Friday January 21, 2022 from 10-11:30AM. Contact a member of the Alliance or COEHDI staff, to obtain meeting access information. You can check our website for monthly Alliance meeting minutes at: https://www.coehdi.org/alliance.

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Gratitude/Acknowledgements

With the new year upon us, we acknowledge that the important work we do in the Colorado EHDI system would not be possible without each and every one of you, our stakeholders. We are grateful for your passion, involvement, and commitment to a refresh of our EHDI system which aims to support services for Colorado’s deaf,hard of hearing, and deafblnd children and their families.

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