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About the Medical Community

Early Identification and Referral

About the Medical Community

Early Identification and Referral

This page was last updated on Apr 29, 2014 at 2:28 pm

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Know the System

The term medical system can have a variety of meanings. For the purposes of this guide it includes hospitals and medical centers serving young children, as well as the pediatricians and specialists who provide care in the hospital setting or private practice.

Hospital or medical center refers to any medical facility that provides inpatient or outpatient services to infants and young children. These include: non-profit, for profit or university hospitals and medical centers, children’s hospitals, neonatal or pediatric intensive care units within hospitals, developmental clinics within or associated with a hospital or medical center and/or therapy centers within or associated with a hospital or medical center. State deaf-blind projects will want to pay particular attention to facilities that provide services to preterm infants; young children diagnosed with syndromes or conditions that result in, or place them at risk for, disabilities; and young children with complex medical challenges.

Medical specialists play a key role in providing care to infants and toddlers with etiologies associated with combined vision and hearing loss. Medical personnel involved with this population include: neonatologists, geneticists, developmental pediatricians, neurologists, pediatric ophthalmologists and pediatric audiologists. Related medical staff personnel such as neonatal intensive care nurses, discharge planners, nutritionists, physical therapists, occupational therapists and speech/language pathologists also operate as part of this complex system that serves many of the infants and toddlers you are trying to identify and support.


Potential Collaboration Opportunities

Varied opportunities for partnerships exist within the medical system. However, it can be challenging to establish and maintain relationships due to the extremely low incidence nature of deaf-blindness. In addition to the challenges associated with raising awareness about deaf-blindness and the services your project offers misconceptions may exist about the developmental impact of dual sensory loss. Sometimes attitudes and practices embrace a “wait and see” rather than a “sooner is better” approach. To maximize your efforts it will be important to look closely at the components of this system and adopt a narrow, targeted focus.

The Table below can be used to inform your planning. It provides an overview of medical services, as well as suggestions for the type of technical assistance your project might provide. Efforts involving the medical community will typically look much different than the involvement a state deaf-blind project is likely to have with the education system. It will be important to keep this in mind as you tailor your technical assistance and related materials to match recipients in the medical system. Enlisting assistance from physicians, nurses or others familiar with how hospitals and medical centers operate can be very beneficial in ensuring your efforts bring about the desired results. If materials for patients are requested it will be important that they be tailored with families in mind. Talking with families whose children see a variety of medical specialists can be very beneficial in creating or adapting such materials.


Table 1: Medical System Overview

What

Who is Involved

Potential TA Activities

Intensive Care Nursery

• Care for preterm infants

• Family education

• Testing and monitoring for long-term implications (medical or developmental

• Child and family

• Neonatal nurses

• Neonatal specialists

• Chaplain, counselor

• Social worker, case manager

Awareness materials for families,nursing and support staff:

• Sensory implications of preterm birth

• Etiologies, risk factors

• Impact of combined vision and hearing loss on early learning

Training

• Grand Rounds

• Nursing CEUs

Discharge Process

• Overnight “rooming-in” stay

• Training on any equipment required at home

• Follow-up referrals and appointments

• Referrals to appropriate programs, agencies, services

• Child and Family

• Discharge planner (nurse and/or social worker)

• May involve one or more case management team meeting(s)

Targeted materials

• Sensory implications of preterm birth

• DB Project referral information

• Impact of combined vision and hearing loss on early learning

Diagnostic Evaluations

• Confirm suspected syndromes, conditions

• Education about diagnosed syndromes, conditions

• Generate results for use in qualifying for eligible services

• Child and family

• Geneticist

• Developmental pediatrician

• Audiologist, Ophthalmologist

• Allied Health professionals (OT, PT, SLP, Nutritionist)

• Psychologist

Targeted materials

• Etiologies, risk factors

• Eligibility definition and referral information

Training

• Appropriate assessment tools and strategies

Provide Functional Vision and Hearing Assessments

Follow-up Clinics

• Genetics, Cranio-facial, etc.

• Referrals to support groups  

• Progress monitoring

• Testing to determine eligibility for continued services

• Recommendations

• Child and Family

• Medical specialists

• Allied Health professionals (Developmental Specialist, OT, PT, SLP, Nutritionist)

• Vision and/or hearing specialists

Targeted materials

• Etiologies, risk factors

• Eligibility definition and referral information

Training

• Appropriate assessment tools and strategies

Provide Functional Vision and Hearing Assessments

Therapy Programs

• Ongoing treatment

• Recommendations

• Home programs

• Therapy groups

• Child and family

• Allied Health professionals (Developmental Specialist, OT, PT, SLP, Nutritionist)

• Vision and/or hearing teachers or consultants  

Training (general or child-specific)

• Setting up the Environment, Trust, Communication, Concept Development, Early Literacy, Hand-under-hand, etc.

Observation & Consultation

• Onsite or video (DMP model)

Adapted from: The Sooner the Better: Effective Strategies for Identifying Infants and Young Children with Combined Vision and Hearing Loss; Barbara Purvis, M.Ed., National Consortium on Deaf-Blindness, Sept 2007.


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