A Medical Home for Children with Hearing Loss Julia L. Hecht, M.D., Deaf Access Program Albuquerque,...
-
Upload
jasper-green -
Category
Documents
-
view
217 -
download
0
Transcript of A Medical Home for Children with Hearing Loss Julia L. Hecht, M.D., Deaf Access Program Albuquerque,...
![Page 1: A Medical Home for Children with Hearing Loss Julia L. Hecht, M.D., Deaf Access Program Albuquerque, New Mexico.](https://reader035.fdocuments.net/reader035/viewer/2022062423/5697bfd41a28abf838cacba4/html5/thumbnails/1.jpg)
A Medical Home A Medical Home for Children with Hearing Lossfor Children with Hearing Loss
Julia L. Hecht, M.D.,Julia L. Hecht, M.D.,
Deaf Access ProgramDeaf Access Program
Albuquerque, New MexicoAlbuquerque, New Mexico
![Page 2: A Medical Home for Children with Hearing Loss Julia L. Hecht, M.D., Deaf Access Program Albuquerque, New Mexico.](https://reader035.fdocuments.net/reader035/viewer/2022062423/5697bfd41a28abf838cacba4/html5/thumbnails/2.jpg)
The Medical Home ModelThe Medical Home Model
• Accessible
• Continuous
• Comprehensive
• Coordinated
• Family-centered
• Compassionate
• Culturally competent
![Page 3: A Medical Home for Children with Hearing Loss Julia L. Hecht, M.D., Deaf Access Program Albuquerque, New Mexico.](https://reader035.fdocuments.net/reader035/viewer/2022062423/5697bfd41a28abf838cacba4/html5/thumbnails/3.jpg)
Linking EHDI to the Linking EHDI to the Medical HomeMedical Home
Physician is key– 8 visits between birth and 18 months– Assess NBHS status – Negotiate the system– Help families with grief and acceptance
![Page 4: A Medical Home for Children with Hearing Loss Julia L. Hecht, M.D., Deaf Access Program Albuquerque, New Mexico.](https://reader035.fdocuments.net/reader035/viewer/2022062423/5697bfd41a28abf838cacba4/html5/thumbnails/4.jpg)
Life after DeafLife after Deaf
• Focus on language access and development– Eye contact– Facial expressions and gestures– Sign language– Spoken language
![Page 5: A Medical Home for Children with Hearing Loss Julia L. Hecht, M.D., Deaf Access Program Albuquerque, New Mexico.](https://reader035.fdocuments.net/reader035/viewer/2022062423/5697bfd41a28abf838cacba4/html5/thumbnails/5.jpg)
Comprehensive CareComprehensive Care• Referrals for infants / children who are newly-
diagnosed with hearing loss– Audiologist– Hearing Aid Provider– Early Intervention / StepHi– Appropriate School placement– Other families– Deaf adult role models– Medical Specialists: Genetics / Dysmorphology, ENT,
Ophthalmology, Others as needed
![Page 6: A Medical Home for Children with Hearing Loss Julia L. Hecht, M.D., Deaf Access Program Albuquerque, New Mexico.](https://reader035.fdocuments.net/reader035/viewer/2022062423/5697bfd41a28abf838cacba4/html5/thumbnails/6.jpg)
Physician as Safety NetPhysician as Safety Net• Coordination of services• Parent satisfaction with services / advocacy• Are parents lost in the politics of deafness?• Risk for additional health problems including
developmental delays• Ongoing evaluation of language development• Impact on the family
![Page 7: A Medical Home for Children with Hearing Loss Julia L. Hecht, M.D., Deaf Access Program Albuquerque, New Mexico.](https://reader035.fdocuments.net/reader035/viewer/2022062423/5697bfd41a28abf838cacba4/html5/thumbnails/7.jpg)
Developing a VisionDeveloping a Vision
Encounters with a community of deaf adults are important for understanding the “deaf world” and the tremendous potential that babies with hearing loss possess.
![Page 8: A Medical Home for Children with Hearing Loss Julia L. Hecht, M.D., Deaf Access Program Albuquerque, New Mexico.](https://reader035.fdocuments.net/reader035/viewer/2022062423/5697bfd41a28abf838cacba4/html5/thumbnails/8.jpg)
Tremendous PotentialTremendous Potential
![Page 9: A Medical Home for Children with Hearing Loss Julia L. Hecht, M.D., Deaf Access Program Albuquerque, New Mexico.](https://reader035.fdocuments.net/reader035/viewer/2022062423/5697bfd41a28abf838cacba4/html5/thumbnails/9.jpg)
A “Typical” Deaf FamilyA “Typical” Deaf Family
![Page 10: A Medical Home for Children with Hearing Loss Julia L. Hecht, M.D., Deaf Access Program Albuquerque, New Mexico.](https://reader035.fdocuments.net/reader035/viewer/2022062423/5697bfd41a28abf838cacba4/html5/thumbnails/10.jpg)
Cultural CompetenceCultural Competence
• Sociocultural model of deafness
• Recognize the value of learning ASL
• Emphasize communication, not necessarily speech
![Page 11: A Medical Home for Children with Hearing Loss Julia L. Hecht, M.D., Deaf Access Program Albuquerque, New Mexico.](https://reader035.fdocuments.net/reader035/viewer/2022062423/5697bfd41a28abf838cacba4/html5/thumbnails/11.jpg)
Family-centered CareFamily-centered Care• Recognize the range of options for
intervention for hearing loss• Reinforce development of the “whole
child”• Support family through the grief and
acceptance process throughout the child’s lifetime
• Support family choices and encourage openness to change
![Page 12: A Medical Home for Children with Hearing Loss Julia L. Hecht, M.D., Deaf Access Program Albuquerque, New Mexico.](https://reader035.fdocuments.net/reader035/viewer/2022062423/5697bfd41a28abf838cacba4/html5/thumbnails/12.jpg)
Linking EHDI to the Linking EHDI to the Medical Home Using Medical Home Using
TelehealthTelehealth
![Page 13: A Medical Home for Children with Hearing Loss Julia L. Hecht, M.D., Deaf Access Program Albuquerque, New Mexico.](https://reader035.fdocuments.net/reader035/viewer/2022062423/5697bfd41a28abf838cacba4/html5/thumbnails/13.jpg)
GoalsGoals• Support families of child who “refers” through the
NBHS process• Support the primary physician in developing a
medical home for the child with hearing loss– Educate physicians about the components of a
medical home for deaf– Link physician with community resources
• Enhance relationships between members of the multidisciplinary team
![Page 14: A Medical Home for Children with Hearing Loss Julia L. Hecht, M.D., Deaf Access Program Albuquerque, New Mexico.](https://reader035.fdocuments.net/reader035/viewer/2022062423/5697bfd41a28abf838cacba4/html5/thumbnails/14.jpg)
AABR #1
AABR #2
Dx ABR
No Hearing
Loss
Refer
Refer
coordinator
coordinator
Family with deaf child
PCP
CONSULTANT
VIA
TELEHEALTH
UNIVERSAL NEWBORN HEARING SCREENING
![Page 15: A Medical Home for Children with Hearing Loss Julia L. Hecht, M.D., Deaf Access Program Albuquerque, New Mexico.](https://reader035.fdocuments.net/reader035/viewer/2022062423/5697bfd41a28abf838cacba4/html5/thumbnails/15.jpg)
TELEHEALTH CONNECTIONS
FAMILY WITHEI PCP
FAMILY WITHPCP
DEAFNESS CONSULTANT
MD
OTHERFAMILY
FAMILY WITHEI
PCP SCHOOL
![Page 16: A Medical Home for Children with Hearing Loss Julia L. Hecht, M.D., Deaf Access Program Albuquerque, New Mexico.](https://reader035.fdocuments.net/reader035/viewer/2022062423/5697bfd41a28abf838cacba4/html5/thumbnails/16.jpg)
FAMILY WITH DEAF CHILD
RELATIONSHIPS ENHANCED BY TELEHEALTH
OTHERFAMILY
OTHERFAMILY
STEP HI -- EARLY INTERVENTION
PCP
COORDINATED TELEHEALTH CONNECTION
SCHOOL
ENT
AUDIOLOGY
GENETICS
![Page 17: A Medical Home for Children with Hearing Loss Julia L. Hecht, M.D., Deaf Access Program Albuquerque, New Mexico.](https://reader035.fdocuments.net/reader035/viewer/2022062423/5697bfd41a28abf838cacba4/html5/thumbnails/17.jpg)
JuanJuan• Spanish speaking family• Diagnosed early• Deaf sister • In “total communication” preschool• Behavorial problems, tantrums• Referred to medical home
– Revealed sister has progressive visual impairment– Family education
• Usher syndrome• Behavior and family dynamic / communication
– Preparation for future vision loss