Bridging the Gaps: Assessment of Pediatric Hearing Loss in Appalachia

This study seeks to document the disparity in hearing healthcare for children who failed newborn hearing screening and define the explanatory factors of the gaps in hearing healthcare in order to develop a long-term intervention program of education and care through telemedicine. The hypothesis of this study is that children in rural Appalachia regions of Kentucky are less likely to obtain timely diagnosis and subsequent intervention after failing newborn hearing screening than those in urban/suburban environments. We seek to analyze the newborn hearing screening records of children in Kentucky between the University of Kentucky, LHSC, and HHI, in conjunction with the State of Kentucky Early Hearing Detection and Intervention (EHDI) program, and compare counties based on failure rates and subsequent follow-up compliance. Additionally, we will examine the records of pediatric cochlear implant recipients in the state of Kentucky and assess the age of intervention and treatment plan compliance and compare with national standards. This examination will allow us to identify regions with gaps in diagnosis and treatment. We will then administer qualitative and quantitative measures to assess knowledge, attitudes, and behaviors among clinicians and patients in those areas. We will also assess the community interest in and perception of the development of a local hearing healthcare telemedicine center by conducting focus groups. These data will define the need for hearing healthcare and allow us to develop methods for improving auditory rehabilitation of children in Appalachia.