As part of the Video Scrapbook, there are 14 videos clips that deal with health care provider education issues related to EHDI. Transcripts of each video clip can be found below. Feel free to use any of the video clips in your own presentations.

Transcripts of EHDI Scrapbook Video Clips

Speaker: Robert Cicco
Video: hc-cicco.mpg

Transcript: I think that the model that we can use for this is actually what's happened with metabolic screening. Very few people realize that in Pennsylvania even though only six diseases are mandated for metabolic screening, 99.5% of the babies in Pennsylvania get screened for 50 diseases. Most of them are optional, but the laboratory that does the supplemental metabolic screening has done a very effective job of gradually making the practicing community aware of the importance of that type of screening. I think that we need to do the exact same thing with hearing screening where with repeated messages over and over again of the importance of getting the diagnostic evaluation done and then getting the children into appropriate intervention services.

Speaker: Beth Cram
Video: hc-cram.mpg

Transcript: For the nurses who are responsible for giving those newborn hearing screenings--for them to even see some footage of how that experience was for a family that it would be helpful for them to see situations where kids could have been identified early and didn't. I think that we need to lend support even down to the basic. . .it's important for being conducting those tests to know why they are doing it and how important that is.

Speaker: Mark Gaylord
Video: hc-gaylo.MPG

Transcript: It's hard enough for those of us who talk in medical lingo especially abbreviated. When you start talking Part C, Part D, Part 5 and Title 5, I think that governmental lingo that goes between departments of health, departments of education, is very confusing to the general pediatrician. Unless they have dealt with or have a large number of children with special care needs in their practices. It's a wonderful opportunity. Many of our parents know more about those systems then we do. If we could just listen to them they'll tell us who they are.

Speaker: Mary Pat Moeller
Video: hc-moel1.mpg

Transcript: Most of us recognize that it's important to outreach to the medical community about newborn hearing screening. In particular to pediatricians, family practice doctors, because in some way they play a gatekeeper role. Children are referred to them; they see infants often following birth. So it's important that they are empowered with the information that will lead to rapid diagnosis and enrollment in intervention.

Speaker: Mary Pat Moeller
Video: hc-moel2.mpg

Transcript: There's also an issue of its not just information that you need in order to change practice, it's important to impact attitudes. When doctors come from hospitals that have high false positive rates, they don't have a lot of trust in screening. And then there's this effect that they don't think that it's that urgent to refer a family on and so we snowball. So we need to address this issue, not just from imparting knowledge, but shaping attitudes as that will have an impact on practice.

Speaker: Mary Pat Moeller
Video: hc-moel3.mpg

Transcript: It didn't seem to take a lot of convincing of nurses that it was a good idea to catch these kids early. They understood development and were geared up and ready to go with that, but they need the specifics. For example; none of the nurses I interviewed knew at what age you could fit a hearing aid on a baby. So there are just informational gaps that if we could fill, I think that the nurses would be in a better position to advocate and that's what nurses said, "Give me the information because I can help convince the parent they need to return for rescreening."

Speaker: Kathy Nichol
Video: hc-nicho.mpg

Transcript: I don't think the average pediatrician has learned a lot about this whole topic in their training or in their post-graduate continuing medical education. We really need to make the pediatricians feel comfortable with what's out there, the kind of testing that's available, the kind of intervention that's available. And what their role should be in helping direct this.

Speaker: Dolores Orfanakis
Video: hc-orfan.mpg

Transcript: I've been excited about the recent chart that the Academy put out, that emphasizes early hearing screening. It's a one page unit it's really accessible, it's attractive. We're accustomed to it because the immunization model looks a little like that if you happened to have seen the immunization program that's on one piece of paper. I think those are good reminders.

Speaker: Sharon Parham
Video: hc-parha.mpg

Transcript: We've come up time and time again with these students with unilateral hearing losses with pediatricians well intentioned, but feeling that the child has one good working ear and even negating parents' clear feeling that their child is struggling with hearing or they notice that sometimes they don't respond well. Or let's say their speech and articulation is not developing at the level that they should be. Pediatricians will often say that the parent is overly anxious or perhaps is over-reacting to some of those things even in this day and time. And why that worries me is that as an educator, I see its impact. I don't know exactly why doctors feel that children can fill that gap. I think it's just a lack of understanding on their part how even a mild loss, much less a unilateral loss, can impact a student's success in school.

Speaker: Tom Tonniges
Video: hc-tonni.mpg

Transcript: I had two experiences with deaf children that I will never ever forget as long as I am a pediatrician. One unfortunately was a child that I had seen at a Medically Handicapped children's clinic in rural Nebraska. It was a five-year-old whose father worked on a ranch and the child wasn't speaking. And he was going to start school the next year and they had heard there was a clinic in town and they brought him in because they were concerned that he had a speech and language problem. And unfortunately within just a minute or two we were able to say that this child probably has been deaf since birth and obviously that child will have been and has been affected by that very late diagnosis for the rest of his life. Not so many months, a few months later in my practice. I had a family that came in that had a girl who was eight months old at the time. They had brought her in for a consultation because they said 'I don't think our baby can hear' and sure enough that baby was deaf. That really…I think it was at that time that when the parents said 'I don't think our baby can hear' that I learned that: 1) you can't say that they'll just out grow it. It was a very teachable moment for me because that baby was evaluated right away and was found to be deaf.

Speaker: Betty Vohr
Video: hc-vohr1.mpg

Transcript: There are a number of aspects of physician education that need to be addressed relative to successful EHDI systems. One of them is education of the physician and his staff about the process, starting with screening. Why every newborn deserves to be screened and it should be their right. What the process should be for the primary care provider when they receive the information from their EHDI system that their child was a miss, or a refer, or that their child was a pass. Pediatricians need to be able to monitor speech language milestones within their practice for all of their children, because we know that some of these children who have a risk factor will pass the newborn screen, but still may have a late-onset hearing loss. So the whole office practice needs to be attuned to this. We're not saying that the pediatrician himself is going to check for language milestones each time he comes in, but someone on that staff, perhaps it's the nurse or the coordinator will check for those milestones. The pediatrician has to be aware of all the resources in his community. Not just who the audiologists are, but who are the qualified audiologists. Who has experience testing young children and infants. Who the otolaryngologist is. When to refer to ophthalmology. When to refer to genetics. How to get their child into early intervention services as soon as possible. The important thing though at each step of the way, he has to learn how to partner with the parents to learn what their wishes are and to make sure that this process is smooth and acceptable. And in tune with the culture of the family within his practice.

Speaker: Betty Vohr
Video: hc-vohr2.mpg

Transcript: We have representatives in pediatrics from the American Academy of Pediatrics, from almost every state and territory, so that's really exciting. We're bringing these physicians together. Pediatricians are then going back to their states, doing Grand Rounds, sharing this information with the pediatricians in their states. I'll be the first to admit pediatricians in medical school in past years have not been educated on these issues. So it's still something that we really need to accomplish.

Speaker: Karl White
Video: hc-white1.mpg

Transcript: I'd say there are two groups that are key players in this being institutionalized so that it continues to happen. One is the primary care physicians and the involvement of the American Academy of Pediatrics has been very important there, but there are other groups that we still need to reach out to, to get them involved, the American Nursing Association, the American Academy of Family Physicians. There are a number of professional organizations that kind of see this in the background, but don't realize what impact it can have and what they have to contribute to it. The other group is the State Departments of Health and this really has become a public health program and that's the only way it's ever going to be successful. And as this gets intutionalized at the state level then I think it will really become effective.

Speaker: Karl White
Video: hc-white2.mpg

Transcript: I think it's important to realize that this is a major shift in how we provide health care to infants and young children. And all of this has become possible because of some really major developments in the technology of screening, diagnosis and intervention. There's a whole educational effort here that needs to take place and needs some time to take place. Most of the health care providers that are providing services for these children were trained fifteen, twenty, twenty-five years ago and they have a lot of stuff to keep up with. Even though congenital hearing loss is the most frequent birth defect in America, most physicians in their practice will only see three or four of these kids in their lifetime. There are a lot of other issues that they have to be dealing with and so we can't really expect them to over night become experts in this and everything else that they have to keep up with. And so those of us involved in early hearing detection and intervention really have to take the initiative to help them learn about what happened, and not just the leadership of the American Academy of Pediatrics. We have to make sure that all of those 70,000 pediatricians who are out there and the 120,000 family practice physician who are out there that they learn about and understand what the resources are and that's a huge undertaking.