Communication is key: at-risk families' perspectives on follow-up in New Jersey's early hearing detection and intervention program.

Babies whose families possess multiple marginalized identities are at-risk for being late or lost to follow-up although there is a universal effort to screen and treat hearing loss in babies as part of state Early Hearing Detection and Intervention (EHDI) programs. Lack of timely follow-up puts young children at risk for delays in language acquisition, social skills, cognitive development, and school success. This qualitative study explored barriers to follow-up audiological care in at-risk families in New Jersey. Using thematic analysis, this research uncovered two major findings: 1) communication normalizes failed screenings, and 2) parents need clearer and more in-depth information. Health care social workers are well-suited to address these challenges due to their training in integrated social work practice, which can help them understand the complex interplay between individuals and their environments. In doing so social workers can improve access to needed services and promote health equity.

Maternal Factors Predicting Loss to Follow-Up from Newborn Hearing Screenings in New Jersey.

Because hearing loss in children can result in developmental deficits, early detection and intervention are critical. This article identifies a constellation of maternal factors that predict loss to follow-up (LTF) at the point of rescreening-the first follow-up for babies who did not pass the hearing screening performed at birth-through New Jersey's early hearing detection and intervention program. Maternal factors are critical to consider, as mothers are often the primary decision makers around children's health care. All data were obtained from the state's department of health and included babies born between June 2015 and June 2017. Logistic regression was used to predict LTF. Findings indicate that non-Hispanic Black mothers, younger mothers, mothers with previous live births, and mothers with obesity were more likely to be LTF. Hispanic mothers and those enrolled in the state's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program were less likely to be LTF. Mothers most at risk for LTF should be targeted for intervention to help children with hearing loss achieve the benefits from early intervention. Being a WIC recipient is a protective factor for LTF; therefore, elements of WIC could be used to reduce the state's LTF rate.

Better late than never? Maternal biopsychosocial predictors of late follow-up from new Jersey's early hearing detection and intervention program.

OBJECTIVES: Early hearing detection and intervention programs are designed to mitigate consequences of hearing loss in infants. Most research examining compliance with program protocols has examined factors related to being lost to follow-up. Another group that warrants study are babies who return for follow-up outside the timelines recommended by public health organizations. This research seeks to identify maternal factors that are associated with late follow-up at the point of diagnosis of hearing loss. STUDY DESIGN: The sampling frame for this study included all babies born in New Jersey in a two-year period. Our final sample consisted of 716 babies who needed diagnostic evaluations and completed them. Five hundred twenty-six babies completed their exams on-time while 190 completed them late. Logistic regression was completed to identify maternal factors related to late follow-up, and additional statistics were utilized to understand characteristics of babies who were late. RESULTS: In the final modeling, maternal education (OR = 0.52), WIC participation (OR = 2.11), and health insurance status (OR = 2.04) were significantly predictive of being late (X2 (6) = 77.71; p < 0.01). Mothers for whom postpartum depression (OR = 1.89) was a concern were more also likely to have babies who were late. Needing to repeat a diagnostic audiologic exam was most predictive of lateness (OR = 5.32). Over one-third of babies who had confirmed hearing loss completed their testing late. CONCLUSIONS: Late completion of diagnostic hearing tests may contribute to delays in children hitting developmental milestones in a timely manner. Low socioeconomic status mothers and those with postpartum depression may have difficulty following up with recommended hearing tests. Limitations include data quality issues inherent in using administrative data.

Measuring Parenting Skills: Validating the Skills Assessment for Parents with Intellectual Disability.

PURPOSE: Parents with intellectual disabilities (ID) are overrepresented in the child welfare system. Valid instruments are needed to assess parenting skills in this population. This research evaluates the psychometric properties of the Skills Assessment for Parents with Intellectual Disability (SAPID), an observational instrument completed to assess parents with ID with child welfare involvement. METHOD: All clients enrolled in a prevention program for parents with ID were included in the sample (N = 133). Confirmatory factor analysis was conducted to understand the validity of the SAPID. Predictive validity was assessed by examining change over time with two outcomes: out-of-home placement and program completion. RESULTS: The validated SAPID consisted of three latent constructs: daily life skills, parent-child interaction, and overall safety. Parenting skills across all domains significantly improved for families remaining intact and those completing the program. DISCUSSION: The validated SAPID should be considered for use in assessing parenting skills for those with ID.

Adherence to follow-up recommendations for babies at risk for pediatric hearing loss.

OBJECTIVE: The purpose of this retrospective study was to evaluate the families' compliance with recommendations for continued monitoring of babies with high-risk factors for hearing loss. METHODS: Hearing screening and follow-up results from 604 babies were tracked across a five-year period. Bivariate analysis, including chi-square analysis, t-tests, and one-way analyses of variance were conducted to test whether various factors predicted likelihood of follow up. RESULTS: Although 86% of the babies returned for the initial follow-up appointment, few completed the protocol or were diagnosed with hearing loss (10.3%). Excluding the babies who never returned, the average age for initial assessment was near the recommended 3-month target (3.5 months). However, babies were last seen at 9.4 months on average, which is earlier than recommended. Some factors positively predicted follow-up: receipt of ototoxic medication, hyperbilirubinemia requiring transfusion, ECMO, syndromes associated with hearing loss, craniofacial anomalies, and passing the newborn hearing screening. Others were negatively predictive: NICU stay >5 days, younger maternal age, and failing the newborn screening. There was no relationship between the results of the last test and whether the families continued with monitoring. Babies with risks categorized as more likely to be associated with delayed onset hearing loss were more often late to the initial follow up, but also followed up for a longer period of time. CONCLUSIONS: These results demonstrate the need to focus on the barriers unique to babies with risk factors for late onset/progressive hearing loss in addition to those barriers that generally affect loss to follow up. Tools for parental engagement are recommended.

Factors Related to Not Following Up with Recommended Testing in the Diagnosis of Newborn Hearing Loss.

Children's hearing is a public health concern, and universal newborn hearing screenings are the first step in detecting and treating congenital hearing loss. Despite the high rate of participation in such programs, loss to follow-up (LTF) with additional recommended diagnosis and treatment has been a persistent problem. The current research seeks to expand the knowledge base at the point of diagnosis, where there is a large drop-off in parents following through with recommended care. This research was organized around the following question: What biopsychosocial factors are associated with LTF between screenings and diagnostic evaluations? A prospective quantitative longitudinal study tracked 203 families whose newborns were referred for additional testing at discharge from the hospital after birth. Binary logistic regression was used to determine what constellation of factors best predicted LTF. Psychosocial factors related to being lost to follow-up at diagnosis included race and ethnicity and access to health care professionals, with African American babies being most at risk for LTF; however, the impact of race and ethnicity declined when parents believed they had more health care professionals with whom to consult.