Early Childhood Intervention
How to refer children with suspected hearing loss

I have a child in my program who was diagnosed with a hearing loss. The family was referred to ECI. What happens next?

The ECI program will contact the family and arrange a home visit so that a team of early intervention specialists can evaluate the child. ECI considers parents important members of the team. In this case, the team will also include a teacher of children who are deaf. The evaluation will consist of a detailed discussion of the child’s developmental strengths as well as the family’s resources and concerns.

If the child qualifies for services, the family will be eligible to receive developmental services from early intervention specialists, speech language pathologists, physical and occupational therapists, social workers, and nutritionists. ECI coordinates services to every child. If the family needs other services, the ECI service coordinator will assist the family in locating and accessing resources in the community

ECI teams help families and caregivers:
learn strategies to promote development
incorporate therapeutic intervention activities into daily life
foster and enhance children’s engagement in routine activities and social interactions
monitor children’s progress
support children to fully participate in their communities

Children who are deaf or hard of hearing may also receive services through Regional Day School Programs for the Deaf, local school districts, or the Texas School for the Deaf.

After enrolling in ECI, the service coordinators can assist families in acquiring hearing aids for their child.

I mentioned ECI to a parent whose child attends my program and is obviously having some hearing problems. The mother wants to wait. Should she call ECI?

If a child has a hearing loss, early referral and identification are important to the child’s speech and language development. ECI encourages families and providers not to take a wait-and-see approach. A referral to ECI can be based on professional judgment or a family’s concern. A medical diagnosis or a confirmed developmental delay is not needed. A referral should be made as soon as a hearing loss or a delay is suspected, or there is any question about a child’s development, even as early as birth.

One of the newborns in my home care program failed his ABR test. What is an ABR screening?

The initials ABR stand for auditory brainstem response. It’s a hospital test that measures how the brain responds to sound. Clicks or tones are played through soft earphones placed in the baby’s ears, and three electrodes placed on the baby’s head measure the brain’s response.

Another newborn screening, otoacoustic emissions (OAE), measures sound waves produced in the inner ear. A tiny probe placed just inside the baby’s ear canal measures the response (echo) when clicks or tones are played into the baby’s ears.

Both tests are quick (about 5 to 10 minutes) and painless. They may be done while the baby is sleeping or lying still. Either or both tests may be used to screen a baby’s hearing.

Without newborn hearing screening, it can be difficult to detect hearing loss in the important first months of the baby’s life. About half the children with hearing loss have no risk factors for it. A baby who fails the ABR or OAE needs to have further screening or testing, and ECI can assist in referring families for further testing. Newborn hearing screening can detect possible hearing loss in the first days of a baby’s life.

What does an audiologist look for before referring a child to ECI? What’s the referral process?

Audiologists should refer infants and toddlers when:
a newborn does not pass an outpatient screening, which indicates a high probability of hearing loss. ECI can help make sure that the baby receives all other necessary testing and follow up.
audiological testing indicates a hearing loss.
the parents have indicated a concern about the child’s language, cognitive, or physical development.

An audiologist can refer a child to a specific ECI program within the family’s residential area.

Anyone wanting to make a referral can use one of the following options:
Call the DARS inquiries line at 1-800-628-5115.
Send an e-mail to DARS.inquiries@dars.state.tx.us and include the child’s ZIP code. You will receive an e-mail response with the contact information for the ECI program that serves the family’s residential area.
Use the ECI website search page: www.dars.state.tx.us/ecis/searchprogram.asp. Do the search either by city or county.