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Children's Medical Services - Special services for children with special needs
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Infant Toddler Development Training
Module 6, Lesson 3


family at paradeAs with vision loss or impairment, hearing impairment and deafness in an infant or toddler brings forth new terms, new ways of planning for the child's future and new issues within a family. One of the most important roles of the ITDS is to assist the child and family in discovering how the child can be integrated within his or her community from the very beginning. The most important resource that can be provided to a family at this time is the information that the SHINE service coordinator and SHINE provider bring. They provide the family with unbiased information on all the methods of communication that can be used with a child who is deaf or hard of hearing. This will help the family make an informed choice regarding how they want to communicate with the child.


It is important to note that first and foremost, all ear infections need careful follow-up by a primary medical provider. When an infant or toddler fails a hearing screen, the child is re-screened and must have a full hearing evaluation to diagnose the problem if the re-screen is also failed. If a family chooses amplification methods to enhance their child's hearing, the aids need to be fit as soon as possible after the diagnosis is made to promote language acquisition.

If the sensorineural system is intact, but middle ear disease is present, then the infection is treated first and a follow-up hearing test and tympanogram is recommended. If there is a positive response to treatment within 8 – 12 weeks, then continued follow-up with the primary medical provider is recommended. If there is no response, then myringotomy with tubes is considered.

If the sensorineural system is not functioning properly, but the middle ear is intact, then hearing aids will be considered. The family may then want to pursue an evaluation for cochlear implant(s).

There is a continuum of intervention methods for deafness or hearing impairment. Families need information on all methods in order to make an informed decision regarding what they want for their child and family. In Florida, all infants who fail their newborn hearing screens are referred to the SHINE program.

Case Examples from SHINE illustrate the outcomes of children who received early intervention services after six months of age and those who received effective intervention prior to six months of age.

Consider this scenario.

Baby Timmy who is three months old moved to Florida from a state with no newborn hearing program. The ITDS sees Timmy's mother in a grocery store. The Mother tells the ITDS that she is concerned because Timmy does not respond to her voice.

What guidelines should the ITDS follow when helping a family with an infant who has moved to Florida from another state or who failed a newborn hearing screen in the hospital?


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