What is EHDI-PALS?

Baby Profile

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The first few days after a baby’s birth can be some of the happiest for a growing family. Even so, the parents can have a certain amount of anxiety associated with caring for the newborn once it is home.  They worry about the car seat placement, feeding and nursing issues, whether the baby sleeps through the night…and on and on.  Today, infant hearing screening prior to hospital discharge is the standard of care because of the recognized benefits of early detection of hearing loss within the first year of life.

So imagine the increased concern parents have when bringing home an infant who may not hear well.  Modern society provides ready access to health information online.  Families may jump onto the internet searching for information without much prior knowledge of hearing loss.  Information gathered this way may be outdated, biased or incorrect.  By the time a family reaches an appropriate pediatric audiology facility they may well be armed with poorly-filtered information that could be confusing or just plain wrong.  At this point in time, it may be necessary for audiologists to provide additional informational and adjustment counseling.

Audiologists and speech-language pathologists know that improved speech and language communication outcomes are possible when hearing loss is identified and managed early in life. The Early Hearing Detection and Intervention process (EHDI) guides professionals and families in reaching these outcomes.  The goals of EHDI are to identify the hearing loss before hospital discharge, diagnose and confirm the hearing loss using advanced testing equipment and provide early access to auditory sounds through modern technology such as hearing aids and cochlear implants within six months of age.

How does a family locate audiology services?

EHDI-PALS will be a national web-based directory of pediatric audiology facilities designed to assist families and professionals in the EHDI process. Not all pediatric facilities are alike or have the equipment or services required by a child at a given time. For example, some facilities do not provide cochlear implant services and others only to children over three years of age.  The directory will contain detailed descriptions of pediatric audiology facilities and centers and will facilitate searching for appropriate services across the country.

The EHDI-PALS website development is in progress and is expected to go “live” in mid-2012. The site will contain links to reliable web information on childhood hearing loss, questions for families to ask the audiologists about where to go for hearing services and the EHDI process, and the EHDI-PALS directory.

The desired outcome for EHDI-PALS is to connect families with services that are family-centered and that create seamless professional audiology service provision across the early years of a child’s life.  Go to www.ehdipals.org and watch the website grow and build.


Pamela Mason, M.Ed., CCC-A is the director of audiology professional practices at the ASHA national office. Before working at ASHA, she directed the Audiology Center at the George Washington University Hospital in Washington DC.

Screenings: A World of Our Own or a Collaborative Effort?

Teacher at table with young students

Photo by woodleywonderworks

(This post originally appeared on Educational Inspirations)

Lately I’ve been reading a lot of comments from SLPs about screenings to identify speech/language issues. There are postings asking what screenings people prefer and sometimes questions about how to go about getting it all done. I’ve also seen some articles discussing the possibility of a universal speech/language screening for RTI purposes. Our changing roles in the school system have really made me look at screenings in a new light.

For instance, how efficient is it to do speech/language screenings? When it comes to articulation it has been my experience that teachers are pretty capable of hearing “funny speech” and sending me e-mails about it. I have never had kids fall through the cracks when it comes to articulation; however, I see the upside to universal screenings for articulation as well. Universal, school-wide screening of articulation three times yearly could identify developmental errors and track progress over time. On the other hand, there are two SLPs in a school of more than 750. The thought of screening 750 kids is enough to have me running for the hills. So, how could this be done?

If teachers are pretty good at identifying when a student’s speech sounds “weird” couldn’t this be used as an initial screening? At our school we talked to the teachers about listening for articulation errors. During our usual reading screenings we asked teachers to mark down the names of students whose speech did not sound appropriate. This is our universal, first line of defense articulation screening. Then the SLP can develop a list of students who need a screening by a more experienced ear.

That sounds pretty easy, but what about language screenings? Language screenings such as the CELF are given individually and can take 10-20 minutes to administer. Completely out of the question when it comes to 750 kids. I have to admit I am intrigued by the idea of an easy to administer universal language screening, but I have to wonder if it is really necessary.

One elementary I work with administers the DIBELS Next to all students. The subtests vary by grade, but the early grades administer phonological awareness, nonsense words, and letter naming tasks. As an SLP, I analyze the results of these quick and dirty screens to determine if there are any students with possible underlying language issues. I look not only at the phonological awareness results, but the emerging phonics skills. A student’s ability to name letters also has some basis for clues about reading (Rathvon, 2004) and thus, language abilities.

For older students, I find it useful to look at screenings like the MAZE (AIMSweb, Shinn) or DIBELS Next DAZE (DIBELS Management Group). These screenings are group administered in 3 minutes and require students to read silently and make semantic and syntactic decisions about their reading. This offers me some clues about the reading comprehension of students. I also like the spelling screenings available from AIMSweb. These are also group administered and give me a bounty of clues about orthographic, morphological, and semantic knowledge of students.

Don’t get me wrong, I’m not opposed to the development of universal speech/language screenings, but I would like to see some research about whether reading screens already in use by schools are effective at also identifying language problems. I also wonder if we could be using the reading screens already in place as a first defense for screening everyone and then possibly do a deeper language screening for those students identified as having possible underlying language problems. As an SLP I’m all about identifying these issues early and doing some preventative work, but I’m also about working smarter, not harder. It seems much easier to me to use what is already in place in a school rather than trying to convince teachers to help me administer a “speech” screening.

What about you? Do you give a separate screening for all students in your school? Do you make use of reading and other literacy screens already in place?

Nicole Power is an SLP and literacy consultant at Bethany Public Schools in Bethany, Oklahoma. She provides language/literacy therapy as well as intervention primarily to elementary students. Nicole is the district coordinator for the Response to Intervention program and collaborates with teachers and other specialists to provide high quality instruction to struggling students. She presents area workshops and created and directs the Oklahoma School SLP Conference.