Telemedicine initiative allows remote hearing tests for newborns

Approximately 50 percent of children who do not pass hearing screenings at birth are later “lost to follow-up,” said Anne Marie Tharpe, Ph.D., professor and chair of Hearing and Speech Sciences and associate director of the Vanderbilt Bill Wilkerson Center.

Through a telemedicine initiative, Vanderbilt audiologists are conducting follow-up hearing tests on newborns whose families live in rural areas of Tennessee.

Tharpe’s group teamed with the Tennessee Department of Health for a pilot project to set up a remote site in Union City, Tenn., that provides follow-up testing for newborns, with a Vanderbilt audiologist in Nashville on the other end of the connection, acting as the hub site.

The technology allows the audiologist to take control of a remote computer during the testing and also interact with the family and technician as if they were standing side-by-side.

“This allows the clinician at Vanderbilt to control the system at the remote site using some simple secure software. Additionally, video-conferencing equipment with high definition cameras is used to provide clear real-time communication between the caregiver and the clinician,” said Devin McCaslin, Ph.D., associate professor of Hearing and Speech Sciences.”

Tharpe said one of the reasons these patients have been lost to follow-up is because families who live in rural areas have to miss work and drive into a city with a major medical center to do their follow-up testing.

“If we can provide this easily, and closer to their homes, then our hope is that once a baby’s hearing loss is confirmed through our follow-up testing those families will seek intervention services for their child,” she said.

The initiative is made possible in part by two training grants totaling $2.5 million from the U.S. Department of Education and additional support from the Maternal Child Health Bureau’s Leadership Education in Neurodevelopmental Disabilities (LEND) grant to the Department of Pediatrics.

The training grant awarded to Tharpe is focused on providing training to graduate students who will work with deaf and hard-of-hearing children.

“Professionals are starting to investigate the use of telepractice, especially in rehab areas like ours, but to my knowledge no one is looking at how we train students to provide remote services, and I think that is an important component. What are the safety and ethical considerations and how do they differ from providing face-to-face care?” Tharpe said.

“We have to make extra effort to notify the patient of who is present in the room, even those they may not be able to see outside of the camera’s range, and to assure the patient that his or her information is secure and confidential, in the same way it is if the visit was on Vanderbilt’s campus.”

The second $1.25 million grant, received by Lynn Hayes, Ph.D., associate professor of Hearing and Speech Sciences, will be used to train deaf educators in the Mama Lere Hearing School, a preschool and kindergarten program for children with hearing loss, and also in working with deaf education graduate students to provide remote consultation to teachers in rural areas across Tennessee.

The goal at the Mama Lere Hearing School is to prepare the children for integration into general education classrooms in their home communities, Tharpe said. “Many of these communities are rural and a lot of the teachers where these students will be going may not have ever had a child who has hearing loss before,” she said.

“This grant will help our graduate students learn to consult with outlying, rural, general education teachers and provide guidance in educating these children with hearing loss in their classrooms with normal hearing children.

“These children are mainstreamed but they may still need special services. In some cases, we will be able to provide direct services via telepractice,” Tharpe said.