BATOD & BAEA response – Kingdon review of children’s hearing services
BATOD submitted a joint online response with BAEA to Kingdon review of children’s hearing services.
Max 300 words/section
Question 1
The following questions refer to the review and recall of children affected by service issues in children’s audiology services. This review and recall exercise is part of NHS England’s Paediatric Hearing Services Improvement Programme.
The deaf children, their families and educational providers affected by service issues in children’s audiology services required rapid response targeted interventions and support from the Sensory Support Services. Once informed of the late diagnosed children, the local authority services could implement a multi-specialist staff approach, Qualified Teachers of Deaf Children and Young People (QToD), educational audiologists, and where available teaching assistants experienced in working with deaf children, communication support workers, British Sign Language (BSL) tutors, deaf models to support their communication, language, social emotional and academic development.
The disjoined systems reported between local authority education services and health services experienced in some areas regarding multi- disciplinary team meetings, impacts on principles of families only needing to ‘tell it once’ as the education services don’t always have access to information in a timely manner. As reported in the annual Consortium for Research in Deaf Education (CRIDE), education services aim to have a QToD establish contact within five working days of notification of a new referral that is identified outside the newborn hearing screening (NBHS), two working days if the referral from the NBHS programme. Those initial meetings with the family and QToD are often home-based and not as restricted as clinic appointment timeframes to allow the family the safe space to ask questions, communicate their thoughts about their child’s communication options, life and education options etc.
The discussions for these children required greater sensitivity as the families rebuilt trust in the service providers and navigated the related additional impact of their experiences. For example, some children missed the critical period for cochlear implant surgery, which is most effective when performed at a young age. Additionally, addressing with professionals if misdiagnosis of other needs was valid regardless of the diagnosis of deafness.
Question 2
If you have any suggestions for how the NHS could improve the way it responds to issues in children’s audiology services, please set them out here. You may also want to share with us your reflections of working within or alongside children’s audiology services in the NHS.
BATOD welcomed the development of universal NBHS in the UK which stemmed from the seminal paper by Yoshinago-Itano et al (1998) that found that deaf children diagnosed with targeted intervention in place within 2 months of diagnosis had better long-term outcomes. Similarly, BATOD promoted evidence-based research in the intervening years, which led to quality standards and good practice guidance around effective joint working practices eg Family-Centred Early Intervention (FCEI) principles and NDCS (2024), Best Practices in Family Centred Early Intervention for Children who are Deaf or Hard of Hearing, Moeller et al, (2013), Early Years Support for Children with a Hearing Loss (NDCS), Quality Standards in Paediatric Audiology (BAA).
Multi-disciplinary working is fundamental to high quality provision across all services and achieving better outcomes for deaf babies, children and their families. The QToD and Educational Audiologist interventions input at the early stages to support the family on the journey and provide information for informed decision-making is essential in the multi-disciplinary team. Annual CRIDE reports have evidenced from the stage of identification, the timeframe of first contact from QToDs as specialist professionals that align with early intervention principles.
BATOD recognises some children may become deaf post NBHS and would welcome the review of the newborn and school screenings that are scheduled for 2024/2025.
BATOD recommends an expected engagement of the Children’s Hearing Service Working Group (CHSWG) as a forum to maintain and nurture collaboration, comprehensive support, and family-centred practices with strong representation from both regional and national services, charities, parents and other stakeholders. Some CHSWGs can demonstrate their activity relating to variations in service provision eg assessment of children with complex needs, management of temporary deafness, reducing waiting times for routine first assessments and hearing aid reviews, improving experiences for the deaf child and their families.
