Harold C. Pillsbury III, MD, FACS

Transcription

1 Harold C. Pillsbury III, MD, FACS University of North Carolina Ear & Hearing Center Department of Otolaryngology / Head & Neck Surgery, University of North Carolina Chapel Hill, USA

2 Audiologists: Erika Gagnon, AuD Shana Jacobs, AuD Corinne Macpherson, AuD Sarah Martinho, AuD Laurel Okulski, AuD Lisa Park, AuD Jill Ritch, AuD Patricia Roush, AuD Jennifer Woodard, AuD Holly Teagle, AuD Speech-Language Pathologists: Hannah Eskridge, MSP Maegan Evans, PhD Lillian Henderson, MSP Sandra Hancock, MA Erin Thompson, MA Otolaryngologists: Craig Buchman, MD Kevin Brown, MD Carlton Zdanski, MD Harold Pillsbury, III, MD Auditory Physiologists: John Gross, Ph.D Shuman He, Ph.D 2

3 No funding for hearing aids» Commercial insurance or Medicaid No funding for cochlear implants 3

4 We were hearing aid dealers at that time Hearing aids cost us $ a piece Required audiogram and financial statement from family obtained from audiologists across North Carolina If met standard below 150% of poverty level, we supplied hearing aid to audiologists statewide to be distributed to these children Spent $58,000 in first year 4

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6 Bringing in people who are passionate about their work Supporting Grass Roots work with parents Providing training and education to local educators and service providers Collaborating with local and state government Keeping allegiances open and unbiased 6

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9 Pediatric CI Erika Gagnon, AuD Lisa Park, AuD Holly F.B. Teagle, AuD Jennifer Woodard, AuD Harold C. Pillsbury, MD, FACS Chair, Department of Otolaryngology/Head and Neck Surgery Craig A. Buchman, MD, FACS Chief, Division of Otology/Neurotology and Skull Base Surgery Carlton J. Zdanski, MD, FACS Associate Professor Oliver Adunka, MD, FACS Associate Professor Pediatric Audiology UNCH Shana Jacobs, AuD Corrine MacPherson, AuD Sarah Martinho, AuD Laurel Okulski, AuD Jill Ritch, AuD Patricia Roush, AuD Speech-Language Pathologists Hannah Eskridge, MSP Maegan Evans, PhD Sandra Hancock, MA Lillian Henderson, MSP Sabrina Simon, MA Erin Thompson, MA Holly F.B. Teagle, AuD Clinical Assistant Professor CCCDP Director Patricia Roush, AuD Associate Professor, Director of Pediatric Audiology Hannah Eskridge, MSP Clinical Instructor NCFI/Barnhardt CASTLE Director Shuman He, PhD Assistant Professor Auditory Physiologists John Gross, PhD Shuman He, PhD

10 Newborn Infant Hearing Screening mandated in 1999, implemented in 2001 Annual births in North Carolina ~130, % screened at birth, failures referred to UNC Estimated 3-4/1000 have hearing loss(~500) 1/1000 have severe to profound loss (~130)

11 Clinical Care Education & Training CCCDP & CASTLE UNC Ear & Hearing Center Financial Assistance Program Research

12 Carolina Children's Communicative Disorders Program Over 1450 cochlear implant devices since 1991 Financial assistance program for NC children with hearing loss

13 Center for the Acquisition of Spoken language Through Listening Enrichment LSL parent sessions, Tele -therapy/ UNC REACH, Diagnostic evaluations, Toddler and Pre -school Language groups Professional Learning & Coaching Opportunities

14 UNC Pediatric Cochlear Implant Program 949 children 1456 ears Bilateral surgeries starting in : 5 surgeries 2013: 129 surgeries /12/15 14

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18 Team Approach Needed Medical Management Directed by ENT surgeon with pediatric experience Audiology & Speech/Language Diagnostic evaluation by pediatric audiologists and SLPs Medical Collaboration Referrals to medical and therapeutic specialties as needed Habilitation & Education Information from Early Interventionists and Parents regarding child development and progress

19 Pediatric Team Approach to Cochlear Implantation Parents & family Educators Surgeon LSLS/SLP/HI Therapists Child Audiologist Other Professionals

20 The Ideal Process NBHS ABR, Hearing Aid Fitting, Medical Evaluation, Early Intervention Behavioral Testing, Early Intervention, CI Evaluation Cochlear Implantation, Early Intervention Birth 2-4 months 6-9 months months 20

21 Ongoing patient management & care Family Involvement Collaboration with local educators and therapists Frequent visits & documentation of communication development Maintenance of individual & group database 21

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23 Provides hearing technologies and Ear and Hearing related services to children in North Carolina Since 1993 have supported 1648 children in 93 of NC s 100 counties 1/12/15 23

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25 Collaborative Research Cochlear Implantation in Special Populations: Auditory Neuropathy Spectrum Disorder Cochlear Malformations CMV Cochlear Implant Revision Bilateral Cochlear Implantation Bimodal Instrument Use (CI + HA) SSD and CI in Adults NIH Sponsored Childhood Development after Cochlear Implantation (CDaCI) Manufacturer Sponsored Studies Cochlear Pediatric Freedom Post Market Approval Advanced Bionics Bilateral Study MED-EL Little Ears Study

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27 Auditory Brainstem Implant 2012: UNC first center in US to obtain permission from FDA (under IDE) to implant ABI in children. First surgery 4/9/ children have undergone surgery and device activation Collaborative effort to collect longitudinal data: Electrophysiological findings Audiological outcomes Speech and language development

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29 Provide quality Listening and Spoken Language services Empower parents as their child s primary teacher and advocate Provide professional learning and coaching opportunities for students & professionals in the development of spoken language through listening

30 Direct Services to Children and Families - LSL Therapy Sessions with parents - UNC- REACH- tele -therapy services - Preschool and Toddler language groups - Speech-language evaluations

31 Professional Learning Opportunities Carolina Summer Institute UNC REACH tele-coaching Online Webinars Modules School consultations

32 REACH: Tele-Coaching & Tele-Therapy Reaching Educators to Access best practices for Children with Hearing loss 32

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