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Early Identification and Referral Toolbox

Take Action

This section provides examples of suggested activities and materials to help you address needs in your state. The strategies you use will depend on the size of your state and the types of health care providers who tend to serve infants and toddlers with complex health care needs or disabilities.


Most health care providers have limited experience with deaf-blindness, so it’s essential to provide information and training to increase their knowledge of: 

  • Common risk factors and etiologies 
  • The unique needs of infants and toddlers with deaf-blindness
  • What your project does and how to contact you

General tips:

  • Make sure your materials are professional looking and targeted to health care providers 
  • Look for opportunities to partner with physicians and other providers on dissemination (they may be more receptive to information shared by peers)
  • Ask families who have benefited from an early referral to your project to share their experiences (e.g., short vignettes or testimonials) that illustrate the importance of early identification and referral


The following handouts can be used to raise awareness. Add your project's logo and contact information, but keep references and permissions for any original sources.

Rack Card: Identifying Infants and Toddlers with Combined Vision and Hearing Loss
Quick and easy to digest, this basic deaf-blind awareness information can be placed on racks in offices, outpatient clinics, and hospitals

The Impact of Combined Vision and Hearing Loss 
Health care providers can share this with family members who have a child identified with deaf-blindness.

Deaf-Blindness Overview – NCDB Website
Encourage providers to visit this resource to learn more about children who are deaf-blind.

Brochure Examples:

Information about risk factors:

Academic Detailing


Academic detailing is a form of educational outreach designed to encourage health care providers to improve patient care. This strategy has been adapted for increasing referrals and involves (Dunst et al., 2006):

  • Building and establishing rapport
  • Repeating a focused message
  • Providing written information about the benefits of referral
  • Follow-up visits to answer questions or provide additional information


Academic Detailing as a Strategy for Increasing Referrals to Early Intervention
Academic detailing principles that may be useful in your outreach to health care providers.

Improving Outreach to Primary Referral Sources
Describes an approach to primary referral source outreach.

National Resource Center for Academic Detailing
National technical assistance center for clinical outreach education.

Recorded Webinar — Academic Detailing: Changing Prescriber Behavior
Overview of academic detailing elements and processes. The focus is on changing behavior related to prescribing medications, but is applicable to other areas of change.

Improve Referral Processes


Create a memorandum of understanding or other type of agreement that outlines the responsibilities of your project and the agency. 

Work with health care community contacts (e.g., social workers in NICUs and medical homes, Children and Youth with Special Health Care Needs program staff, developmental pediatricians) to develop a process that outlines how to refer children with suspected or confirmed deaf-blindness to your project. It should include:

  • Information about how to talk to a family about deaf-blindness
  • An explanation of your state deaf-blind project and its services for families and early intervention providers
  • Concise materials and referral forms that are easy to read and complete

Provide Training


Talk to your contacts in the health care system about their training and information needs and ways to incorporate information on deaf-blindness into existing meetings or activities. Examples include:

  • Grand rounds
  • Pre-service nursing and medical school training
  • Residency training
  • Conferences
  • Continuing education 

Contact state chapters of organizations that provide professional development for additional ideas (see “Build Partnerships”).

Relevant training topics:

  • The impact of having a child with deaf-blindness and why early identification and referral are important (this is likely to be especially interesting and relevant to health care providers if presented by a parent) 
  • Characteristics and risk factors of deaf-blindness
  • Cortical visual impairment

Use child count data to enhance discussions and presentations.


Introduction to Deaf-Blindness Slide Presentation
Can be customized for presentations on risk factors and etiologies commonly associated with deaf-blindness, the importance of early identification and referral, and the uniqueness of deaf-blindness as a disability.

The Sooner the Better: A Framework for Training Early Intervention Practitioners on Deaf-Blindness 
A collection of online resources to provide training to early intervention providers and families. The section, “Overview of Deaf-Blindness,” focuses on the identification of children with combined vision and hearing loss.

Share Screening and Assessment Tools


Provide vision and hearing screening and assessment resources to health care providers, that they can use with families and educators. There are a number of checklists and tools available for these purposes.


What Does Your Child See?/What Does Your Child Hear?
A basic checklist to assist in determining the possibility of vision and/or hearing loss.

Informal Functional Hearing Evaluation (IFHE)
A comprehensive tool to help identify functional hearing loss. 

A Tool for Identifying Vision and Hearing Loss in Children with Multiple Disabilities
A checklist to assist in determining vision or hearing loss. 

What is CVI?
Visual behaviors that suggest a child may have a cortical visual impairment (CVI).


Dunst, C. J., Trivette, C. M., Shelden, M., & Rush, D. (2006). Academic detailing as an outreach strategy for increasing referrals to early intervention. Snapshots, 2(3), 1-9.