It is recommended that in addition to an audiologic evaluation, a medical evaluation is done to identify any possible medical conditions that may be interfering with the hearing screening results. The medical evaluation may include a medical history, physical examination, laboratory testing or consultation with other doctors.
Information for Healthcare Professionals
Prenatal
During prenatal visits, discuss the hearing screening done at birth. It is important to know that a hearing screening will likely be done before the baby leaves the hospital.
Screening and Diagnostic Evaluation Timeline
Screen by 1 month of age
Your baby's hearing can be screened soon after birth and before leaving the hospital.
In South Dakota, all of the hospitals that deliver babies on a regular basis have hearing screening equipment.
If the baby does not pass the first hearing screening, it is important that the family follow-up with a second screening, called a re-screening. The re-screening should be done before the baby is one month of age.
3 Month Diagnostic Evaluation
Newborn Hearing Loss Risk Factors & Causes
Genetic
> 50% of all infant hearing loss cases may be attributed to genetics
> Family history of permanent childhood hearing loss
> Syndrome commonly associated with hearing loss (account for 1/3 of genetic cases)
> Down
> Usher
> Wardenburg
> Neurofibromatosis
Environmental
Exposure to an infection in-utero:
> Cytomegalovirus (CMV) - a virus from the same family as herpes. There is no immunization against CMV. It is spread in the air and in droplet form.
> Toxoplasmosis - an infection found in people, cats, birds and other animals. Most people with toxoplasmosis have no symptoms. To prevent exposure, pregnant women should avoid cat litter or dirt and should not eat uncooked meat.
> Group B Strep (GBS)
> Syphilis
> Rubella (German Measles)
> Herpes Simples Virus (HSV)
NICU stay
Physiological
> Hyperbilirubinemia needing a blood transfusion
Exposure to certain medications used in high doses:
> Gentamicin
Physical
> Low birth weight - less than 1,500 grams
> Head, face and ear anomalies
Delayed-onset Hearing Loss
> Delayed-onset hearing loss is when a child passes their newborn hearing screening as an infant but develops hearing loss by the age of 3. Delayed-onset hearing loss can happen at any time to a child who was born with a risk factor like those listed above.
6 Month Early Intervention & Beyond
Provide the appropriate referrals:
- South Dakota Department of Health (SD DOH) Newborn Hearing Screening Program
- South Dakota Department of Education (SD DOE) Birth to Three Early Intervention Program
- Other specialists if needed such as otolaryngologists, ophthalmologists, cardiologists, nephrologists, geneticists, etc. (per NCHAM)
It is essential that appropriate services begin as soon as possible, preferably before six months of age, so speech and language development is not delayed. These delays can negatively impact a child's social and emotional growth and academic achievement.
Beyond 6 months of age
Some babies have a hearing loss that is not present at birth. These babies develop a hearing loss as they grow. This change in hearing may result from risk factors such as a head trauma, certain illnesses, medications or genetic causes.
Helpful Links for Providers
- ASHA Audiologist Roles, Knowledge and Skills
- Newborn Hearing Program | South Dakota Department of Health
- Guidelines for the Audiologic Assessment of Children From Birth to 5 Years of Age
- EHDI 101
- Microsoft Word - Act Sheet - Hearing Loss _4.17.06_.doc
- Hearing Assessment Recommendations
- EDHI_FAQ for Pediatricians
- Guidelines for Medical Home Providers
- Provider Checklist for Hearing Screenings
- Follow-up-handout-generic.pdf
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