EPSDT Care for Kids Newsletter

EPSDT Care for Kids Newsletter

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Identifying Infants at Risk for Hearing Loss
Lenore Holte, Supervisor, Speech Pathology and Audiology Services
University Hospital School, University of Iowa Hospitals and Clinics
Summer 2001

Recent research has demonstrated that early identification and treatment of hearing loss in infants is crucial. As a result, Iowa and several other states have implemented programs of universal hearing screening for newborns. But even infants who pass the newborn hearing screen can be at risk for progressive hearing loss. The indicators below can tell you whether an infant in your care needs to be referred to an audiologist for further hearing evaluation.

Image of a new baby

Most children with hearing loss can develop language skills that are not substantially different from those of other children IF:

Hearing loss is identified before the child is 6 months old
Professional intervention begins immediately
The child uses appropriate hearing aids

For newborns from birth to 28 days old, the indicators below are associated with sensorineural or conductive hearing loss:

In utero infection, such as cytomegalovirus (CMV), rubella, syphilis, herpes, or toxoplasmosis.

An illness or condition requiring admission of 48 hours or longer to an NICU, including hyperbilirubinemia at a serum level requiring exchange transfusion, persistent pulmonary hypertension, and conditions requiring the use of extracorporeal membrane oxygenation (ECMO).
Other findings associated with a syndrome known to include hearing loss
Craniofacial anomalies
Family history of permanent childhood hearing loss

When any of these indicators exist, the primary care provider should refer the child to an audiologist for hearing evaluation.

Later-onset risk indicators are usually identified in the medical home during early well-baby visits. The hearing of infants with any of the following indicators should also be monitored every six months:

Parental or caregiver concern about hearing, language use, or developmental delay.
Infections associated with sensorineural hearing loss, including bacterial meningitis.
Presence of syndromes or conditions associated with progressive hearing loss, such as neurofibromatosis, osteopetrosis, Usher syndrome, Hunter syndrome, Friedreich's ataxia, or Charcot-Marie-Tooth syndrome.
Head trauma.
Recurrent or persistent otitis media with effusion for at least 3 months.

Again, when any of these indicators exist, the primary care provider should refer the child to an audiologist for hearing evaluation.

The hearing of a newborn with any of the early- or late- onset indicators listed above should be closely monitored at least every six months until the child is three years old.

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