For Specialists

Hearing

Health Care Providers Are Essential

Health Care Providers and Hearing Professionals are an essential part of the Florida EHDI team. This page will provide easy access to the eReports system in order to report screening and diagnostic results, as well as making relevant resources available to the medical professionals around the state.

The objective of the EHDI program is to encourage early diagnosis of hearing loss and provide the opportunity for early intervention.

Florida Statute requires that all babies are screened for hearing loss at birth, unless a parent objects. EHDI staff tracks all newborns that do not pass their initial hearing screening to encourage rescreening and diagnostic testing, if needed. This data is reported annually to the Centers for Disease Control and Prevention.

Reporting Hearing Screening Results

How to Report Screening Results

There are three methods to report results:

1. Hearing screening results are preferred to be entered through eReports, no later than 10 days after the hearing screening is completed.

2. Enter results on the newborn screening blood specimen card. Please use the link below for instructions on how to complete the hearing section of the card.

How to Complete the Hearing Section of the Blood Card (link to new version of card with annotations or interactive hints for completion).

3. Enter results through the Newborn Screening Web Order Application (if your facility participates in this system).

Hearing Screening Methods

  • Otoacoustic Emissions (OAE) – A miniature earphone and microphone are placed in the ear, sounds are played and a response is measured.
  • Auditory Brainstem Response (ABR) – The best test available for newborns and infants up to 6 months of age that can provide information about the softest level of sound the ear can hear. Sounds are played to the baby’s ears and band-aid like electrodes are placed on the baby’s head to detect responses. Sounds are presented to the ears using small earphones. The electrodes pick up responses from the hearing nerve and a computer measures the responses to identify babies who have a hearing loss.

Best Practices

  • Hearing Screenings must be reported via eReports as soon as possible, but no later than 10 days
  • Use of the Repeat Hearing Screening Form is no longer preferred for reporting hearing screening results and should only be when eReports is not available
  • Newborns may be screened by either AABR or OAE equipment 
  • Babies who received NICU care > 5 days should be screened using an AABR
  • A child who does not pass the initial screening but is still at the hospital should be retested prior to discharge. 
  • Rescreening should be completed on both ears. even when one ear passed the initial hearing screening.
  • Hospitals are cautioned not to allow excessive rescreening to try to obtain a passing result.  
  • If a baby does not pass two hearing screenings, referral for diagnostic testing is necessary. Ask baby’s PCP for a referral to a pediatric audiologist by three months of age.

More Resources

Provider Road Map
1-3-6 Guidelines
Section 383.145, Florida Statutes
NCHAM Newborn Hearing Screening Training Curriculum

Reporting Diagnostic Results

Who should be reporting:

  • Audiologists performing diagnostic hearing testing on children 0-3 years of age must report results to EDHI program via eReports

What should be reported:

  • All diagnostic hearing test results, for every appointment until confirmed diagnosis is reached for each ear, including normal hearing
  • Follow-up appointment date (must contain 8 digits, xx/xx/xxxx) 
  • Diagnosis entered for each appointment; this includes reporting for no show and cancelled appointments

When should these results be reported:

  • Evaluation testing results must be reported to the EHDI Program with two business days of the evaluation via eReports
  • Reporting diagnostic results timely is critical to ensure infants receive timely referrals to Early Steps, as well as to reduce or eliminate unnecessary follow-up.
  • The EHDI Program refers all infants reported with hearing loss directly to the Early Steps Program, which will assist families with purchasing hearing aids, as well as providing access to speech therapy, and other hearing-related services. 
  • EHDI staff also sends each family of children diagnosed with hearing loss a packet of information about hearing loss, as well as resources within the state that may be helpful for parent-to-parent support and deaf mentorship. Timely reporting is critical to ensure these families receive the information they need, right when they need it most. 

How should diagnostic results be reported to EHDI?

  • Diagnostic test results must be reported via eReports. 
  • To set up an eReports account, please send an email to eReports@flhealth.gov with the following information:
    • Your last, first name
    • Audiology practice or clinic name
    • Email and phone number

Once your account is activated, you will receive an email confirmation with your username and temporary password (you will be prompted to change the password when at initial log in)

  • Use of the Diagnostic Testing Form is no longer preferred for reporting diagnostic results and should only be used when eReports is not available 

Diagnostic testing included for reporting: 

  • Auditory brainstem response (ABR) is the gold-standard for determining the softest level of hearing for infants under 6 months of age.  ABR provides ear specific and frequency (or tone) specific information necessary for diagnosis of the type and degree of hearing loss.
    • A diagnostic ABR test uses small earphones or earmuffs to produce soft sounds into each ear.  Band aid-like electrodes are attached to your baby’s skin that detect how sounds are carried to and from the brain. An ABR provides the most information about the softest level of sound your baby can hear
    • Diagnostic ABR testing is painless for your baby
    • Diagnostic ABR is not a screening and will require your baby to sleep during testing (average testing time is 2 hours)
  • Diagnostic Otoacoustic Emissions (OAEs) provides important information about how well the inner ear, or cochlea receives sound.  When the cochlea is functioning normally, it will produce a low-intensity sound or “echo” called an OAE.  The OAE is measured and determined to be present or absent. 
    • An OAE test uses a miniature earphone placed in each ear that produces soft sounds.  These sounds generate an “echo” that is measured by a microphone inside the earphone. 
    • Diagnostic OAE testing is painless for your baby and should be completed  while your baby is resting or asleep
    • Diagnostic OAE testing takes much less time than for diagnostic ABR (average testing time is a 5-10 minutes); often both tests can be completed during the same appointment
  • Tympanometry measures the condition of your baby’s middle ear system, which includes the eardrum and middle ear bones. Specialized equipment that produces a high frequency tone is used for very young infants due to the soft, smaller ear canals.  
    • A tympanometry measurement uses a small probe tip placed in the opening of your baby’s ear canal 
    • The probe creates variations of air pressure inside the ear canal
    • Tympanometry is painless for your baby and should be completed while your baby is resting or asleep 
    • Tympanometry testing takes about 5-10 minutes to complete
  • Visual Reinforcement Audiometry (VRA) is a hearing test for babies 6 months to 36 months of age who are able to sit up and turn their head, while sitting on a caregiver’s lap.  As your baby grows, behavioral testing in a sound booth allows for more specific “plotting” of hearing test results using an audiogram (graph showing hearing test results).  
    • During VRA testing, sounds are presented to baby inside the sound booth, through speakers, headphones or earphones
    • A light or moving toy will activate when baby turns toward the sound
    • Speech may also be presented to check how well your baby responds to speech sounds

The audiologist presents sounds at the lowest level (threshold) to find out how your baby can detect sound at different frequencies (or pitch levels)

More Resources:

Electronic diagnostic form (only when eReports not available)
Diagnostic eReporting and link to ppt provided
Section 383.146, Florida Statutes
List of ES Providers