For Parents

Hearing

PARENTS

It is important to determine whether a baby has hearing loss as soon as possible so parents and health care providers can provide the best possible resources for language and communication development. Florida’s Early Hearing Detection and Intervention (EHDI) Program is committed to providing parents with relevant and helpful information before and after diagnosis. Explore the links below to get more information and resources on newborn hearing screenings and what to do if your baby is diagnosed with hearing loss.

Diagnosis & Intervention

All children deserve the best chance for reaching their full potential. To help achieve this outcome for children diagnosed with hearing loss, Florida EHDI staff will provide parents with educational resources and materials, and referrals to early intervention programs such as the Florida Early Steps Program. Early Steps offers intervention services, hearing aids, speech therapy, and other types of support.

The objective of the EHDI Program is to encourage early diagnosis of hearing loss and provide the opportunity for early intervention. Florida follows the Joint Committee on Infant Hearing (JCIH), 2019 guidelines for:

  • Hearing screening by 1 month of age;
  • Hearing loss diagnosed by 3 months of age; and
  • Early intervention by 6 months of age.

Hospitals and audiology practices providing inpatient and outpatient hearing screens are an essential part of the Florida EHDI team. This page provides easy access to the eReportsTM system in order to report screening and diagnostic results, and it makes relevant resources available to medical professionals around the state.

Florida Statutes requires hearing screenings of all newborns, unless a parent objects. Florida EHDI staff tracks all newborns who do not pass their initial hearing test and, if needed, facilitates rescreening and diagnostic testing. All related data are reported annually to the Centers for Disease Control and Prevention.

The Florida EHDI Program strives to meet the following time frames set forth by the Joint Committee on Infant Hearing to ensure optimum outcomes for infants and toddlers.

A Florida Parent’s Guide to Hearing

After diagnosis is confirmed, EHDI staff will send parents a copy of A Florida Parent’s Guide to Hearing. It is also available to download in English or Spanish. Request free copies by submitting a request form.

Each section of the Parent Guide offers information and resources for every step in your child’s journey, including information on:

  • How to understand and address your emotions, fears, and concerns;
  • The types, degrees, and causes of hearing loss;
  • Hearing aids, cochlear implants, and other hearing technologies;
  • The professionals who may be part of your child’s intervention team; 
  • The wide variety of communication options available to your family;
  • Laws supporting your child’s education; and
  • How to become an advocate for your child

PARENT RESOURCES

The Florida Newborn Hearing Screening/EHDI Program has partnered with the Parent Infant Program, an outreach program of The Florida School for the Deaf and the Blind, to provide expanded services for families with infants and toddlers who are newly diagnosed as Deaf or Hard of Hearing.

These services include:

  • Parent-to-Parent Support through the Parent Empowerment Program initiative.
    • Parent support is provided by Parent Leaders who themselves are parents of children who are deaf or hard of hearing and are specially trained to help parents navigate the emotions, the questions, and the logistics of parenting a deaf or hard of hearing child. 
  • Deaf Mentor Program
    • This program pairs families that have questions about deafness with deaf adults from varying communication modalities and backgrounds.
    • Families are provided the opportunity to meet with a deaf adult and ask questions without fear of judgement.
    • Opportunities to explore Deafness as a culture and American Sign Language are available. 
  • Regional Learning Communities
    • Groups are being formed around the state with stakeholders of the EHDI Program: parents, pediatric health care professionals from various organizations, clinicians, care coordinators, early intervention professionals, and education professionals. The purpose is to increase the knowledge and engagement of pediatric health care professionals and families as well as to identify regional gaps and barriers for infants and toddlers who are deaf or hard of hearing.  Together we will work towards closing gaps and improving access to services that address early access to communication and language.

Explore these additional resources for in-depth information about hearing screening and why it’s so important:

American Speech-Language-Hearing Association (ASHA) – Provides causes of hearing loss in children.

Boys Town National Research Hospital (My Baby’s Hearing) was created to answer parents’ questions about infant hearing screening and follow up testing, steps to take after diagnosis of hearing loss, hearing loss & hearing aids, language and speech, and parenting issues.

EHDI-PALS a national web-based directory of facilities that offer pediatric audiology services to young children who are younger than five years of age.

Giving Your Baby a Sound Beginning (English): A short video introduction on why hospitals conduct newborn hearing screening. Also available in Spanish.

National Center for Hearing Assessment and Management (NCHAM) – Serves as the national resource center for the implementation and improvement of comprehensive and effective EHDI systems. As a multidisciplinary center, the goal is to ensure that all infants and toddlers with hearing loss are identified as early as possible and provided with timely and appropriate audiological, educational, and medical intervention.

Explore these additional resources for in-depth information about hearing loss and support for families of infants and toddlers who are deaf and hard of hearing. 


Early Steps Regional Office Contact List

Florida Deaf and Hard of Hearing Resource Directory

Centers for Disease Control (CDC) Free Materials on Hearing: Brochures, posters, fact sheets, and more for parents, health care providers, and public health professionals

Hearing Loss in Children: The Centers for Disease Control and Prevention (CDC) resource website for pediatric hearing loss.

Florida Kidcare: Comprehensive child-centered health and dental insurance for children ages 0-18.

What is a hearing screening?

A hearing screening is a safe, painless, and quick test that is performed while the newborn is sleeping. This test checks to see how well your baby’s hearing responds to different sounds. Your baby will either pass or refer (need more testing) in one or both ears. Results are often available before hospital discharge.

  • Not all babies pass the hearing screening the first time.
  • If your baby does not pass the first hearing screening, additional screenings may be completed at the hospital before discharge. 
  • If your baby does not pass the final hearing screening, additional hearing testing is necessary before your baby is 3 months old.

 

How long does a hearing screening take?

There are two tests that are used to examine baby’s hearing; an otoacoustic emissions (OAEs) test and automated auditory brainstem response (AABR) test. Both tests are painless and performed at the hospital while your baby is resting or asleep. Hospitals may use one or both types of equipment for testing.

  • 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. This test typically takes between five to ten minutes to complete.
  • An AABR 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. Average testing time for this type of test takes between 10 to 20 minutes to complete.

My baby is in the Neonatal Intensive Care Unit (NICU), will my baby receive a hearing screening?

Yes, your baby will be screened before discharge from the NICU. Babies who spend more than five days in the neonatal intensive care unit (NICU) should receive an AABR test. If your baby did not pass the hearing screening in one or both ears, it is very important to find out if your baby has a hearing loss.  Talk to your baby’s primary care doctor about a referral to a Pediatric Audiologist.

How will I get my baby’s hearing screen results?

In most cases results will be given to the parent before leaving the hospital or birth center. Your primary care physician will also have access to the results.

What happens if my baby doesn’t pass the second hearing screening?

  • Talk to your baby’s doctor about a referral to see a Pediatric Audiologist.
  • If your baby needs more testing, get it done as soon as possible. 
  • All testing to find out if your baby has a hearing loss should be finished by 3 months of age.

Why didn’t my baby pass the hearing screening at birth?

If your baby did not pass the hearing screen, it does not necessarily mean that your baby has hearing loss.  There are many reasons why babies don’t pass hearing screenings, but the only way to know if your baby has a hearing loss is to do additional testing.

Why did I receive a letter or phone call from Florida EHDI when my baby passed the hearing screen at birth?

Sometimes parents will receive a letter from the Department of Health stating that baby didn’t pass the newborn hearing screening. This is not intended to alarm, in most cases, this occurs when the hospital completes another hearing screening before your baby was discharged but did not provide the updated passing records to the Florida EHDI Program. If you received a letter, and have passing results for your infant’s hearing screening, please call the phone number on the letter and let the Program know so that your baby’s records can be updated.

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.

How does my baby hear?

Your baby’s ear is made of many parts that carry sound to the brain. These parts are called: the outer ear, middle ear and the inner ear.  Each are responsible for sending sounds to your baby’s brain. Many different things can happen to parts of the ear that can impact baby’s hearing.

Vector Illustration Of Human Ear Detailed Anatomy

 

All children deserve the best chance for reaching their full potential. To help achieve this outcome for children diagnosed with hearing loss, Florida EHDI staff will provide parents with educational resources and materials, and referrals to early intervention programs such as the Florida Early Steps Program. Early Steps offers intervention services, hearing aids, speech therapy, and other types of support.

How do pediatric audiologists test a baby’s hearing?

When a part of the hearing system is not working in the usual way, a pediatric audiologist will test your baby’s hearing to determine the degree and type of hearing loss. Diagnostic hearing testing takes longer than a hearing screening (typically 1-2 hours) and requires your baby to rest or sleep for the duration of testing.

  • 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).

Are there different levels or degrees of hearing loss?

Yes, not all hearing loss is the same. Hearing loss is described using different levels or degrees. 

  • Mild hearing loss: may hear some speech but soft sounds are hard to hear
  • Moderate hearing loss: may not hear speech when someone else is speaking at a normal level
  • Severe hearing loss: unable to hear speech when someone is speaking at a normal level and some loud sounds
  • Profound hearing loss: unable to hear speech and only very loud sounds

Are there different types of hearing loss?

Yes, there are four types of hearing loss:

  • Conductive hearing loss: sounds are not carried through the outer or middle ear
  • Sensorineural hearing loss: sounds are not carried through the inner ear or hearing nerve 
  • Mixed hearing loss: both conductive and sensorineural hearing loss
  • Auditory Neuropathy Spectrum Disorder (ANSD): problem with transmission of sound from the inner ear to the brain

 

What happens if my baby is diagnosed with hearing loss?

The EHDI Program offers information, resources, and consultation for parents with newborns who are deaf or have varying levels of impaired hearing. EHDI staff also will refer your baby Early Steps, an early intervention program. Early Steps offers early intervention services, hearing aids, speech therapy, and other types of support that may benefit infants and toddlers up to age 3.

If your baby has been diagnosed with hearing loss and you would like to speak with the parent of a child who is deaf or hard of hearing, please contact our Parent Advocate, Miranda Nerland, at 850-404-3014, or Miranda.Nerland@flhealth.gov

If you still have questions or concerns, please don’t hesitate to contact the EHDI staff.

Address:
Division of Children’s Medical Services
Florida Department of Health
4052 Bald Cypress Way, Bin A-06
Tallahassee, FL. 32399-1707

Phone: 866-289-2037

Email: CMS.NBSHearing@flhealth.gov

Website: floridanewbornscreening.com/hearing