In Iowa, newborn screening is performed shortly after birth to check for hearing differences. For babies born outside of the hospital, a family can take their baby to any local Area Education Agency, private audiologist or local hospital to perform the hearing screening. Contact EHDI staff at 833-496-8040 (toll free) to assist you in find a hearing screening location near you.
A hearing screen takes just a few minutes. It is safe and painless. There are two types of hearing screenings performed in Iowa. Oto-acoustic emissions (OAE) screenings are done by sending sound into the baby’s ear canal as a small microphone measures the response of the cochlea inside the ear. Another test used is called an automated auditory brainstem response test (AABR), which provides sounds to the baby with earphones. Electrodes are placed on the baby’s skin to measure brainstem activity in response to the sound. If your baby is in the Neonatal Intensive Care Unity (NICU), your baby is required to have an AABR screening. Examples of hearing screening can be watched in the video links below.
Please contact Iowa Family Support Network for the locations nearest you or call the EHDI program at (833) 436-8040. You may be able to return to the birth hospital, see an educational audiologist at your local Area Education Agency or visit a private practice audiologist.
This means the baby did not pass the newborn hearing screen. It does not necessarily mean your baby has hearing difference. Your baby must return for a follow-up hearing screen which is similar to the newborn screen. Some audiologists may complete a diagnostic test at the time of the re-screen.
Options for re-screening include returning to the birth hospital, seeing an educational audiologist at your local Area Education Agency or seeing a private practice audiologist.
It is possible. Some babies are born with medical conditions that are associated with hearing differences. These may include infections, such as CMV, herpes, rubella, syphilis or toxoplasmosis. Children with some syndromes or differences in the shape of the head/face can have hearing differences. Newborns that have stays longer than five days in an intensive care unit or require transfusions for jaundice may also be at risk for hearing differences. Certain chemotherapy treatments or medications typically used to treat severe infections are known to be toxic to the hearing system. Additionally, a family history of childhood hearing differences may indicate a genetic disposition towards hearing differences.
Much of a child’s ability to communicate relies on hearing. It is important to find hearing differences as early as possible because babies start learning how to use sound as soon as they are born. Listening in the first months of life prepares babies to speak. Babies start by babbling and using many of the sounds they hear spoken around them. By their first birthday, babies are already learning what words mean. These early steps are building blocks for communication. The first step to identifying hearing differences and avoiding the disruption of development is screening.
You and your primary care doctor will receive a letter outlining suggested follow up for children with risk factors for late onset hearing differences. If you have questions about whether your child is at risk for hearing differences, ask your primary care provider or audiologist.
Auditory Brainstem Response (ABR) testing is a hearing test for babies who have not passed their newborn hearing screening or follow-up screening. An ABR helps an audiologist test how a sound is being sent through your baby’s ear system. Because your baby cannot raise their hand to a beep when they hear it, your audiologist has another way to check their hearing. Sticky electrodes are placed on your baby’s head and soft foam tips are placed in their ears during the test to check hearing.
Your child will not feel anything during this test and should sleep comfortably throughout the testing process. It is important to the testing process that your child is still and does not move throughout the test. If your child wakes up or cannot settle into a comfortable sleep during testing, the test make take longer or you may need to reschedule for additional time. When the test is over, you will have a better idea about your child’s hearing ability.
Your audiologist may have specific directions for you to follow before your baby is tested. Please make sure you check with the audiologist that will be seeing your baby prior to their appointment if you have any questions.
Here are some additional tips for your baby’s ABR appointment:
Do not let your child sleep on the way to the appointment. Keep your baby awake prior to testing. It may be necessary for you to bring another adult to keep the child awake in the car ride.
Medication is usually not used to make your child sleep, so the audiologist will need to wait until your child is sleeping before beginning the testing process.
You may want to arrive 20 to 30 minutes early to your appointment so that you can change your baby’s diaper or prepare a bottle for feeding before the appointment begins.
Be aware that the testing process may take up to two hours, depending on the ability of your child to sleep. Please plan enough time in your schedule.
If you have a feeding time close to your ABR appointment, wait to feed your child until you are at the office. Feeding your child just before your appointment time or as the ABR is being set up can help your child feel sleepy, comfortable and full when the testing begins.
You will want to bring extra diapers and change your child when you arrive at the appointment. A diaper change before the test begins will help to your baby stay comfortable and sleep during the test.
If possible, bring your child’s car or baby seat to the appointment. If your child does fall asleep on the way to the appointment, or seems drowsy, do not remove them from their car seat to bring them to the appointment.
Do not put lotion on your child’s face the day of the appointment as this may make it hard for the electrodes to stay in place during the test.
Do not bring other children with you. The testing room is not set up for playing with small children and a quiet environment is very important for testing.
If your newborn undergoes screening and does not pass the hearing screens, it is recommended he or she receives a diagnostic assessment before three months of age. A diagnostic assessment is a test to give you more information about the hearing abilities of your newborn. You can learn from an audiologist about how a diagnostic assessment is performed. Not all audiology providers are able to provide this test for young infants. Find an appropriate diagnostic audiology center near you by contacting the Iowa EHDI staff at (833) 496-8040.
If your newborn has already received a diagnosis of a permanent hearing differences, you will receive the written results from your provider. There is a spectrum along which diagnosis could occur, from completely deaf to slightly hard-of-hearing to at-risk for hearing differences. Your understanding of your baby’s hearing differences and the services available to your baby and family will play an essential role in helping your child to succeed. We are here to help your family learn about hearing differences and where to go for support services.
After your child has received a diagnosis of a permanent hearing difference, our program will send your family a family guide. The family guide is available in English and Spanish (Guia para Familia en Español). This family guide is meant to get you started in knowing what are some next steps and resources available to your child and your family related to the newly diagnosed hearing difference. The family guide is not a comprehensive list, however, it was designed by families and professionals with families like yours in mind.
Need help understanding the medical and audiology terms and vocabulary used to describe your child’s hearing differences, communication methods, assistive hearing devices, etc.? Use this glossary to improve communication with the health professionals caring for your child.
If diagnostic testing shows that your baby has a hearing difference, a number of professionals will work together to help your baby and family. Professionals may include the following:
Pediatric Audiologist - A professional who specializes in testing the hearing of infants and children and recommends hearing aids and other forms of treatment or interventions.
Pediatrician or Family Practitioner - A doctor who provides health care for infants and children.
Ear, Nose and Throat Physician - A doctor who specializes in problems of the ear, nose and throat.
Early ACCESS Service Coordinator – A mediator that works with early intervention programs. They work closely with families to identify their needs and ensure that providers work together to meet those needs.
Early Intervention Specialist – An educator that specializes in working with infants who have hearing differences.
Genetics Team - A group of professionals that help counsel on the potential genetic component of hearing differences.
Speech Pathologist - A trained professional that works with individuals who have speech and language difficulties.
All of these professionals will provide support to your family and work together to assist in your baby’s development.
After diagnostic testing shows that your baby has a hearing difference or is at-risk for hearing difference, it is important that conversations begin about intervention options. By intervening early, speech delays can be avoided. Early intervention is a system of services that helps babies and toddlers with developmental delays or disabilities. Early intervention focuses on helping eligible babies and toddlers learn skills that typically develop during the first three years of life.
Iowa's early intervention system is called Early ACCESS. Early ACCESS works with families to identify child and family needs and coordinate services to meet those needs. Early intervention can make a difference. If you are interested in early intervention, refer to the Iowa Family Support Network's website below. Together, with the help of other parents of children with hearing differences, professionals and your family, you will work towards incorporating your child’s hearing differences into your everyday life.
Making decisions throughout the hearing screening process requires accurate information. Explore the common misconceptions surrounding hearing differences below.
Fact: Children identified with hearing differences after 6 months of age are more likely to have speech, language, and cognitive delays than children identified before 6 months. Children identified early can avoid these delays through evidence-based early intervention programs.
Fact: Hearing difference affects about 1 to 3 children per 1,000 births, and is considered to be one of the most common birth defects.
Fact: Before newborn hearing screening, most children were not found to have a hearing difference until 2-3 years of age. Children with milder hearing difference weren't found until 4 years of age.
Fact: As many as 50% of infants born with hearing differences have no known risk factors.
Fact: Babies younger than 3 months can typically be tested without need for sedation.
Fact: Children as young as 1 month of age can now be fit with and benefit from hearing aids.
Fact: 95% of babies born with hearing differences are born to parents with normal hearing.
