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E-Michigan Deaf and Hard of Hearing People.

Infant Hearing Screening

Downloads below are the first printing with revisions, of the Guidelines for Newborn Hearing Services for the Michigan’s Early Hearing Detection and Intervention System. In the Fall of 2000, The Michigan Association for Deaf, Hearing, and Speech Services (MADHS) along with the Michigan Department of Community Health, Early Hearing Detection and Intervention (MDCH/EHDI) Program, asked professionals and families in the Michigan community to develop statewide protocols for newborn hearing services. Five protocol committees were formed: Medical Home, Hearing Screening, Audiologic Assessment, Genetics, and Early Intervention. Committee members met over the next year, spending countless hours researching, discussing important issues, and writing drafts. Drafts were distributed to consumers, professionals in related hearing fields, educators, organizations, audiologists, physicians, and others for review and comments. Comments and suggestions were thoroughly discussed and incorporated into the final guidelines. It is hoped that after such efforts, the Guidelines for Newborn Hearing Services will provide direction and consistency in the standard of care for Michigan’s newborns. The guidelines will be open for public comment once a year in the month of December. Comments should be submitted in writing to MADHS (2929 Covington Court, Suite 200 Lansing, MI 48912, Early Identification Subcommittee.

You are welcome to order the guidelines or copy selected guidelines as may be needed. Copies can be obtained by calling the MADHS at (517) 487–0066 or the MDCH/EHDI Program at (517) 335–9560.

Michigan’s Early Hearing Detection and Intervention System continues to grow since its beginning in 1997. The goals of the program are 1) to have all Michigan newborns receive a hearing screen by one month of age, 2) for newborns who do not pass the hearing screen to have hearing outcomes by three months of age, and 3) for infants identified with hearing loss to have early intervention services initiated by six months of age. Michigan is making progress on these goals.

  • As of 2002, 101/102 birthing hospitals have universal newborn hearing screening programs
  • In the 4th quarter of 2001, 89.5% of newborns had a hearing screen reported
  • In the Year 2000, 72% of newborns with a bilateral refer hearing screen received a diagnostic outcomes
  • In the Year 2000, the prevalence of hearing loss was 1.92 per 1000 newborns
  • In the beginning of 2002, 52% of infants with hearing loss had documented enrollment in Early On ® Michigan, and 18% were pending medical treatment.

We have come a long way but, we still have work to do.

Michigan’s Early Hearing Detection and Intervention System is a voluntary system, relying on Michigan’s efforts in reporting (i.e., hearing screen, diagnostic and early intervention outcomes) to the MDCH/EHDI Program and the continual collaboration with hospitals, Medical Homes, audiologists, early interventionists, educators, local health departments, advocates, parent(s)/caregiver(s) and others with interest in the early hearing detection and intervention.

The Word document download below contains the following contents:

Guidelines for Medical Home

The Medical Home should ensure that all newborns receive a hearing screen before ONE MONTH OF AGE. If the result of the hearing screen is unknown, the Medical Home should contact the birthing hospital’s newborn hearing screening program to determine the hearing screen result. For those newborns who do not pass the birth–admission hearing screen, the Medical Home should ensure that a complete diagnostic outcome is obtained before the infant is THREE MONTHS OF AGE. If a hearing loss is identified, the Medical Home should ensure that early intervention services are initiated before the infant is SIX MONTHS OF AGE.

Guidelines for Hearing Screening

A goal of newborn hearing screening is to ensure that all newborns receive a hearing screen before discharge from the hospital or before one month of age. All hospitals performing hearing screening services should inform families that their newborn will have a hearing screen as part of the hospital’s standard of care. The family should have the opportunity to waive this service if desired. The importance of newborn hearing screening and early identification of potential hearing loss should be relayed to parent(s)/caregiver(s) relative to its impact on speech, language, social, emotional, and cognitive development. Information on developmental milestones for speech and language development should also be made available to families of newborns. The brochure, Michigan’s Hearing Screening Program: Information for Parents can assist with this information. Brochures are available, free of charge, in English, Spanish, and Arabic by contacting the Michigan Department of Community Health, Early Hearing Detection and Intervention (MDCH/EHDI) Program at (517) 335–9560.

Guidelines for Audiologic Assessment

Audiologic evaluation of infants should be completed as soon as possible after a referral from the newborn hearing screening. The assessment should be completed by the time the child is three months of age to determine ear specific and frequency specific information regarding the type, degree and configuration of hearing loss. In the best interest of infants and children with hearing loss, these guidelines are strongly recommended.

Guidelines for Genetic Evaluation Referral

Genetic hearing loss is usually divided into two categories. In approximately 70% of cases present at birth, the hearing loss occurs as an isolated trait and is called nonsyndromic. The auditory deficit in nonsyndromic hearing loss can vary, but is most often sensorineural. It can be unilateral or bilateral, congenital or late–onset, and stable or progressive. The remaining 30% of hearing loss is classified as syndromic, meaning that it occurs as part of a collection of anomalies (i.e., physical features and/or medical conditions). Syndromic hearing loss varies widely and can be conductive, sensorineural or mixed; unilateral or bilateral; congenital or late–onset; and stable or progressive (Resendes et al, 2001). There are at least 75 genetic types of nonsyndromic hearing loss (Van Camp & Smith, 2002) and more than 400 genetic types of syndromic hearing loss (Gorlin, et al, 1995; Stell & Kros, 2001). Children born with hearing loss often have the same physical and cognitive development as those who are born hearing.

Guidelines for Early Intervention

The goals of newborn hearing screening are to provide a hearing screen to all newborns before one month of age, to ensure that all newborns who do not pass the birth admission hearing screen obtain a diagnostic outcome before three months of age, and for all infants identified with hearing loss to obtain intervention services before six months of age. Identifying a baby with hearing loss as early as possible, can allow early intervention strategies to optimize the critical language learning years of a young child. The goal of early intervention is to provide every child with a hearing loss the opportunity to develop an effective communication system. Thus, a primary focus of early intervention is on providing parent(s)/caregiver(s) with the information and skills needed to communicate naturally with their child, as they are engaged in everyday activities.


Below are the links to Infant Hearing Screening documents including powerpoint presentations.

Final protocol documentation on infant hearing screening:
Download Word Document file (323KB) of the documentation.

Powerpoint presentation on Hearing Screening:
Download MS PowerPoint ScreenFlowChart file (30KB) of the presentation.

Powerpoint presentation on Early On Flow Chart:
Download MS PowerPoint EarlyOnFlowChart file (41KB) of the presentation.

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