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Parent information on what to do next when your baby fails a hearing screen

What is the Early Hearing Detection and Intervention Program (EHDI)?

Since 2007, State law has required that all babies born in Michigan have their hearing screened (checked) before leaving the hospital or before one month of age. A quick and painless screening test is used to measure whether your baby can hear. You should get the results of the hearing test before you leave the hospital.

Most babies pass, but if your baby does not pass, it is very important to have more testing done. If you find out early that your baby has a hearing loss, there are steps you can take to help your baby communicate with you and others.

Why do babies need to be screened?

Hearing loss cannot be seen. Without a newborn hearing screening, the average age of identifying child’s hearing loss is at about 2 ½ years of age. When a hearing loss is not identified until later, speech and language learning are often delayed. When a hearing loss is found early, families can learn how to help a child learn language and communication skills earlier. Newborn hearing screening can be the first step in finding out if your baby has a hearing loss.

What if my baby’s hearing was not screened or my baby was not born at a hospital?

Talk to your baby’s doctor/midwife about checking your baby’s hearing as soon as possible or before they turn one month of age. It’s easier to test a newborn baby than a 6 month baby or older.

Can I refuse a hearing screening for my baby?

Michigan law states that all babies born in Michigan must have their hearing screened. However, families do have the right to refuse the hearing test. It is important to note that having your baby’s hearing checked is painless and does not involve injections, x-rays or the use of blood products. If you have more questions about your hospital’s newborn hearing screening program, talk to your Pediatrician, the hospital’s audiologist, nurse or the Michigan EHDI program for additional details.

How is the screening performed?

A baby’s hearing is usually checked within the first few days of life using one of two quick and painless screening methods; an Otoacoustic Emission (OAE) screening or an Auditory Brainstem Response (A-ABR) screening. Most hospitals will use only one type of screening, but some hospitals do both. Both types of screening methods only take a few minutes to complete.

OAE- screening is done by placing a soft tip, similar to an earplug, at the opening of your baby’s ear canal. The earplug sends sounds into your baby’s ear and, through the use of a computer, measures the ear’s response.

ABR- screening is done by placing 3-4 adhesive electrodes on different areas on your baby’s head. Earphones are placed in or on your baby’s ear, which send clicking sounds to the ear. The ABR computer records the responses of the ear to sound.

Both screening methods use a computer to interpret the results of the infant’s responses to sound. The screening results are recorded as a “pass” or “refer.”

When/How will I get the results of my baby’s hearing screening?

You should receive the results from the hospital before you and your baby are discharged.

What are the possible results of screening?

Most babies pass their hearing screening, but some babies may need to have their hearing checked again (does not pass, fail, refer, pass with risk indicators). This may be because your baby made noise during the test or had fluid in his/her ears. It is also possible that your baby has a hearing loss. Your nurse, pediatrician or pediatric audiologist should give you more information on how to get your baby’s hearing checked again. It is important to do this as soon as possible.

Does a “refer” result mean that my baby cannot hear?

Some babies do not pass their hearing screening but may have normal hearing. If your baby does not pass the hearing screen in the hospital, you must have his/her hearing rechecked to find out if your baby can hear.

The most common reasons that a child would need a re-screening include:

  • Fluid in the baby’s ear
  • Testing room too noisy
  • Baby not quiet
  • Baby has a hearing loss

Do I need to have my baby’s hearing checked again if he or she passes the screening?

Some babies are born with a hearing loss; others can develop a hearing loss months or even years after they are born. Even if your baby passes the hearing screening, he/she can have “risk indicators” that may cause a hearing loss.

Children who have risk indicators for late onset hearing loss need to have their hearing checked periodically. The most common of these risk indicators is a family member with a hearing loss since early childhood. You should be told of other risk indicators and how often your baby should have his/her hearing checked by your doctor or hospital.

If a child passes the newborn hearing screening but has trouble with speech/language development or if parents or doctors think there may be a possible hearing loss, the child’s hearing should be re-checked.

What if my child fails the hearing screen and needs more testing?

The hospital hearing screening staff and/or your doctor will tell you where you can go to get your baby’s hearing retested after you go home. You should make an appointment to have your baby’s hearing tested as soon as possible (no later than one month of age for another screening and before 3 months of age if your baby needs a full diagnostic hearing test). Your baby’s doctor will tell you whether your baby needs to have another hearing screening or a diagnostic hearing test.

What is the difference between a hearing screening and a diagnostic hearing test?

A hearing screening will only tell you there is a possibility of a hearing loss and whether or not your baby needs a full diagnostic hearing test. If your baby does not pass the hearing screenings, a diagnostic hearing test should be done by a pediatric audiologist. This test will check for a hearing loss and will tell you how much of a hearing loss your baby has or if your baby’s hearing is normal.

Where can follow-up hearing screening and/or diagnostic testing be performed?

The Michigan Early Hearing Detection and Intervention (EHDI) program maintains a list of diagnostic facilities that perform screening and/or diagnostic hearing test services throughout Michigan.

Some hospitals can re-screen your baby’s hearing in the nursery or in the hospital’s audiology department. Other hospitals may tell you where you can take your baby to get his/her hearing screened. Check the facility list to find services that are available to you. Still don’t know where to go? Call EHDI at 517-335-8955 for help.

What can I do to best prepare my baby to get his/her hearing checked?

It will help if your baby is asleep during the follow-up testing. Try not to let your baby nap near the time of the visit. Bring a blanket, extra diapers, a favorite soft toy, a bottle or pacifier; anything that will help makes sure your baby is comfortable.

What is an audiologist?

An audiologist is a professional, trained in the field of hearing who diagnoses, treats and manages infants children and adults with a hearing loss. Audiologists are trained to use special equipment to determine whether or not a patient has a hearing loss. Their role is to perform hearing test, refer patients with hearing loss or medical treatment and provide hearing rehabilitation services, such as hearing aids or other assistive listening devices.

Will I be charged for hearing screening and diagnostic testing?

Many health insurance plans pay for the hearing test as required by state law. However, some insurers are exempt from state law, so you should contact your insurance company to verify their policy for payment.

If you do not have insurance, your baby may qualify for Children Special Health Care Services to help cover the cost of a hearing screen or diagnostic evaluation. Visit