Parents

Shortly after birth most infants in Oklahoma receive a newborn hearing screening. The hearing screening is non-invasive and can even be done while your baby is sleeping.

Hearing loss in infants and children is more common than most people think. Hearing loss is one of the most common birth defects in the United States, with approximately 3 newborns per 1,000 births being diagnosed with hearing loss each year.

Since hearing is an essential part of brain development, it is important to know if your child has a hearing loss as soon as possible. The sooner a hearing loss is diagnosed, the sooner your care team can connect you with resources for communication and language development.

Oklahoma’s Early Hearing Detection and Intervention (EHDI) Program is dedicated to ensuring families have all the resources and support needed from the initial screening process through the diagnostic and intervention process. Because this early diagnosis and intervention is key for growing brains, Oklahoma EHDI uses the 1-3-6 guideline.

1 Month: All infants should have a hearing screening by 1 month of age
3 Months: If after two screenings the baby does not pass, a medical and hearing evaluation is needed before 3 months of age
6 Months: If a hearing loss is detected, treatment and intervention should be started by 6 months of age

Pass:
- No other testing is needed unless there is a risk factor for late onset hearing loss.
Refer/Did not pass:
- More testing is needed as soon as possible, does not mean there is a hearing loss just that more testing is needed.
- A repeat hearing screening (or a rescreen) or a diagnostic hearing test will be recommended.
If you do not know your child’s hearing screening results, you can contact your pediatrician’s office or contact the Oklahoma Newborn Hearing Screening office at (405) 426-8309.
Just because your child passed their newborn hearing screening does not mean they won’t ever need another hearing test. If you have concerns about your child’s hearing or speech development or your child has frequent ear infections, schedule a hearing test as soon as possible.

Family history of childhood hearing loss
Neonatal intensive care unit (NICU) stay longer than 5 days
Hyperbilirubinemia with exchange transfusion
Use of certain antibiotics for more than 5 days
Asphyxia or Hypoxic-ischemic encephalopathy (HIE)
In utero infections (herpes, rubella. Syphilis, toxoplasmosis)
Craniofacial anomalies
Certain Syndromes associated with hearing loss
Extracorporeal membrane oxygenation (ECMO)
Cytomegalovirus (CMV)
Encephalitis
Head trauma
Learn more about risk factors for hearing loss

0-3 months
- Startle to loud sounds
- Recognizes familiar voices
- Makes cooing sounds
3-6 months
- Looks towards sounds
- Enjoys toys that make noise
- Begins to babble
6-10 months
- Turns head towards sound
- Imitates speech sounds
- Increases sounds in babbling
9-12 months
- Follows simple one step commands
- Uses gestures
- Uses first word
- Responds to name
12-15 months
- Points to familiar objects when asked
- Correctly uses mama and dada
15- 18 months
- Puts two words together
- Understands and uses 50 words
By 24 Months
- Understand and use 100-150 words
- Answer yes/no question
By 3 years
- Use 500 words
- Use 3-4 words in a sentence

A hearing screening is a safe, non-invasive, and quick test that can even be performed while the newborn is sleeping. It checks to see how well your baby’s hearing system responds to different sounds. Your baby’s hearing screening results will be either pass or refer/did not pass in one or both ears.
Pass:
- No other testing is needed at this time unless there is a risk factor for late onset hearing loss
Refer/Did not pass:
- More testing is needed as soon as possible, does not mean there is a hearing loss just that more testing is needed.
- A repeat hearing screening (or a rescreen) or a diagnostic hearing test will be recommended

Even if you child is in the NICU, they should still have a hearing screening before going home. The type of hearing screening they receive is called an AABR which uses small stickers and headphones to watch how your baby’s hearing nerves responds. Even if your infant passes their newborn hearing screening in the NICU, they should have their hearing monitored again in 6 months of age.

There are a variety of ways to test an infant’s hearing without needing a response from the infant.
- Auditory brainstem response (ABR) is the gold-standard for determining the softest level of hearing for infants. It uses stickers and earphones to look at how the hearing nerve responds.
- Diagnostic Otoacoustic Emissions (OAEs) are used to look at how well the inner ear or the cochlear (the hearing organ) is working. This is done by playing small sounds through a headphone and looking for little “echoes” from the hearing organ.
- Tympanometry is used to see if there is anything along the outer or middle ear that might be blocking sounds, such as fluid from an ear infection. This is done by putting a little puff of air in the ear canal with a small headphone.

There are different types of hearing loss.
- Conductive hearing losses are typically caused by problems in the outer or middle ear space. Sometimes they can be medically corrected, like in the case of an ear infection.
- Sensorineural hearing losses mean the hearing loss is coming from the inner ear or the cochlea, the hearing organ. This type of hearing loss is typically considered permanent in nature.
- Auditory Neuropathy Spectrum disorder (ANSD) can cause a hearing loss because it affects how well the hearing nerve is able to send sounds to the brain.

If your baby is diagnosed with a hearing loss in one or both ears, your audiologist will make some recommendations which may include the following.
- A visit to see an Ear Nose and Throat (ENT) doctor
- Referral for early intervention services
- Hearing technology, such as hearing aids or cochlear implants
- Seeking support from other families

Contact Information:

Mailing Address:
Oklahoma State Department of Health
Newborn Hearing Screening Program
123 Robert S. Kerr Ave., Suite 1702
Oklahoma City, OK 73102-6406

Phone: (405) 426-8309
Fax: (405) 900-7554
E-Mail: OSDH.newbornhearing@health.ok.gov

Parents

1-3-6 Guidelines

Understanding Results

Risk Factors for Hearing Loss in Children

Hearing and Speech Milestones

Finding a Pediatric Audiology Clinic

Resources

Frequently Asked Questions

Contact Information: