Early Hearing Detection and Intervention

Newborn Hearing Screening

For many reasons, children can develop hearing loss as they grow. If you suspect that your child may have trouble hearing, see an audiologist immediately.

Here are some common medical reasons why a child may develop hearing loss:

  • Family history of early, progressive, or delayed onset permanent childhood hearing loss.
  • Neonatal intensive care of more than five days.
  • • Hyperbilirubinemia (high bilirubin level) with exchange transfusion regardless of length of stay
  • Aminoglycoside (drugs that may be harmful to hearing) administered for more than five days.
  • Asphyxia or hypoxic (not getting enough oxygen) Ischemic Encephalopathy.
  • Extracorporeal membrane oxygenation (ECMO) (putting oxygen into the baby’s blood).
  • In utero (in the womb) infections, such as herpes, rubella, syphilis, and toxoplasmosis.
  • Cytomegalovirus (CMV).
  • Mother + Zika and infant with no laboratory evidence and no clinical findings.
  • Mother + Zika and infant with laboratory evidence +/- clinical findings.
  • Craniofacial malformations, congenital microcephaly, congenital/acquired hydrocephalus, or temporal bone abnormalities.
  • Syndromes associated with hearing loss.
  • Culture-positive infections associated with sensorineural hearing loss, including confirmed bacterial/ viral meningitis, herpes viruses, varicella, or encephalitis.
  • Events associated with hearing loss (head trauma, chemotherapy).
  • Maternal substance abuse (alcohol/drug abuse).


The age of the child will determine what tests will be done.

Different tests may be completed depending on the age of the child.

Before any appointment, rub and lightly tug your child’s ears to get them used to the sensation. Most audiologic testing requires the child’s ears to be touched. Helping your child get used to allowing their ears to be touched can make the test go more smoothly and reduce the number of appointments needed to complete all testing. Even if your child does not let the audiologist touch the ear, most testing requires placing the tip of a probe into the child’s ear. The audiologist may ask you to place this tip into the child’s ear, to help continue the testing.

Auditory Brainstorm Response (ABR)

ABRs must be completed in a silent environment on a child who is mostly being still and quiet. It is ideal for your child to be asleep or quietly feeding.

Otoacoustic Emissions (OAEs)

This is a quick and easy test that only needs the child and the environment to be quiet. Feeding or a quiet phone/tablet may help distract your child and keep them quiet during the test.

Video Reinforcement Audiometry (VRA)

This test is for babies under the age of 2. The best way to start training your baby for this test is to have a noisy toy. Create sound to the left and right of the baby, watching for him/her to locate the sound. When your baby locates the sound, reward him/her with praise or by giving the toy to your baby.

Conditioned Play Audiometry (CPA)

Usually, this test is done when a child is between 2-5 years of age. The best way to prepare your child for this test is to play a “sound” game. The goal is to get your child to show you that they heard a specific sound by putting a toy in the bucket. For example, you make a sound. Tell your child that you heard that sound (say “I heard that” and point to your ears) and put a toy in a bucket. You may need to repeat yourself two or three times to show your child how this game works. Again, the goal is that when your child hears the sound, he or she gets to put a toy in a bucket. Examples of sounds you can use include “beep beep beep” and “buh buh buh.” When your child puts the toy in the bucket, give them a smile, and clap your hands or praise them.


If your child is identified with a hearing loss, we recommend you find a pediatric audiologist. They are uniquely trained to provide care for babies and children with hearing loss. If you cannot find a pediatric audiologist nearby, do not hesitate to look specifically for an audiologist who has experience working with kids. The following website includes a list of pediatric audiologists in the United States to help you get started.

Also locate and work with an early intervention specialist to determine the best next steps. This can include a speech and language evaluation to determine the milestones your child should be meeting. You can find your state’s early intervention program here

Monitor changes in your child’s hearing

Your child’s hearing may change depending on the cause of the hearing loss. Your audiologist can tell you what kind of hearing loss your baby has and how much it may change over the course of your child’s life. You should monitor any changes and discuss what you see with your audiologist to determine if further testing is needed.

How can I find out the cause of my child’s hearing loss?

We do not always know whether a hearing loss is inherited or if a hearing loss has occurred for some other reason. We do know that there are a large number of genes (more than 90) that can cause a hearing loss to occur. The best way to determine the cause of hearing loss is to talk with an ear, nose, and throat specialist. Some causes of hearing loss are very obvious and easy to detect, such as a conductive hearing loss. Other causes of hearing losses may be hidden. Genetic testing may identify the source of hearing loss.

Will my child develop other disabilities?

Some causes of hearing loss are associated with a syndrome. About 30% of hearing losses that are genetic are syndromic, which means that there are other factors as well as hearing loss, such as vision loss. It’s important to identify if your baby has one of these syndromes as early as possible so families can better prepare for other disabilities that may show up or worsen later in your child’s life.

Frequently Asked Questions

Sensorineural hearing loss occurs when there is hair cell damage or nerve damage. The signal (sound) cannot reach the brain to be processed. Some causes of sensorineural hearing loss include genetics, infections, malformation of the cochlea, high noise levels, ototoxic medication, hypoxia, and tumors. Sensorineural hearing loss is a permanent type of hearing loss. Research is currently being conducted for a cure; however, no significant findings are available yet.

Important Things to Remember if Your Child has a Hearing Loss!

At AG Bell, one of our primary goals is to help families find information and resources related to listening and spoken language services, and professionals that help a child hear and talk, including audiologists and listening and spoken language professionals. AG Bell can help point you in the direction of local services and resources. AG Bell recognizes that parents/caregivers need or may want comprehensive information regarding all of the communication options (e.g., Cued Speech/Language, American Sign Language) and opportunities available to their child. If we do not have answers to your questions, we will point you to other organizations that may be able to help you.

It is important that your child and family connect with services and providers who can help you reach the outcomes you have identified (e.g., I want my child to make the most of his hearing and learn to talk). Whether you contact the AG Bell Parent Consultant, your local AG Bell chapter, or another organization, the most important thing is that your child and family get the support you need so your child can live a life without limits!


Need to Talk with a Parent Consultant?

Where else can I get more information about newborn hearing screening?

Contact your state coordinators! Every state has a coordinator for information on hearing loss for individual states. There may be resources that are available that you can take advantage of.

Reach Us

Alexander Graham Bell Association
for the Deaf and Hard of Hearing

3417 Volta Place NW
Washington, D.C. 20007

Tel: 202-337-5220
TTY: 202-337-5221


Our Mission

Working globally to ensure that people who are deaf and hard of hearing can hear and talk. 

We want all families to be informed and supported, professionals to be appropriately qualified to teach and help children with hearing loss, public policy leaders to effectively address the needs of people with hearing loss, and communities to be empowered to help their neighbors with hearing loss succeed.