- What is the Early Hearing Detection and Intervention Program (EHDI)?
- Why do babies need to be screened?
- What if my baby’s hearing was not checked or my baby was not born at a hospital?
- Can I refuse a hearing screening for my baby?
- How is the screening performed?
- When /How will I get the results of my baby’s hearing screening?
- What are the possible results of screening?
- Does a "refer" result mean that my baby can not hear?
- Do I need to have my baby’s hearing checked again if he or she passes the screening?
- Is there anything I can do at home to monitor my baby’s hearing?
- What if my child needs to have his/her hearing checked again?
- What is the difference between a hearing screening and a diagnostic hearing test?
- Where can follow-up hearing screening and/or diagnostic testing be performed?
- What can I do to best prepare my baby to get his/her hearing checked?
- What is an audiologist?
- What is an otolaryngologist?
- What is a hearing aid dispenser?
- What should I do if my baby has a hearing loss?
- What is the Early Intervention System (EIS)?
- Are there other parents I can talk to?
- What services does the New Jersey Department of Health and Senior Service’s Early Hearing Detection and Intervention program (the EHDI Program) offer?
- Will I be charged for hearing screening and diagnostic testing?
1. What is the Early Hearing Detection and Intervention Program (EHDI)?
Since January 2002, state law has required that all babies born in New Jersey 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 will get the results before you leave the hospital.
Most babies pass, but if your baby does not pass, it is very important to make sure your baby can hear. 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.
2. Why do babies need to be screened?
Hearing loss cannot be seen. Without a newborn hearing screening, the average age of identifying a child’s hearing loss is at about 2 ½ years of age. When a hearing loss is not identified, 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.
3. What if my baby’s hearing was not checked or my baby was not born at a hospital?
Talk to your baby’s doctor about getting your baby’s hearing checked as soon as possible or before they turn one month of age.
4. Can I refuse a hearing screening for my baby?
New Jersey Law states that all babies born in New Jersey must have their hearing screened (checked) unless it is against a family’s religious beliefs. If it is, you will be asked to sign a form before you leave the hospital stating that your baby will not be participating in the newborn hearing program due to a conflict with your religious beliefs. It is important to note that having your baby’s hearing checked is painless and does not involve injections, x-rays or 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 New Jersey EHDI program for additional details.
5. 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 (ABR) screening. Most hospitals will use only one type of screening, but some hospitals use 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.”
6. When /How will I get the results of my baby’s hearing screening?
You will get the results in writing before you leave the hospital.
7. 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 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.
8. Does a "refer" result mean that my baby can not hear?
Some babies do not pass their hearing screening (which is called a “refer” result) but may have normal hearing. If your baby does not pass the hearing screen in the hospital, you must have his or 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
- Hearing loss
9. 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 having a family member who had 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. More information on risk indicators and screening schedules can be found at http://jcih.org.
If a child passes the newborn hearing screening but has trouble with speech/language development or if parents or doctors think that there may be a possible hearing loss, the child’s hearing should be re-checked.
10. Is there anything I can do at home to monitor my baby’s hearing?
The following checklist shows expected speech and hearing skills at different ages throughout early childhood. If your baby does not do some of these things at the ages indicated, see your pediatrician and request an appointment for an audiologic evaluation by a licensed audiologist. For a hearing checklist, go to
11. What if my child needs to have his/her hearing checked again?
The hospital hearing screening staff and/or your doctor will tell you where you can go to get your baby’s hearing checked after you go home. You should make an appointment to have your baby’s hearing checked 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 diagnostic hearing test). Your baby’s doctor will tell you if your baby needs to have another hearing screening or a diagnostic hearing test.
12. What is the difference between a hearing screening and a diagnostic hearing test?
A hearing screening will only tell you there is the possibility of a hearing loss and whether or not your baby’s hearing needs to be rechecked. If your baby does not pass the hearing screening, a diagnostic hearing test should be done by an 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.
13. Where can follow-up hearing screening and/or diagnostic testing be performed?
The New Jersey Early Hearing Detection and Intervention (EHDI) program maintains a list of facilities that perform screening and/or diagnostic hearing test services throughout the State where you can find a location nearest to your home that provides the services your baby needs.
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 rechecked. Check the facility list to find services that are available in your area.
14. 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 make sure your baby is comfortable.
15. 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 hearing loss. In New Jersey , audiologists must be licensed to practice and must have either a Master’s or Doctoral degree in Audiology. Audiologists are trained to use special equipment to determine whether or not a patient has a hearing loss. Their role is to perform hearing tests, refer patients with hearing loss for medical treatment and provide hearing rehabilitation services, such as hearing aids or other assistive listening devices. For more information, please visit www.audiology.org.
16. What is an otolaryngologist?
Otolaryngologists are medical doctors who are specially trained in treating children and adults with disorders of the ear, nose, throat and related structures of the head and neck. They are also known as ENT physicians. Some otolaryngologists specialize in pediatric otolaryngology (focusing on diagnosis and treatment of children with ENT problems) or otology/neurotology (focusing on diagnosis and treatment of diseases of the ear). The otolaryngologist can determine the cause of a child’s hearing loss, decide what medical or surgical treatments are needed, and give clearance for hearing aid fitting. For more information, please visit www.entnet.org
17. What is a hearing aid dispenser?
A hearing aid dispenser is licensed by the state to measure hearing and to fit and sell hearing aids. In New Jersey , a hearing aid dispenser must have a training permit, work under the supervision of a licensed hearing aid dispenser for at least six months and pass both written and practical examinations. Hearing aid dispensers perform hearing testing, make impressions of the ear, give advice on hearing aid selection and fitting, dispense hearing aids, and provide hearing aid related products. New Jersey licensed audiologists can also become licensed hearing aid dispensers.
18. What should I do if my baby has a hearing loss?
Checklist for babies with hearing loss:
Talk with your baby’s doctor about all of the following:
- Make an appointment with an audiologist
- Make an appointment with an otolaryngologist
- If needed, get information and medical approval for:
hearing aids, assistive listening devices, FM systems, cochlear implants, etc.
- Discuss communication options
Speech reading, sign language, etc.
A communication options reference chart from BEGINNINGS for Parents of Children Who are Deaf or Hard of Hearing, Inc. Raleigh, NC
- Ask about other early intervention services (therapies or services)
- Ask about educational resources
- Meet with the Early Intervention program to make a plan for your family
- Contact other families with children that have hearing loss, as well as adults with hearing loss
19. What is the Early Intervention System (EIS)?
All infants identified with hearing loss should be enrolled in appropriate early intervention services no later than six months of age.
The EIS, under the department’s Division of Family Health Services, is a statewide system of services for infants and toddlers up to age three, with developmental delays or disabilities, and their families. The Governor has appointed the Department of Health to be the state lead agency for the Early Intervention System.
Health care, case management and early intervention professionals give families information about the full range of intervention options so that parents can make the best choices to meet their family’s needs. More information on New Jersey ’s Early Intervention System can be found at:
20. Are there other parents I can talk to?
If you would like to talk to parents who have children that have had diagnostic testing or have a hearing loss, you can contact:
21. What services does the New Jersey Department of Health and Senior Service’s Early Hearing Detection and Intervention program (the EHDI Program) offer?
The New Jersey EHDI program offers support to local hospitals to help them provide hearing screening and follow-up services for all New Jersey newborns. In addition, the New Jersey EHDI program tracks the number of infants screened and how many children are identified with hearing loss. The EHDI program works side by side with hospital hearing screening programs, audiologists, physicians, New Jersey Parent to Parent support services, Early Intervention Services, Case Management Services and the Special Child Health Services Registry. These programs are designed to ensure that infants and toddlers with hearing loss receive timely diagnostic testing, appropriate rehabilitation services and enrollment in specialized parent infant programs designed to meet the needs of children with newly identified hearing loss.
22. 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 under New Jersey law. (P.L. 2001 c.373)
If you do not have insurance, your baby may qualify for New Jersey Family Care (low-cost or no-cost health insurance) or your hospital’s "Charity Care" program. The New Jersey EHDI program has also funded three Child Evaluation Centers to provide follow-up screening and diagnostic testing for uninsured children who are not eligible for the above programs. NO child should be denied hearing screening, re-screening or ongoing audiologic monitoring services because of payment concerns. If you are concerned about the cost of these services please contact the New Jersey EHDI program for a list of centers in your area that can provide assistance. (609) 292-5676 (voice) or (609) 984-1343 (voice and TTY)