Hearing Screening Programs
Universal newborn hearing screening became mandatory in Minnesota in September 2007 under Minnesota Statute 144.966. This legislation has greatly enhanced the comprehensive system of hearing screening for all newborns. The objective of the MDH Newborn Screening/ Early Hearing Detection and Intervention (EHDI) program is to ensure that all infants are screened, test results are promptly reported, and all infants who do not pass their hearing screening are referred to an audiologist or other professional for diagnostic evaluation.
The EHDI program goals are:
- Screen newborns for hearing loss by one month of age
- Identify hearing loss by three months of age
- Offer early intervention services to deaf and hard-of-hearing infants and families by six months of age
A critical role of the primary care provider is to facilitate appropriate referrals. They should stress to families the importance of following up on hospital referral from newborn hearing screening (NHS) in a timely manner. Up to one fifth of infants referred for further testing after properly administered NHS have a hearing loss (CDC, 2013).
For additional information about newborn hearing screening, refer to the MDH Universal Newborn Hearing Screening and EHDI websites.
Follow-Up After Diagnosis of Hearing Loss
For a confirmed diagnosis of hearing loss, MDH Children and Youth with Special Health Needs (CYSHN) staff are responsible for ongoing follow-up services to children and their families. CYSHN ensures appropriate, timely intervention and connects families to statewide services and resources until the child transitions to adulthood.
Hearing Screening After the Newborn Period
Periodic hearing screening throughout early childhood is an essential safety net for identifying children who have delayed-onset or progressive hearing loss or did not receive further testing after their first newborn screening. It is the goal of the EHDI Program to identify children with hearing loss and connect them with intervention services as soon as possible.
Children who are income eligible for Medicaid or MinnesotaCare qualify for screening through the C&TC program, Minnesota's version of the Federal Early Periodic Screening, Diagnosis and Treatment (EPSDT) program. For children age one month through 24 months of age, the C&TC program requires newborn hearing screening, follow-up, risk assessment and at specific ages, recommends developmental screening with a standardized instrument. Refer to the C&TC Schedule of Age-Related Screening Standards.
Please note that as of October 1, 2017 high frequency screening was added for ages 11 and older to identify children who may have noise-induced hearing loss (NIHL).
Beginning at 11 years of age, it is required to add the 6000 Hz level to the required hearing screening.
Part C of the federal Individuals with Disabilities Education Act (IDEA) requires that the evaluation and assessment of an infant or toddler (birth through two years of age) be based on informed clinical opinion and include an evaluation of the child's level of functioning in a variety of identified areas, including hearing. For Minnesota specific recommendations, refer to Guidelines for Hearing Screening After the Newborn Period to Kindergarten Age.
Federal Performance Standards mandate that all children receive a standardized screening within 45 days of admission to the program.
Minnesota statute 121A.17 requires one early childhood or preschool pure tone screening at age three (preferred) or four years before entering public school kindergarten.
IDEA (Part B) ensures children and youth three to 21 years of age receive special education and related services. The rules indicate that the child be assessed in all areas related to the suspected disability, including, if appropriate, health, vision, hearing, social and emotional status, general intelligence, academic performance, communicative status, and motor abilities. For Minnesota-specific recommendations, refer to Hearing Screening Guidelines After the Newborn to Kindergarten Age.
MDH recommends that all children receive a hearing screening annually from kindergarten through third grade and in grades five, eight, and eleven. Hearing screening should be performed for students who are new, receive special education, or have the following risk factors:
- Chronic or recurrent otitis media
- Cleft palate or other craniofacial anomalies
- Family history of hearing loss in childhood
- Exposure to potentially harmful levels of noise