Audiology

To maximize the outcome for infants who are deaf or hard of hearing, the hearing of all infants should be screened at no later than one month of age. Those who do not pass screening should have a comprehensive audiological evaluation at no later than three months of age. Infants with confirmed hearing loss should receive appropriate intervention at no later than six months of age from health care and education professionals with expertise in hearing loss and deafness in infants and young children.

Regardless of previous hearing-screening outcomes, all infants with or without risk factors should receive ongoing surveillance of communicative development beginning at two months of age during well-child visits at the doctor's office.

Screen infants and toddlers who have not previously received and passed hearing screening, or if they have indicators associated with congenital or acquired hearing impairment. Such indicators include:

• Concerns regarding hearing, speech, language, and/or developmental delay based on observation and/or standardized developmental screening
• Birth weight under 3.3 lbs
• Bacterial meningitis and other infections associated with sensorineural hearing loss
• Apgar scores of 0–4 at one minute or 0–6 at five minutes
• Mechanical ventilation lasting five days or longer
• Head trauma associated with loss of consciousness or skull fracture
• Family history of hereditary childhood sensorineural hearing loss
• In utero infection, such as cytomegalovirus, rubella, syphilis, herpes, and toxoplasmosis
• Recurrent or persistent inflammation of the ear lasting at least three months

Some children may pass an initial hearing screening, but be at risk for fluctuating, delayed-onset, or progressive sensorineural and/or conductive hearing impairment. Those children's hearing should be monitored at least every six months until three years of age, and at regular intervals thereafter dependent on the risk factor.

Preschool children are screened as needed, requested, or mandated, or when they have conditions that place them at risk for hearing impairment.

Indicators associated with delayed-onset, progressive or acquired hearing impairment include:

• Concerns regarding hearing, speech, language, and/or developmental delay based on observation and/or standardized developmental screening
• Family history of hereditary childhood hearing loss
• In-utero infection, such as cytomegalovirus, rubella, syphilis, herpes, and toxoplasmosis
• Bacterial meningitis and other infections associated with sensorineural hearing loss
• Head trauma associated with loss of consciousness or skull fracture
• Recurrent or persistent inflammation of the ear lasting at least three months

• Screen adults as needed, requested, or when they have conditions that place them at risk for hearing disability (e.g., family history, concern of family member, noise exposure).
• Screen at least every decade through age 50 and at three-year intervals thereafter