Maternal and Child Health
Newborn Hearing Screening
The newborn hearing screening program is responsible for assuring all infants born in Tennessee received a hearing screening before discharge or prior to one month of age. The 1-3-6 plan for newborn hearing program works to assure that: 1 - All infants will be screened for hearing loss prior to discharge or before 1 month of age. 3 - All infants who do not pass the screening will have a diagnostic audiological evaluation before 3 months of age. 6 - All infants identified with hearing loss will receive appropriate early intervention services no later than 6 months of age. AND - All families of children with hearing loss have access to parent support services. Hearing screening is required by Tennessee Code Annotated Title 68, Chapter 5, Part 9, Sections 901-906 , Rules and Regulations 1200-15-01 (Claire’s Law, July 2008).
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- Services are provided by all birthing hospitals and facilities. The families of infants that are not born in a hospitals can contact a hearing provider near their home using the “Pediatric Hearing Provider Directory” of audiology providers and ear, nose, and throat (ENT)/otolaryngology physicians. Most insurance covers hearing screening.
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Learn About Hearing Loss:
- Ask your baby’s medical provider or hospital of birth to provide you with the hearing results.
- If your baby did not pass the hearing test, contact your baby’s medical provider or a hearing provider right away to schedule a follow-up appointment. Check for a hearing provider near you:
- Even if your baby passes the newborn hearing test, hearing can change. A baby can develop a hearing loss after birth because of middle ear infections or fluid in the middle ear. There are a number of risk indicators that may lead to a hearing loss in your infant or child. Family history or illness such as meningitis can also affect hearing. These children need have their hearing tested on a regular basis to monitor any changes in hearing levels.
Types of Newborn Hearing Screening:
- There are two kinds of hearing screening methods: Automated Auditory Brainstem Response (AABR) and Otoacoustic Emissions (OAE). Bothe methods are safe and take only a few minutes. Most babies sleep through the screening.
- For more information visit the National Center for Hearing Assessment and Management (NCHAM).
Finding Other Families Like Yours:
- Family Voices – Tennessee – Newborn Hearing Parent Consultants parent to parent support, education, and advocacy for families. A Family Notebook is available at no cost to families of children with hearing loss. This is a great tool to help track your child’s progress.
- Hands and Voices – Tennessee - This organization offers parent-to-parent non-biased support for families of children who are deaf and hard of hearing.
Getting Services for Your Child:
Audiology and Ontological Services
Early Intervention for Communication:
- There are choices to consider when deciding how you will communicate with your child that is deaf or hard of hearing. Ask your child’s audiologist or early interventionist about the choices. You will receive help in taking your steps to review options such as hearing aids, American sign language, cued speech, cochlear implants or others. You will be encouraged to make decisions based on your child’s and families needs. See the following resources:
Helping to Pay for Services:
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Hospitals and Birthing Facilities:
- Results of the hearing screening are to be reported on the Newborn Screening blood spot lab form and sent to the State Laboratory. Results may also be reported on the HEARING ONLY Form. For additional information contact Jacque Cundall 615-262-6160 or email: Jacque.Cundall@tn.gov.
- Newborn Hearing Screening Guidelines for Hospitals:
Tennessee Department of Health
Newborn Hearing Screening Guidelines for Hospitals and Birthing Centers
- Hospital missed screen: If a hospital is unable to report the results of the initial screen at the time the blood spot lab form is submitted, remove the PINK copy of the form that has a picture of an ear, and send to the state lab after the hearing test is completed. Report the results of the final test before discharge. Additional tests may be reported on the HEARING ONLY form. Contact 615-262-6160 to order more forms
or download Materials Order Form (PH-3907).
- Reporting of Risk Indicators by Hearing Screeners: Infants that have one or more risk indicators for progressive or late onset hearing loss are to be reported on the hearing report form. An abbreviated list of risks are listed on the back or the pink copy of the reporting form. For a complete list of risk indicators, download the Joint Commission on Infant Hearing (JCIH) position statement.
- Medical Providers (Medical Home, Primary Care, Pediatricians, Family Physicians, etc.)
Tennessee medical providers are encouraged to assure all infants receive a newborn hearing as part of a standard of care. They should assist the child and family to obtain an audiological hearing assessment as recommended in the AAP “Bright Futures Guidelines Ed. 3”. Refer to American Academy of Pediatrics Algorithm for Early Hearing Detection and Intervention
National Center for Medical Home Implementation
Newborn: Assure infants receive a newborn hearing screen.
For Audiologists, ENT/Otolaryngologists
The Tennessee Newborn Hearing Program is committed to assuring families have access to audiology providers who demonstrate the knowledge and skills necessary to provide current pediatric hearing assessment methods as outlined in documents from the American Speech-Language-Hearing Association, ASHA, and the American Academy of Audiology, AAA (ASHA Guidelines for the Audiological Assessment of Children from Birth to 5 Years of Age, 2004; AAA Pediatric Amplification Protocol and the Exposition on Cochlear Implants in Children, 2003; AAA Cochlear Implant Guidelines, 1995).
The Tennessee Pediatric Audiologic Assessment Guidelines have been adopted from those developed by the American Speech-Language-Hearing Association (ASHA, 2004). A panel of nationally recognized experts in audiology developed the ASHA Guidelines for the Audiological Assessment of Children from Birth to 5 Years of Age. Some sections were adapted from the original guidelines have been made in acknowledgement of changes in the knowledge base in the field of audiology and needs specific to the state of Tennessee.
Primary Purpose Statement:
Infants and young children suspected of having a hearing loss should receive appropriate medical and audiologic evaluations as well as intervention services in a timely, efficient manner. Suspicion of hearing loss may occur as a result of any one of the following factors:
- failure of the newborn hearing screening (NHS);
- risk indicators for hearing loss (per the Joint Committee on Infant Hearing 2007 JCIH);
- expressed concern from parents, caregiver, family, or the child’s medical home provider.
Additionally, any infant or young child demonstrating a delay in speech/language development, regardless of prior hearing result, should also be evaluated. All infants who do not pass the NHS and any subsequent re-screening should receive appropriate audiologic evaluations to confirm the presence of hearing loss by three months of age. (Joint Commission on Infant Hearing 2007 Position Statement - Risk Indicators for Progressive and Delayed Onset or Acquired Hearing Loss).
Reporting to State Program:
Audiologists are encouraged to report hearing follow-up to the newborn hearing program on all children birth to three years old. Audiology Reporting Form
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Reports and Publications
- Hospital - Newborn Screening Laboratory Forms (PH-1580A)
- Hospital - Hearing Only Report Form may be ordered by faxing the Materials Order form listed above
- Hospital - Is this Baby at Risk for Hearing Loss?/Did this Baby Refer the Hearing Screen?
(Two-side laminated document to place by hearing equipment)
- Newborn Hearing Screening Protocols for Tennessee Hospitals and Birthing Centers
- DVD Newborn Hearing Screening Training Curriculum -
Competency-Based Training for screeners
- DVD Newborn Hearing Follow-up Parent Education (1 minute).
Use as a loop for hospitals and provider
For Audiologists and ENT/Otolaryngologists:
For Early Intervention Providers:
(pediatricians, family practice physicians, medical home providers):
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For More Information
National Resources for Early Hearing Detection and Intervention
(Newborn Hearing Screening)
For More Program Information:
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Updated August 2012