Hearing Screening Programs

Universal newborn hearing screening is mandatory in Minnesota under Minnesota Statute 144.966. This legislation has greatly enhanced the comprehensive hearing screening for all newborns. The MDH Newborn Screening/ Early Hearing Detection and Intervention (EHDI) program aim 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

Of the 68,063 infants born in Minnesota in 2015, 99.1% were screened for hearing loss. However, 4.6% percent of infants did not pass initial screening. Of the 322 infants that did not pass the screening, 242 had permanent hearing loss and 91 infants had transient/undetermined hearing loss.

A critical role of the primary care provider is to facilitate appropriate referrals. They should stress to families the importance of prompt follow up on hospital referral from newborn hearing screening (NHS). Up to one-fifth of infants referred for further testing after properly administered NHS have a hearing loss.

For additional information about newborn hearing screening, refer to the EHDI website.

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 those who did not receive a follow up after a first abnormal newborn screening. The EHDI Program aims 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. C&TC requires review of newborn hearing screen results at the initial newborn C&TC visit with appropriate follow up. C&TC requires hearing risk assessment at every visit for all children up to 3 years of age or until pure tone audiometry can be performed, a standardized pure tone audiometry is recommended at three years and required starting at four and at ages indicated on the C&TC Schedule of Age-Related Screening Standards.

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 (PDF).

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 that children and youth 3 through 20 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 Period to Kindergarten Age (PDF).