Through legislative action, the Georgia Universal Newborn Hearing Screening and Intervention (UNHSI) Program* has made newborn hearing screenings and referrals to diagnostic audiologists a requirement in birthing hospitals. The screening and referrals for follow-up care are now a mandatory part of hearing screening protocol to help more babies get the diagnostic and interventional services they need for hearing loss/ impairment.
Although the screening is a standard of care in most Georgia hospitals, some newborns were not being referred or getting the follow-up care necessary. Family physicians must help strengthen the continuity of care by always checking the status of a newborn’s hearing screening on discharge papers or SendSS , educating parents on hearing loss and communicating the importance of following through with the referrals to get the interventions underway as quickly as possible
Hospitals are sanctioned to test up to two times for hearing loss starting when the newborn is 12 hours old. If the newborn fails both the initial or follow-up hearing screenings, the hospital should refer for a follow-up diagnostic hearing test before one month of age to ensure the failed screening wasn’t due to water on the ears. Hearing loss/impairment is defined as a threshold average of 15 dB or greater between 500Hz – 4000Hz, whether unilateral or bilateral.
Hearing loss should be reported on SendSS and to the Children First coordinator in the health district where the newborn resides. Georgia Department of Public Health districts also have a representative designated to call the family physician’s office if the child fails the hearing screening in the hospital. Although these protocols are in place, the family physician should help ensure a diagnosis is not missed or made late by making a referral to a specialty provider.
Parents don’t follow up with abnormal hearing screenings as often as other conditions. One reason may be that babies with hearing loss might look and respond to sounds just like babies with normal hearing and hearing loss and impairments can often be left undiagnosed and therefore untreated.
Some intervention guidelines for family physicians:
- Obtain written results of newborn hearing screening from birthing facility on all newborns.
- By one month of age, ensure that all newborns have a minimum of one hearing screening or a secondary screening if infant “referred” (failed) inpatient hearing screening.
- Refer for audiological diagnostic evaluation for infants “referring” secondary screening before three months of age.
- Provide referrals to early intervention, otolaryngologist, ophthalmologist and genetics after diagnosis of permanent hearing impairment.
- Continue to monitor for signs of hearing loss in infants who pass newborn hearing screening as hearing loss may develop at any age.
- Refer for audiological evaluation per Joint Commission on Infant Hearing recommendations, developmental/speech delay or parental concern.
* The UNHSI Program includes screening for hearing loss in the birthing hospital; referral of those who do not pass the hospital screening for rescreening; for newborns who do not pass the rescreening referral for diagnostic audiological evaluation; and, linkage to appropriate intervention for babies diagnosed with hearing loss. The UNHSI Program provides technical assistance and training about implementing and maintaining a quality newborn hearing screening program is provided to hospitals, primary care physicians, audiologists, early interventionists, and public health staff.
New Core Screening Contact Information
Georgia law requires all babies are screened at 24 hours-old. The Georgia Newborn Screening Program requires providers caring for newborns to verify that the screen was performed. If the baby was not screened, a bloodspot card should be collected before the child is one week of age and a hearing screen should be completed before one month of age. The Georgia Public Health Laboratory provides bloodspot cards for physicians. Your local health department is a resource for hearing screenings.
or call 404-657-2887
Newborn Screening Program Information for Parents: