STEP 1: Hearing screening is offered and explained to parents and/or legal guardians
Hearing screening is usually done in a hospital or community-based setting. The tests used are reliable, quick and give results right away. They measure the ear or brain’s response to soft sounds played in baby’s ear and may use small stickers placed on baby’s head. Hearing screening is not mandatory but is considered standard of care and is strongly recommended. Parents or legal guardians can decline hearing screening but should speak with a health care provider about the pros and cons of this decision.
Risk factor screening for PHL is only available for babies born on or after July 29, 2019 whose parents/guardians consent to infant hearing screening in Ontario. Once consent is obtained for hearing screening, the hearing screener will ask if you would like to also have risk factor screening for PHL for your baby.
The hearing screener will document and notify Newborn Screening Ontario of your choice.
STEP 2: Risk factor screening for PHL is done by Newborn Screening Ontario
When a request for testing is received by Newborn Screening Ontario, risk factor screening for PHL can be performed. This involves testing the sample that was collected for routine newborn screening for Cytomegalovirus (CMV) and some common genetic risk factors for PHL. No additional blood or other sample is needed to have risk factor screening.
Risk factor screening results should be available within 1-2 weeks.
Please note that testing for CMV needs to be performed on a blood sample taken during the first 3 weeks of life. If for some reason the dried blood spot sample was not collected before 3 weeks of age, CMV screening cannot be performed.
STEP 3: Risk factor screening results are sent to the Infant Hearing Program
Risk factor screening results are routinely sent to the Infant Hearing Program (IHP) in the region where the baby was screened.
The parents/guardians of babies with a positive CMV risk factor screening result will be informed of the result by their primary care provider, or a member of the clinical team at NSO. These babies will be referred by NSO to a Pediatrician or Infectious Diseases (Clinic) for an assessment to see if the baby has any signs of the infection. A hearing (audiology) assessment with an IHP audiologist will also be arranged.
The parents/guardians of babies with a positive genetic risk factor screening result will be informed of the result by their primary care provider, or a Genetic Counsellor at NSO. These babies should have a hearing (audiology) assessment with an Infant Hearing Program (IHP) audiologist to find out if the baby has PHL. This will be arranged by the IHP.
IMPORTANT NOTIFICATION (March 2020)
In light of the COVID-19 pandemic and discontinuation of non-essential services, the Infant Hearing Program (IHP) is postponing all audiometric hearing screening and is temporarily unable to obtain consent for risk factor screening for PHL. After careful review by the Ontario Ministries of Health (MOH) and Children Community and Social Services (MCCSS), a decision was made to continue with the risk factor screening program. All specimens from babies born on or after March 26, 2020 will be screened for CMV and genetic risk factors for PHL without the need for additional consent by the IHP. Screen positive results continue to be referred for medical and audiologic follow-up. These are temporary measures, and we will revert to our original consent practice as soon as the IHP returns to regular operations. Please contact NSO if you have any questions.