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Newborn Screening Ontario
Expanded Hearing Screening

What to Expect

STEP 1: Parents will be asked if they want to consent to hearing screening

Hearing screening is not mandatory but is a medical recommendation.  Parents or legal guardians can decline hearing screening.  However, before making a final decision please speak with a health care provider about the pros and cons of this decision. 

STEP 2: The Infant Hearing Program performs the hearing screen and expanded hearing screening is offered as an option if it is recommended that the baby have an appointment with an audiologist

Based on a baby’s hearing screening results, the Infant Hearing Program might recommend that the baby have an appointment with an audiologist for a hearing assessment. If so, the baby is eligible for expanded hearing screening and the Infant Hearing Program hearing screeners will discuss this option with parents/legal guardians.

Once a parent or legal guardian has had their questions answered and has enough information to make a decision, the hearing screener will document the choice for expanded hearing screening.  The selection will be recorded on the hearing screening form, along with the name of the person providing consent and the hearing screener who provided the information.  The last page of the hearing screening form (parent education page) will be torn off and the selection recorded and provided to the parent or legal guardian for their records.  

STEP 3: If the parent/guardian consents to expanded hearing screening, the Infant Hearing Program screening form is sent to Newborn Screening Ontario and the test is performed 

The Infant Hearing Program sends the screening form to Newborn Screening Ontario (NSO) to notify NSO to perform the hearing loss risk factor blood spot screen. If a baby passes their hearing screen, they will not be eligible for the hearing loss risk factor blood spot screen

Results from the hearing loss risk factor blood spot screen should be available within a week once NSO is notified to perform the screen.

Newborn Screening Ontario and the Infant Hearing Program have collaborated toprovide screening for hearing loss risk factors.  The dried blood spot is already available for many babies so it is painless to have the hearing loss risk factor blood spot screen.  As well, testing for congenital cytomegalovirus needs to be performed on a blood sample taken during the first 3 weeks of life.  In most cases the dried blood spot is taken in the first week of life and sent to Newborn Screening Ontario for newborn blood spot screening.

Regardless of the decision surrounding expanded hearing screening, the form is sent to NSO as documentation that hearing loss risk factor blood spot screening was offered for eligible babies and to help monitor the rate of uptake. 

STEP 4: Results of the hearing loss risk factor screen will be sent to the Infant Hearing Program

If the results do not detect cytomegalovirus (negative) they will be sent to the Infant Hearing Program.

If the results detect cytomegalovirus (positive) they will be sent to the closest Follow-Up Centre Infectious Diseases (ID) clinic and to the Infant Hearing Program.  Someone from NSO or the ID clinic will contact the family directly to talk about the screen positive results and arrange an appointment.

If congenital cytomegalovirus infection is found through the hearing loss risk factor blood spot screen, the baby will be checked for symptoms.  If symptoms are present, they will be followed by specialists and may be offered additional treatment.  If they do not have symptoms at birth, they will be offered ongoing appointments to check for hearing loss and problems with development during early childhood.  The risk of going on to develop a problem during early childhood is ~7-15%.