Newborn hearing screening is a quick procedure that checks your baby’s hearing and identifies those babies who need further testing. It is performed on babies prior to discharge from hospital.
Why is newborn Hearing Screening important?
Newborn hearing screening is the first step in determining how your baby hears. Babies use their hearing to learn to talk, so it’s important to identify hearing loss early. Although it’s unlikely that your child has hearing loss, it is helpful to know how your baby hears as soon as possible.
How is Newborn Hearing Screening done?
Newborn hearing screening is painless and takes about 15 minutes. It should be done while your baby is asleep in a quiet environment. A computer based screener is used to record each ear’s response to sound. It automatically gives a pass or refer result and does not require your baby to respond. There are 2 ways to screen your baby’s hearing:
Automated Brainstem Response (ABR): Three sensors are placed on your baby’s head and soft sounds are presented through earphones.
OtoAcoustic Emissions (OAE): Soft sounds are presented through foam tips which are placed in your baby’s ears.
What do the Newborn Hearing Screening results mean?
Pass means that your baby has adequate hearing at the time of the screening. Some babies who pass the screening may require further testing due to family history or medical conditions.
Refer means that your baby did not pass the screening. If your baby did not pass the first screening, a second one will be done. If your baby does not pass or “refers” on the final hearing screening, your baby will need to be scheduled for diagnostic hearing testing with an audiologist. The audiologist will be able to determine if there is a hearing loss. It is important that you follow up with your audiologist to have this test completed as soon as possible.
Passing a newborn hearing screening means that the infant could hear at the time of the screening. Hearing loss can occur at any age. A hearing screening should be done ANY TIME there is a concern about hearing.
Hearing Loss is the found in 3 out of every 1000 births in the US, which is 12,000 children in the US every year. Early intervention is crucial in enabling your child to maintain language development in whichever communication mode you choose. The aim is to have your child with a hearing loss, receive medical, audiological, educational and support services as soon as possible. Receiving services at an early age will help your child develop communication and language skills.
Language and Hearing Milestones to look out for
Around 3 months
Quiets to a familiar voice
Startles to loud sounds
Cries differently to express needs
Around 6 months
Looks towards voices
Begins to respond to name
Coos, gurgles, giggles
Around 9 months
Understands a few words and names of family members
Lifts arms for the word “up”
Around 12 months
Bounces or moves to music
Turns exactly toward noises
Knows 10-50 words
Stops in response to “no”
Around 18 months
Follows simple directions
Knows body parts
Says 20-50 words
Begins to understand questions
The above information is provided from the DHHS-EHDI brochure “Newborn Hearing Screening: Information for Families,” November 2010.
For further information, please contact:
The Early Hearing Detection and Intervention Program (EHDI)
Maternal & Child Health Section
NH Department of Health and Human Services
29 Hazen Dr.
Concord, NH 03301
Sensorineural hearing loss (SNHL) occurs when there is damage to the inner ear (cochlea), or to the nerve pathways from the inner ear to the brain. Most of the time, SNHL cannot be medically or surgically corrected. This is the most common type of permanent hearing loss.
Conductive Hearing Loss
Conductive hearing loss occurs when sound is not conducted efficiently through the outer ear canal to the eardrum and the tiny bones (ossicles) of the middle ear. Conductive hearing loss usually involves a reduction in sound level or the ability to hear faint sounds. This type of hearing loss can sometimes be corrected medically or surgically, though it can also be permanent.
Sensorineural and conductive losses can sometimes occur simultaneously, this type of loss is referred to as a mixed loss.
There are a variety of DEGREES of hearing loss:
Typical -10 to 15 Decibels (dBs)
Mild 16 to 40 dBs
Moderate 41 to 55 dBs
Severe 56 to 90 dBs
Profound 91+ dBs
The following diagram will help to explain the decibel level and frequency of sounds that occur in the environment.
There are a few different hearing tests that your audiologist may use for your child depending on age and developmental level; these may be used alone or together to test hearing and auditory function:
Behavioral Hearing Tests
Behavioral Observation Audiometry (BOA)
Visual Reinforcement Audiometry (VRA)
Conditioned Orientation Reflex (COR) Audiometry
Conditioned Play Audiometry (CPA)
Tests of Auditory Function
Acoustic Immitance: This may include tympanometry (opens new tab), acoustic reflexes or acoustic reflex decay). These tests check the status of the middle ear system.
Otoacoustic Emissions (OAE): This tests the function of the outer hair cells in the inner ear
Auditory Brainstem Response (ABR): This tests the Auditory nerve function and estimates the peripheral hearing levels. This test may be performed either sedated or unsedated (birth to 5 months)
There are several items that can help children and youth with hearing loss become more independent. For instance, they can wake themselves up in the morning with an alarm clock that has amplification or a vibrating pad that can be placed under their pillow or the family can use a signaler placed in the child’s room so that a light flashes when the telephone or the doorbell rings.Some of the popular kinds of Assistive Technology are listed below. Our parent organization, Northeast Deaf and Hard of Hearing Services, temporarily loans Assistive Technology to families and individuals, and the Education Initiative is able to loan Assistive Technology to students and schools for temporary school use. To find out more about NDHHS’s loan program, give us a call at 603-224-1850 or email firstname.lastname@example.org. Find out more about the Education Initiative’s loan program. You can also check out Harris Communications (opens new tab), a business specializing in products for those with hearing loss.
(In Alphabetical Order)
Alarm clocks may feature extra loud audible alarms, a bed shaker for use under your mattress or pillow, a lamp flasher, high-intensity LED lights with or without dimmers, and/or compact size for travel or home.
Baby monitors can detect even the quietest noise from a baby and alert the user by a variety of methods: a flashing light on the receiver, a desk or room lamp flashing, or a vibrating pad under the pillow. The transmitter is placed with the baby and the receiver is located near the user.
There are a variety of doorbell signalers that will notify you by a flashing light if someone knocks on the door or rings the doorbell. Signalers may also be activated by a visitor stepping on a designated spot (like a welcome mat). Some signalers may have the capability to be connected to the smoke detection system, baby monitors, or telephones.
Captioned telephones, like CapTel or CaptionCall, have a display screen so that a person with hearing loss can both listen and read what the other person is saying.
Captions are created by a relay operator using a computer with voice recognition software. The relay operator listens to and makes corrections to the hearing party’s side of the conversation if the voice recognition software makes a mistake. Once the captions are created (and possibly corrected) they are transmitted to the captioned telephone where they are read by the user.
You can see a CapTel phone in action at our parent organization, Northeast Deaf and Hard of Hearing Services. Email email@example.com to make an appointment to see a demonstration.
Smoke alarms and CO2 detectors can help your family stay safe. They come equipped with a strobe light and a loud alarm and can be hard-wired into your home’s electric system or plugged into a wall outlet.
Telephones with Amplification
There are many phones, both corded and cordless, that have amplification above and beyond the phones you may find at electronic or department stores. Northeast Deaf and Hard of Hearing Services has a range of amplified phones available to try out and the Telecommunications Equipment Assistance Program (opens new tab) may be able to help you purchase one.
The Television Decoder Circuitry Act in 1990 mandated that all new television sets 13 inches or larger that were to be sold in the United States contain caption-coding technology. The Telecommunications Act of 1996 required that all digital television receivers contain caption-decoding technology. The Twenty-First Century Communications and Video Accessibility Act of 2010 required captioning for television programs that are redistributed on the Internet and for HDTV-decoding boxes to include a button that controls closed captioning in the output signal.
TV amplification systems allow you to listen to the tv at a sound that you can hear that is not too loud for other people. A transmitter will transmit the signal wirelessly to a receiver worn by the listener, usually in the form of a headset.
Videophones have overtaken the TTY as the way that Deaf or Hard of Hearing people make phone calls today. Think of Skype for Deaf folks and you’ve got the idea. There are Video Relay Service companies who employ sign language interpreters so that when a Deaf person needs to call a hearing person the call can be placed via the interpreter. The interpreter will voice or speak for the Deaf person and then relay the response in sign language to the Deaf caller.
Videophone users can also call other videophone users directly.
Wrist watches can include vibrating alarms, smaller wrist bands for children, sound alarms, backlit displays, and can also use standard watch batteries.
The TTY is a text telephone that allows people to type messages to each other. Both people need to have a TTY in order for this to occur or a hearing caller can call the Relay Service to connect to a person who uses a TTY. Conversely, the person who uses a TTY can dial the Relay Service, provide the phone number for the person or business he/she wishes to call, and the Relay employee will place the call and act as the person’s voice relaying the typed message and typing the response to the original caller. Dial 7-1-1 to be connected to the Relay Service. You can also check out the Relay New Hampshire website (opens new tab) for more information.
New Hampshire Telecommunication Equipment Assistance Program (NH-TEAP)
The NH-TEAP provides specialized phones and phone accessories at no cost to qualifying individuals with hearing, vision, or mobility loss as well as cognitive and speech difficulties.
Reside full-time in the state of New Hampshire.
Have a disability that hinders the use of standard telephones.
Have a gross income at or below 200% of the federal poverty level.
Have existing landline service or cell phone service.
If you do not meet the above requirements, you will still qualify for the cost sharing program. Cost share is for applicants whose income is greater than 200% of the federal poverty level. Under this program, NH-TEAP will cover half the cost of one specialized phone and accessories. You will still qualify for this program if you do not want to give any financial information.
There is a vast array of equipment available to individuals with disabilities. To help applicants better decide what best fits their needs, Northeast Deaf & Hard of Hearing Services has set up a display of current specialized telephones and accessories for viewing and testing. Walk-ins are welcome to try out equipment.
Contact: Brianna Cameron, NH-TEAP Coordinator, at firstname.lastname@example.org or at 603-224-1850 x207.
Ed 507.41 Special Education Teacher in Area of Deaf and Hearing Disabilities. To be certified as teacher in the area of deaf and hearing disabilities, the candidate shall:
(a) Have at least a bachelor’s degree; and
(b) Have the following knowledge, skills, and dispositions through a combination of academic and supervised practical experiences in the following areas:
(1) In the area of foundations, the ability to:
a. Identify models, theories, and philosophies that provide the basis for educational practice for individuals who are deaf or have hearing disabilities;
b. Articulate educational definitions, identification criteria, labeling issues, incidence, and prevalence figures for individuals who are deaf or have hearing disabilities;
c. Identify etiologies of hearing loss that can result in additional sensory, motor, or learning differences;
d. State issues and trends in the field of education of individuals who are deaf or have hearing disabilities;
e. Identify major contributors to the field of education of individuals who are deaf or have hearing disabilities;
f. Apply theories, philosophies, and models of practice to the education of individuals who are deaf or have hearing disabilities;
g. Explain basic audiological principles; and
1. Amplification systems, including, but not limited to, personal hearing aids and cochlear implants; and
2. Assistive listening devices, including, but not limited to, C-print, CART, and Relay services;
(2) In the area of development and characteristics of learners, the ability to:
a. Apply theories of cognitive development of individuals who are deaf or have hearing disabilities;
b. Identify characteristics and effects of the cultural and environmental milieu on an individual with hearing loss and the individual’s family;
c. Integrate current knowledge about the effects of various medications and medical and technological advancements on individuals with hearing loss;
d. Explain the hierarchy of auditory development; and
e. Describe the impact of the age of onset of hearing loss, age of identification, incidental learning, and provision of services on the development of the individual who is deaf or has hearing disabilities;
(3) In the area of individual learning differences, the ability to:
a. Analyze the impact of educational placement options with regard to cultural identity and linguistic, academic, social, and emotional development;
b. Assess the cultural implications of hearing loss that may impact an individual;
c. Apply information on the cognitive, physical, cultural, social, academic, and emotional characteristics of children who have special needs in addition to hearing loss; and
d. Evaluate the impact of various hearing losses, including, but not limited to, unilateral, hard of hearing and deaf, on an individual’s social, emotional, cognitive, and language development;
(4) In the area of instructional strategies, the ability to:
a. Demonstrate the language used to teach an individual who is deaf or who has hearing disabilities specific to the methodology determined by the team;
b. Integrate the sources of specialized instructional and assessment materials for an individual who is deaf or has hearing disabilities;
c. Select the appropriate procedures and technologies consistent with a variety of philosophies necessary to educate individuals who are deaf or have hearing disabilities;
d. Prepare individuals who are deaf or have hearing disabilities in the use of interpreters, note takers, peer tutors, amplification devices, and assistive listening devices;
e. Apply various applicable language teaching strategies to the needs of an individual;
f. Implement educational designs and practices of various programming options for individuals who are deaf or have hearing disabilities;
g. Select appropriate auditory training techniques that will maximize residual hearing for deaf or individuals with hearing disabilities; and
h. To maintain and troubleshoot hearing aids, cochlear implants, and FM systems using radio broadcast technology;
(5) In the area of learning environments and social interactions, the ability to:
a. Promote the processes for establishing ongoing interactions of individuals who are deaf or hard of hearing with peers and role models who are deaf or hard of hearing;
b. Promote opportunities for interaction with communities of individuals who are deaf or hard of hearing on local, state, and national levels;
c. Make accommodations to the instructional environment to meet the physical, cognitive, cultural, social, and communication needs of the individual who is deaf or hard of hearing;
d. Promote incidental language experiences to fit the visual and other sensory needs of individuals who are deaf or hard of hearing and
e. Design a classroom environment that maximizes opportunities for visual or auditory learning, or both, for individuals who are deaf or hard of hearing via:
1. Daily routines;
2. Improving classroom acoustics;
3. Limiting distance, noise and reverberation; and
4. Suggesting modifications and accommodations as necessary;
(6) In the area of communication, the ability to:
a. Demonstrate fluency in communication approach(es) salient to the individual who is deaf or hard of hearing that are necessary to enhance cognitive, emotional, and social development;
b. Evaluate the communication approach(es) salient to the individual who is deaf or hard of hearing;
c. Apply the various components of nonlinguistic and linguistic communication used by individuals who are deaf or hard of hearing;
d. Apply strategies to facilitate cognitive and communicative development in individuals who are deaf or hard of hearing;
e. Develop communication between the individual who is deaf or hard of hearing and his/her family/community; and
f. Select appropriate communication strategies and resources to facilitate understanding of subject matter for students whose primary language is not English;
(7) In the area of instructional planning, the ability to:
a. Identify and evaluate programs, including career/vocational and transition, for individuals who are deaf or hard of hearing;
b. Select, design, and use technology, materials, and resources required to educate individuals who are deaf or hard of hearing;
c. Integrate speech skills, as consistent with the individual’s ability and the program’s educational philosophy, into all areas of the curriculum;
d. Modify instruction for individuals who are deaf or hard of hearing and who have multiple disabilities and special needs;
e. Define roles and responsibilities of the educational interpreter related to instruction, intervention, and direct service; and
f. Prepare individuals to self- advocate as related to hearing loss;
(8) In the area of assessment, the ability to:
a. Explain specialized terminology used in assessing individuals who are deaf or hard of hearing;
b. Utilize the specialized materials and procedures for evaluation, eligibility, placement, and program planning for individuals who are deaf or hard of hearing;
c. Gather and analyze verbal and nonverbal communication samples;
d. Articulate the specialized policies on referral and placement procedures for individuals who are deaf or hard of hearing;
e. Report assessment results using effective communication;
f. Evaluate instruction and monitor progress of individuals who are deaf or hard of hearing;
g. Develop or modify individualized assessment strategies;
h. Use performance data and informal input from students, parents, educators, and administrators to do the following for individuals who are deaf or hard of hearing:
1. Identify appropriate modifications in the learning environment;
2. Develop instructional assessment strategies; and
3. Evaluate results of instruction and appropriateness of program options; and
i. Assess developmental skill levels in the domains of cognition, language, motor, and social emotional development.
(9) In the area of professional and ethical practice, the ability to:
a. Promote appropriate roles and responsibilities of teachers and support personnel in educational practice for individuals who are deaf or hard of hearing;
b. Model adherence to professional conduct and confidentiality policies;
c. Participate in professional development activities to increase knowledge and skills related to educating and communicating with individuals who are deaf or hard of hearing; and
d. Utilize the knowledge of the various organizations and publications relevant to the field of education of individuals who are deaf or hard of hearing; and
(10) In the area of collaboration, the ability to:
a. Understand the various services, networks and organizations available to individuals who are deaf or hard of hearing at the local, state and national levels;
b. Coordinate support personnel to meet the diverse communication needs of the individual who is deaf or hard of hearing;
c. Provide families with resources, knowledge, skills, and support to make choices regarding communication modes/philosophies and educational options across the lifespan;
d. Promote effective communication and collaboration with individuals with exceptional learning needs, including families, school personnel, and community members;
e. Collaborate with school personnel, parents, clinical personnel, and community members in integrating individuals with exceptional learning needs into various settings;
f. Model techniques and coach others in the use of instructional methods and accommodations;
g. Demonstrate the ability to impart specific knowledge of the needs of deaf and hard of hearing individuals to educational staff; and
h. Support instruction in the regular education classroom by observing, evaluating, and providing specific knowledge to educational and support staff.
Source. #8229, eff 12-17-04; ss by #9157, eff 7-1-08
Parents are an integral part of the special education process. In New Hampshire parents have rights (known as “procedural safeguards”) in place insuring that their child can fully access a free appropriate education at the public expense (FAPE), and also insuring that the testing and evaluation for placement occurs in a timely manner.
The New Hampshire Procedural Safeguards Handbook for Special Education (opens new tab) (December 2008) states “The Special Education process is most effective when parents and school personnel are well informed and able to work together. It is particularly important that parents and others involved in the special eduation process understand their rights and are aware of the statues of limitations, and other restrictions in order to fully access a free appropriate education at public expense.” The Individuals with Disabilities Education Act (IDEA 2004) requires that school districts must provide parents a copy of the procedural safeguard (parent’s rights) handbook.
(The following information is taken from the New Hampshire Department of Education – Bureau of Special Education Complaint Procedures Manual for Special Education Complaints January 26, 2011)
“The decisions parents make regarding their children should be based upon knowledge and understanding of their rights and procedural safeguards. This requires open communication and trust between parents and their school district. If problems do arise, there are several options parents have for resolution.
Working with your school district is of course your first and most readily available option. If that fails, or if parents or school district wishes to use more formal procedures, the following options are available:
“IEP Facilitation” – a process designed to assist parents and school districts to reach agreement on their child’s program within the IEP Team process.
“Neutral Conference” – a voluntary and nonbinding formal process with an impartial person designed to assist parties in reaching agreement.
“Mediation” – a voluntary process designed to assist parties in reaching a mutually agreeable solution.
“Due Process Hearing” – the most formal process in which attorneys can be present, evidence and sworn testimony can be given and the Hearing Officer’s decision is binding.
The “Complaint Process” is one method parents or others have to resolve an issue if they believe a public agency (LEA or SEA) has not complied with a special education law. Because most differences are successfully resolved at the local level, parents may wish to notify their school district to give them the opportunity to resolve the issue at the local level before filing a complaint.
The “Complaint Process” is one of the Procedural Safeguards afforded to parents under Federal and State laws. The New Hampshire Department of Education (NHDOE) is required to make available to parents and other individuals the ability to file formal complaints against a school district if they believe the school district violated a federal or state special education law.
New Hampshire Department of Education – Bureau of Special Education Complaint Procedures Manual for Special Education Complaints provides information regarding definitions; a description of the process for filing a complaint; a list of the responsibilities of the complainant, school district, investigator and the New Hampshire Department of Education throughout the process; checklists, model letters and forms; and frequently asked questions regarding the process.