CE/CME

Newborn Hearing Screening

Welcome to the training on Newborn Hearing Screening provided by the Texas Health and Human Services Commission (HHSC) and the Texas Department of State Health Services (DSHS).

Credit Hours: 1.50 CE

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Goal

The goal of this module is to equip Texas Health Steps providers and other interested health-care professionals to support the state’s newborn hearing screening program, provide follow-up and referrals for infants suspected to have or identified with deafness or hard-of-hearing status, and counsel families to help ensure that infants receive appropriate services.

Target Audience

Texas Health Steps providers and other interested health-care professionals.

Specific Learning Objectives

After completing the activities of this module, you will be able to:

  1. Summarize the implications of being deaf or hard of hearing and the benefits of early detection and intervention through newborn hearing screening and follow-up testing.
  2. Specify recommended culturally sensitive methods for communicating with parents and caregivers about their infants’ hearing screening results.
  3. Assess best practices for promoting parental participation in hearing status identification and early intervention services for infants who are deaf or hard of hearing.

Definitions of Terms for the Purposes of this Module

Deaf or hard of hearing: Inclusive term use in a clinical context to include the entire spectrum of people with varied hearing levels, per the Joint Commission on Infant Hearing and American Academy of Pediatrics. Individuals so identified prefer those terms and the term “Deaf” when referring to individuals who embrace the cultural norms, values and beliefs of the Deaf community. These are recommended terms when communicating with patients, families and caregivers.

Hearing difference: Broader term to describe any kind of hearing loss, deafness or other auditory difference.

Parents: Also refers to an infant’s caregivers and guardians.

Please note this module expires on 10/26/2026.

This module was released on 10/26/2023.

Featured

American Speech-Language-Hearing Association (ASHA). (n.d.). Hearing Loss at Birth (Congenital Hearing Loss).

Arnold, C. L., Davis, T. C., Humiston, S. G., Bocchini, J. A., Bass, P. F. III, Bocchini, A., … Forsman, I. (2006). Infant Hearing Screening: Stakeholder Recommendations for Parent-Centered Communication. Pediatrics, 117(Supplement 3), S341-S354.

Boys Town National Research Hospital. (n.d.). babyhearing.org. Cochlear Implants.

Centers for Disease Control and Prevention. (2023). 2020 Summary of Hearing Screening Among Total Occurrent Births.

Centers for Disease Control and Prevention. (2023). Data and Statistics on Down Syndrome.

Centers for Disease Control and Prevention. (2023). Data and Statistics on Spina Bifida.

Centers for Disease Control and Prevention. (2023). Hearing Loss Treatment and Intervention Services. Available in English and Spanish.

Centers for Disease Control and Prevention. (2023). 2020 Summary of National CDC EHDI Data.

Centers for Disease Control and Prevention. (2019). Babies Born with Congenital CMV. Available in English and Spanish.

Centers for Disease Control and Prevention. (2019). Congenital CMV and Hearing Loss. Available in English and Spanish.

Centers for Disease Control and Prevention. (2023). Genetics of Hearing Loss.

Centers for Disease Control and Prevention. (2023). What is Hearing Loss in Children? Available in English and Spanish.

Centers for Disease Control and Prevention. (2023). Data and Statistics About Hearing Loss in Children.

The Joint Committee on Infant Hearing. (2019). Year 2019 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs. The Journal of Early Hearing Detection and Intervention (JEHDI), 4(2): 1–44.

Mayo Clinic. (2020). Cytomegalovirus (CMG) infection.

National Center for Hearing Assessment and Management (NCHAM) Utah State University. Early Hearing Detection & Intervention (EHDI): National Technical Resource Center (NTRC). (n.d.). Texas Summary of Universal Newborn Hearing Screening Legislation.

National CMV Foundation, Prevention Tips. (n.d.). CMV Prevention and Healthy Pregnancy Tips.

National CMV Foundation, Start Here. (2023). What is CMV?

U.S. Department of Health and Human Services, National Institute on Deafness and Other Communication Disorders (NIDCD). (2021). Quick Statistics About Hearing.

U.S. Department of Health and Human Services, National Institute on Deafness and Other Communication Disorders (NIDCD). (2018). Auditory Neuropathy.

U.S. Department of Health and Human Services, National Institute on Deafness and Other Communication Disorders (NIDCD). (2021). Cochlear Implants. 

U.S. Department of Health and Human Services, National Institute on Deafness and Other Communication Disorders (NIDCD). (2022). Hearing Aids.

Pimperton, H., Blythe. H., Kreppner, J., Mahon, M., Peacock, J. L., Stevenson, J. . . . Kennedy, C. R. (2016). The impact of universal newborn hearing screening on long-term literacy outcomes: a prospective cohort study. BMJ Journals: Archives of Disease in Childhood, 101:9-15.

Smalley, J, Hole, K. Prevalence, behavioral, and management outcomes of infants with auditory neuropathy spectrum disorderDev Med & Child Neurol. 2021; 64: 593– 599.

Texas Department of State Health Services. (2021). Healthy Texas Mothers and Babies Data.

Texas Department of State Health Services. (2020). Screened Disorders.

Texas Department of State Health Services. (2020). Texas Early Hearing Detection and Intervention (TEHDI).

Texas Education Agency (TEA). (n.d.). Early Childhood Special Education (ECSE).

Texas Department of State Health Services, Texas Health Steps. (2021). Texas Health Steps Periodicity Schedule for Infants, Children and Adolescents.

Texas Health and Human Services Commission. (n.d.). Deaf and Hard of Hearing.

Texas Health and Safety Code, Title 2. Health, Subtitle B. Health Programs, §47. Hearing Loss in Newborns.

Texas Administrative Code, Title 25 Health Services, Part 1 Department of State Health Services, Subchapter S Newborn Hearing Screening, §37.504. (2020). Required Reporting. 25Tex. Amin.

Texas Medicaid & Healthcare Partnership (TMHP). (2023). Texas Medicaid Provider Procedures Manual, Volume 2, Provider Handbooks, Children’s Services Handbook.

Texas Medicaid & Healthcare Partnership (TMHP). (n.d.). Provider Search.

U.S. Department of Health and Human Services, Office of Minority Health. (2019). Culturally and Linguistically Appropriate Services (CLAS).

Medical Definitions

The medical definitions in this module were adapted from the federal Centers for Medicare and Medicaid Services, Mayo Clinic, the National Institutes of Health, the U.S. Department of Health and Human Services, the National Institute on Deafness and Other Communications Disorders, Texas Health Steps, the National Eye Institute and the U.S. National Library of Medicine.

Continuing Medical Education

The Texas Department of State Health Services, Continuing Education Service is accredited by the Texas Medical Association to provide continuing medical education for physicians. 

The Texas Department of State Health Services, Continuing Education Service designates this enduring material for a maximum of 1.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Nursing Education

The Texas Department of State Health Services, Continuing Education Service is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. The Texas Department of State Health Services, Continuing Education Service has awarded 1.50 contact hour(s) of Continuing Nursing Education.

Social Workers

The Texas Department of State Health Services, Continuing Education Service under sponsor number CS3065 has been approved by the Texas State Board of Social Worker Examiners to offer continuing education contact hours to social workers. The approved status of The Texas Department of State Health Services, Continuing Education Service expires annually on December 31. The Texas Department of State Health Services, Continuing Education Service has awarded 1.50 contact hour(s) of Continuing Social Work Education.

Certificate of Attendance

The Texas Department of State Health Services, Continuing Education Service has designated 1.50 hour(s) for attendance.

General Disclosure

One of the requirements of continuing education is disclosure of the following information to the learner:

  1. Notice of requirements for successful completion of continuing education activity. To receive continuing education credit the learner must successfully complete the following activities:
    • Create a Texas Health Steps account.
    • Complete on-line registration process.
    • Thoroughly read the content of the module.
    • Complete the on-line examination.
    • Complete the evaluation.
  2. Commercial Support.
    The THSTEPS Web-based Continuing Education Series has received no commercial support.
  3. Disclosure of Relevant Financial Relationships.
    The THSTEPS Continuing Education Planning Committee and the authors of these modules have no relevant financial relationships to disclose.
  4. Non-Endorsement Statement.
    Accredited status does not imply endorsement of any commercial products or services by the Department of State Health Services, Continuing Education Service; Texas Medical Association; or American Nurse Credentialing Center.
  5. Off-Label Use.
    Using a disclosure review process, the THSTEPS Continuing Education Planning Committee has examined documents and has concluded that the authors of these modules have not included content that discusses off-label use (use of products for a purpose other than that for which they were approved by the Food and Drug Administration).

The following are policies and definitions of terms related to continuing education disclosure:

The intent of disclosure is to allow Department of State Health Services (DSHS) Continuing Education Service the opportunity to resolve any potential conflicts of interest to assure balance, independence, objectivity and scientific rigor in all of its Continuing Education activities.

All faculty, planners, speakers and authors of Department of State Health Services (DSHS) Continuing Education Service sponsored activities are expected to disclose to the Department of State Health Services (DSHS) Continuing Education Service any relevant financial, relationships with any commercial or personal interest that produces health care goods or services concerned with the content of an educational presentation. Faculty, planners, speakers and authors must also disclose where there are any other potentially biasing relationships of a professional or personal nature.

Glossary of Terms

Conflict of Interest: Circumstances create a conflict of interest when an individual has an opportunity to affect Continuing Education content about products or services of a commercial interest with which she/he has a financial relationship or where there are any other potentially biasing relationships of a professional or personal nature.

Commercial Interest: Any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.

Financial Relationships: Those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected. Relevant financial relationships would include those within the past 12 months of the person involved in the activity and a spouse or partner. Relevant financial relationships of your spouse or partner are those of which you are aware at the time of this disclosure.

Off Label: Using products for a purpose other that that for which it was approved by the Food and Drug Administration (FDA).

Texas Health Steps courses are best viewed using a current browser. If you are using an out-of-date browser or a version of Internet Explorer less than 11, lesson progress and interactive features may not function properly.

Resources for Health-Care Providers

American Academy of Pediatrics. (2020). Early Hearing Detection & Intervention Implementation Tip Sheet.

Centers for Disease Control and Prevention. (2022). Annual Data: Early Hearing Detection and Intervention (EHDI) Program.

Centers for Disease Control and Prevention. (2019). Congenital CMV and Hearing Loss.

Centers for Disease Control and Prevention. (2023). Cytomegalovirus (CMV) and Congenital CMV Infection: For Healthcare Providers.

Culturally sensitive health care:

The Joint Committee on Infant Hearing. (2019). Year 2019 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs. The Journal of Early Hearing Detection and Intervention (JEHDI), 4(2): 1–44.

Language Line Solutions. Professional interpreters and translators.

Early Hearing Detection & Intervention (EHDI): National Technical Resource Center (NTRC). (2022). The National Center for Hearing Assessment and Management (NCHAM) Book.

Texas Association of Parents and Educators for the Deaf (TAPED). Resource Center.

Texas Department of State Health Services, Newborn Screening Program. (2020). Screened Disorders.

Texas Department of State Health Services, Newborn Screening Program, Texas Early Hearing Detection and Intervention (TEHDI). Educational Materials.

Texas Department of State Health Services, Texas Early Hearing Detection and Intervention (TEHDI). Parent Resources & Guidance - TEHDI.

Texas Department of State Health Services, Texas Early Hearing Detection and Intervention (TEHDI). (2022). MIS login page. 

Texas Department of State Health Services, Texas Health Steps. (2021). Texas Health Steps Periodicity Schedule for Infants, Children and Adolescents.

Texas Department of State Health Services, Texas Health Steps Catalog.

Texas Health and Human Services Commission. Physician Referral and Orders for Early Childhood Intervention (ECI).

Texas Health and Human Services Commission, Texas Health Steps. Forms.

Texas Medicaid & Healthcare Partnership. (2023). Texas Medicaid Provider Procedures Manual, Volume 2, Provider Handbooks, Medicaid Managed Care Handbook, Section 2.5 Cultural Competency and Sensitivity.

Texas School for the Deaf. Statewide Outreach Center.

U.S. Department of Health and Human Services, National Institute on Deafness and Other Communication Disorders (NIDCD). (2021). Cochlear Implants. 

U.S. Department of Health and Human Services, National Institute on Deafness and Other Communication Disorders (2023). Hearing, Ear Infections, and Deafness.

U.S. Department of Health and Human Services, National Institute on Deafness and Other Communication Disorders (NIDCD). (2022). Hearing Aids.

Resources to Share with Patients and Families

¡Aprende Lengua de Señas Mexicana en menos de 10 minutos! Video introduction to Lengua de Señas Mexicana (LSM) Mexican Sign Language. 

Boys Town National Research Hospital: babyhearing.org. (n.d.). Parenting a Child who Is Deaf or Hard of Hearing. Available in English and Spanish.

Deaf Latinos Y Familias Organization.

Parent Companion: First Five Years. A guide for Texas parents and caregivers of children with diagnosed or suspected disabilities from birth through 5 years of age. Available in English and Spanish.

Relay Texas (7-1-1). A free service that provides telephone access for people with speech or hearing loss who find it challenging or impossible to use a traditional telephone.  Available in English and Spanish.

Texas Association for the Deaf

Texas Education Agency (TEA). Sensory Impairments

Texas Education Agency (TEA), State Deaf of Hard of Hearing (DHH) Plan. A Comprehensive Statewide Plan for Educational Services for Students who are Deaf or Hard of Hearing.

Texas Department of State Health Services. Vision and Hearing Screening. Hearing Screening Requirements.

Texas Department of State Health Services. Vision and Hearing Screening. Vision Screening Requirements.

Texas Department of State Health Services, Texas Early Hearing Detection and Intervention (TEHDI). Parent Resources & Guidance - TEHDI.

Texas Hands & Voices. A parent-led nonprofit organization providing resources, peer support and advocacy in an unbiased manner to families with children who are deaf or hard of hearing.

Texas Health and Human Services Commission. Deaf Blind with Multiple Disabilities (DBMD)

Texas Health and Human Services Commission. Deaf Blind with Multiple Disabilities (DBMD) Program Manual.

Texas Health and Human Services Commission. Early Childhood Intervention Services (ECI)

Texas Health and Human Services Commission. Early Childhood Intervention Services (ECI). ECI Program Search.

Texas Parent to Parent. Texas Parent to Parent provides support, information, and education for families of children and adults with disabilities, chronic and mental health conditions and other health care needs. 

Texas School for the Deaf

Texas School for the Deaf. Statewide Outreach Center

The University of Texas at Dallas Callier Center for Communication Disorders.

Videos to Share with Families

Washington State Department of Health. (2019). How Newborn Hearing Screening Helps Children.

Nemours KidsHealth, Cochlear Implants. (2022). What Are Cochlear Implants? Available in English and Spanish.