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Frequently Asked Questions

1. Why should I have my baby's hearing screened?

It's really important to find out if your baby has hearing loss. Undetected hearing loss can cause delays in your baby's learning to talk, which can lead to behavioural and emotional problems and, later on, to problems in school.
The sooner hearing loss is identified, the better. There are many services available to help children with hearing loss. Finding out early means that they can get the help they need right away. And this gives them the same chance to develop language skills as hearing children.
"Every year in Ontario, approximately four in 1000 babies are born deaf, hard of hearing or will develop early progressive childhood hearing loss. Most deaf and hard of hearing children whose hearing loss is identified early, and who receive the support they need, will have the same chance to develop language skills as hearing children."

2. How do I get my baby's hearing screened?

All birthing hospitals and midwives in the Regions of Brant, Haldimand-Norfolk, Hamilton and Niagara provide the newborn hearing screens. Additional follow-up screens are available at local community clinics in: Brantford, Caledonia, Dunnville, Fort Erie, Grimsby, Hamilton, Langton, Niagara Falls, Simcoe, Stoney Creek, St. Catharines and Welland.

3. How is my baby’s hearing screened?

There are 2 pieces of equipment used to screen a baby's hearing:

DPOAE (Distortion Product Oto-acoustic Emissions)
(This is the test most often done in a well-baby nursery in a Hospital or at a midwifes office)

This is a picture of a probe being placed in a baby’s ear.
A small probe is placed in a quiet or sleeping baby's ear. The probe emits soft sounds and the ear's response to these sounds is measured and recorded. The entire screen takes a few minutes and results are available right away. A pass indicates the baby's cochlea responded to the sounds. A refer indicates that a response could not be detected and further testing is required.




AABR (Automated Auditory Brainstem Response)
(This is the test most often done on babies in the NICU or at a community clinic if your baby has not passed the DPOAE)

This is a picture of the electrodes placed on the baby’s forehead.

Sounds are generated from a small probe in the baby's ear. Electrodes placed on the baby's forehead and behind the ears monitor the brain's response to the sounds and a computer interprets the response. A pass indicates the baby's auditory system, up to and including the brainstem, has responded to the ear. A refer indicates the baby needs a more comprehensive hearing assessment.





4. Where can I go to get the screening?

Infant Hearing Screenings are offered in many places, often they are in Ontario Early Years Centres, and Preschool Speech and Language Programs. To find your closest screening location please call:

For the Hamilton Area: 905-385-7927 x 227
For the Brant Area: 519-759-1236
For the Haldimand Norfolk Area: 519-426-6170 x 3451
For the Niagara Area: 905-688-1890 x 150

5. Will the screening process hurt my baby?

The screening process is quick, simple and safe. Most babies sleep through the process. In the first stage of screening (DPOAE), which occur most often in the hospital before your baby is discharged, a very small earphone is placed in your baby's ear and soft sounds are played through it. The ear's response to these sounds are measured and recorded. Your baby does not have to give a response.
In the second stage of testing (AABR) which most often occurs in NICU hospital units and in community clinics, the baby’s forehead and behind each ear are cleaned with an alcohol swab. Three sticky pads (electrodes) are placed in these areas. A small earphone is place in the baby’s ear and very soft clicking sounds are played through it. The baby is connected to a laptop computer which measures and records the response to sound.

6. How do I prepare my baby for the screening?

The screening takes only a few minutes and it is best completed when your baby is sleeping. Try to leave your baby in their carseat for testing purposes. If possible feed your baby just before arriving for the appointment. Do not put any creams, lotions, or oils on your baby's forehead or behind their ears. Make sure to bring extra diapers, a soother, and milk/formula to the appointment. No Health Card is required.

7. Can I go to my family doctor for the screening?

NO. The Infant Hearing Program has specially trained screeners to perform the infant hearing screening. If a child requires Audiology Services the Infant Hearing Program has specially trained audiologists who have experience working with infants and children using the Ministry of Health's standard Infant Hearing Program protocol for testing.

8. My baby did not pass one or both ears at the hospital or midwife hearing screening, what happens next?

If your baby did not pass the hospital screening, or the screening done by the midwife, in one or both ears, it is important to know that this does not mean that your child is deaf or hard of hearing. It does mean that they should be tested in a different way with the AABR equipment in the community. You will be contacted by your local IHP to arrange this appointment. If you do not hear from someone regarding this appointment within 3 weeks please call:
905-385-7927 x 227 or 1-866-826-4327 to inquire

9. My baby did not pass the community screening (AABR) what happens next?

Not passing an AABR screening in the community does not mean that your baby is deaf or hard of hearing, there are usually other reasons why a baby may receive refer results. However it is very important to have the follow up assessment done in order to determine your baby’s hearing levels. This requires your baby to have a full audiological assessment done. This testing is done at 2 months of age (corrected) and is only available by specially trained Audiologists at the Audiology Department of McMaster Sick Kids Hospital at the Chedoke Site in Hamilton. The audiology department will contact you directly to arrange this appointment as your child will be automatically referred to them from the Infant Hearing Program following their last hearing screening.

This test is painless but does require a longer appointment time. Usually 2 hours are booked for this testing and your baby needs to sleep for a portion of this test. It is best to follow the guidelines given to you to ensure the best possible testing situation. Due to the unpredictable nature of babies, further appointments may be necessary to complete testing.

This testing is similar to that in a community clinic setting with an AABR but is more involved and requires one more (4) electrodes to be placed on the baby’s head. You will stay with your baby throughout the testing.

The following are some guidelines to prepare your baby for their audiological assessment:

  • Bring the baby awake and ready to be fed to the appointment
  • Make sure you have milk/formula, a soother, a blanket, diapers etc. on hand
  • Do not put any lotions or creams on the baby’s head or behind the ears
  • If you are driving the baby to the appointment have someone come with you to keep the baby awake in the car during the drive, so the baby arrives tired for the appointment
  • You will need money for parking!
  • Reschedule the appointment if your baby is ill

10. My baby has recently been diagnosed with a hearing loss what happens next?

If your baby has been diagnosed with any type of hearing loss from a unilateral loss, a mild, moderate, severe, profound hearing loss or Auditory Dyssynchrony/Neuropathy, the Infant Hearing Program will be involved with you and your child until your child reaches 6 years of age.

The IHP Audiologist involved with your baby will make a referral for any child identified with a permanent hearing loss to a Pediatric Otolaryngologist (Ear, Nose and Throat Specialist), for consultation and evaluation.

A Family Support Worker (FSW) will be involved with your family to support you throughout the process from diagnoses to discharge. She will help you to understand the hearing loss and its impact on you and your child’s life. The FSW will coordinate services for your child and liase with other professionals on your behalf. The FSW will inform you of, and help you to apply for any applicable funding. At the time of school entry there will be a transition to school plan in order to transfer some services your child may be receiving.

The IHP will also provide services to support the development of the language and communication skills of the baby. Each family will make an informed decision about which mode of communication is best for their child and which community agency (ies) would best suit the family's needs d3ependidng on the nature of the hearing loss. The IHP will support the family in their choice (s).

Your child will require ongoing hearing assessments and depending on the nature of the loss will require various other services available through the Infant Hearing Program.

11. What do the results from the screening mean?

A) My baby received Pass results:

If your baby receives a pass at the hearing screening appointment, this indicates that the baby is hearing well at the time of testing. If the baby has no family history of hearing loss, and no medical conditions which put a baby at increased risk for hearing loss the baby is then discharged form the Infant Hearing program. Parents are encouraged to monitor their child’s speech, language and hearing milestones. If you have any concerns please contact:

B) My Baby received a Pass result but is at increased risk for developing a hearing loss:

If your baby passes the screening it indicates that your baby is hearing fine at the time of screening. However if your baby passes the screen but is also known to be at increased risk for developing a hearing loss (either through family history or medical condition) the baby needs to return at 4 months of age, and 12 months of age for follow-up screening. The 4 month testing is only available in Hamilton at the audiology department at the Chedoke Hospital Site of McMaster Children’s Hospital. 12 month appointments occur at a few different locations depending on where you live. There will also be 18 month and 24 month follow up surveillance. All of the surveillance appointments are set up for you and your baby.

C) My Baby received Refer results:

A refer result indicates that the equipment used to test your baby could not adequately measure responses to give a pass result at the time of testing. It does not necessarily mean the baby has a hearing loss. A slight cold, stuffiness, fluid, earwax, fidgeting, noise in the room and other poor testing conditions can affect the results. Most babies who receive a refer result from the stage one (DPOAE) or stage 2 (AABR) screening have perfectly normal hearing, however further assessments are required. The baby will be referred to an IHP Audiologist for a full hearing assessment. This assessment is done when the baby is the corrected age of 2 months.

12. I am not sure if my older child (over the age of 2) has a hearing loss or a speech and language problem?

I have one or more of the following speech and language development concerns about my preschool child (0 to age 5):

  • My child is not learning to talk well.
  • I have questions about how my child communicates.
  • I am worried about my child's play or social skills.
  • My child often repeats sounds or words.
  • I am concerned about my child's voice sounding different or odd.
  • My child is having problems understanding me or trying to tell me something.

Problems with communication development in preschool children are surprisingly common. In fact, one in 10 preschool children has difficulties with speech and language development.

If you have concerns regarding your child’s speech or language please contact your local Preschool Speech and Language Program: