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For Families and Caregivers

Hearing Screening

Hearing screening is easy, painless, and can identify whether more testing is needed. Babies often sleep while being screened. It usually takes only a few minutes. All infants should receive a hearing screening no later than 1 month of age. Babies born in the hospital should receive a screening before discharge. Many birth centers provide hearing screening. Midwives and primary care offices may have screening equipment. If baby does not pass the hearing screening, it's very important to make an appointment for a full hearing test before baby is 3 months of age. Most babies bond, communicate and learn through hearing. If baby cannot hear well, we need to act fast so that you can communicate with your baby, and baby can learn language.

If Your Baby Refers on Hearing Screening


All infants should be screened for hearing loss no later than one month of age. If the baby does not pass this hearing screening, it is very important to make an appointment for a full hearing test and any needed medical tests no later than three months of age.

A professional trained to test hearing loss, such as an audiologist or an ear, nose, and throat doctor will be able to perform these tests. The baby's doctor should perform or order any needed medical tests to find out the cause of the hearing loss. Because a newborn baby can pass the hearing screening and still develop a hearing loss, the baby's doctor should routinely follow the baby's general health, development, and well-being.

If Your Child is Deaf or Hard of Hearing

The first few weeks and months after learning about your child’s hearing loss can be a busy and overwhelming time. Here are some ideas to help you:

Interact and communicate with your child

Start communicating with your baby now. Some studies indicate that over 90% of what we “say” is shown through nonverbal communication, such as facial expressions and body language. Your baby can learn how to read your face and body, even if he or she can’t hear your spoken words.

Babies learn from the routines you have and things you do or say in everyday life. Talk to your child as you do daily tasks such as changing a diaper, giving a bath, or feeding a meal. Your child will also learn when you sing songs, do finger plays, and play games like peek-a-boo.

Things to Try


Use a natural voice when speaking to your child. Talk and sing to your child.

While rocking or cuddling with your baby, sing lullabies and tell him how much you love him.

Use facial expressions that match your words and actions.

While playing peek-a-boo, say “Peek-a-boo!” with a surprised, happy look on your face.

Say, “Do you need your diaper changed?” with a questioning look on your face.

Use gestures and hand movements while speaking.

When saying, “Let’s go change your diaper,” point to the child’s diaper.

Wave your hand or your baby’s hand when saying, “Hello” or “Goodbye.”

Explain when it is time to do something.

Say, “It’s time for a nap. Let’s go take a nap.”

Make lots of eye contact and use touch, hugs, and kisses to help your baby learn how to interact with you and your family.

Look at your baby’s face and say/sign, “I love you,” then give lots of hugs and kisses.

Guide your child’s hand as he gently pets your family dog. At the same time, look your baby in the face and say, “Gentle,” or, “Nice doggy.” Your baby will learn how it feels to pet the dog gently.

Watch and listen for your child to sign/say words and respond to them.

If your child is making an “M” sound, respond by saying, “Mmmm… milk!” and pointing to your child’s bottle/cup.

If your child makes the sign for milk, repeat the sign while saying, “Milk!” and pointing to your child’s bottle/cup.

Respond to your child’s facial expressions.

Say, “You look like you’re having fun!” with a big smile.

Say, “Uh oh. You look sad,” with a sad face.

Keep a journal for your child

Here are some writing topics to help you get started:

  • Sounds that your child responds to or makes – as your child grows, this may help you see how far he/she has come!
  • Questions or concerns that you have
  • Your feelings and experiences during this process
  • Your hopes, dreams, and thoughts about the future

Get organized

Consider making a binder or notebook to keep copies of clinical reports and important forms. Include a cover sheet with names and phone numbers for your child’s primary health care provider, audiologist, and insurance company. Take this notebook to your child’s appointments, so you can provide old information and have a place to store new materials, too. Make sure you bring any questions you have, and extra paper to take notes. Parents have also recommended establishing a case manager with your insurance provider.

Seek support from family and friends

People who are close to you can be great support. Invite the support people in your child’s life to participate in visits to the audiologist, early intervention meetings, and parent groups.

Helpful links

1) Babies need to feel connected to family and other loved ones.

In the first year, your baby needs to feel connected to you. Because of reduced hearing, your baby may be less aware of the people and action around him or her. Even with appropriate amplification, your baby will need touching, holding, smiling and eye contact. Your baby will then see, feel, and hopefully hear you and others talking. Put your baby in the middle of the action. Feeling connected to you will lay the foundation for your child to feel secure, comfortable and ready to join in activities and conversations.

2) Babies need to develop non-verbal and verbal communication skills.

Much of the communication in the first year of a baby’s life is non-verbal. All parents use certain gestures, such as gesturing up with open arms accompanied with “Want up, baby?” They point or use an open hand indicating, “Can I have it?” Parents gesture to come, stop, put it there, with simple words attached. Using these gestures and simple verbal language helps your baby learn the basic skills to begin interacting with your family. These simple interactions are also chances for your baby to “take a turn.” Be sure you pause after you say something to give your baby a chance to respond. He might take that turn by looking at you, smiling and reaching up. By the end of that first year, he may be beginning to use sounds that are starting to sound like “something” or using gestures back with you.

3) Babies need to be exposed to frequent repetition of routine language and direct conversation.

Through simple words, gestures, songs, rhymes and finger plays, babies learn the meaning of words and the pleasure of music. Babies listen to intonation more than specific words. Singing, rhyming and using varying intonation in your voice will help your baby enjoy the communication around him or her. This is referred to as “baby talk” or “parentese;” it is the way most parents naturally communicate with their baby. Talk directly to your baby, and label his or her favorite people and things repeatedly.

4) Babies need access to sound as soon as possible.

All babies need auditory input in the first year of life to learn about the world around them. They will hear talking, dogs barking, cars going by, singing, and doors closing. Your baby will begin to use these sounds to find out where mom is, what brother is doing, and who is home. In order to have access to these key ways of knowing the world, many babies with hearing loss will need to be fitted with hearing assistance technology (hearing aid) as soon as possible.

Early Hearing Detection and Intervention (EHDI) Program

ehdi logo

A comprehensive, coordinated system of early identification and provision of support services for children under three years of age with hearing loss and their families. The Oregon EHDI program is housed within the Oregon Health Authority and is tasked with monitoring hearing health for all children less than three years of age. The EHDI program collaborates with hospitals, audiologists, local public health, Early Intervention facilities, and other partners to ensure that infants with a hearing loss receive appropriate and timely intervention. The goal of the program is to identify infants with a hearing loss prior to three months of age and link infants to Early Intervention services by six months of age.
Phone: 1-888-917-HEAR (4327)
Email: Oregon.ehdi@dhsoha.​

Early Intervention (EI)

A system of services that helps eligible babies and toddlers learn the skills that typically develop during the first three years of life. Once you and your child enroll in an Early Intervention program, specialists in that program will provide support, information and expertise to you. Your time and commitment to your baby are essential for his/her success. Your audiologist will refer you to the EI program in your county. Should you desire additional services for your child, there are also private EI providers. See the section below titled “What is Early Intervention” for more information.

Guide By Your Side (GBYS)

guide by your side

A Hands & Voices program that coordinates with the Oregon EHDI program. Guide By Your Side matches trained Parent Guides with families of children newly identified with hearing loss. The Parent Guides also have children with hearing loss and can provide you with unbiased support, resources, and insights. This is an unexpected path for most families and having another parent to talk to can be beneficial. The Guides can be a great help while you weave your way through the many different decisions and appointments you may need to make.
Contact: Helen Cotton Leiser, GBYS Parent Coordinator
Phone: 971-673-2302

Public Health Nurse

A public health nurse provides home-visiting services to families, assisting in care coordination and encouraging the development of good health habits. You may be contacted by a Babies First! and/or a CaCoon nurse working in your county.

Babies First!: For families of children ages 0 to 5 years old. The goal of this program is to improve the health outcomes of high-risk/vulnerable children through prevention and early intervention.

CaCoon: For families of children ages 0 to 21 years with special healthcare needs. The goal of this program is to assure these children have access to needed health services, spanning multiple systems of care, resulting in the best health possible.


Early intervention (EI) is a system of services that helps eligible babies and toddlers learn the skills that typically develop during the first three years of life, such as:

  • communication (talking, listening, understanding);
  • cognitive (thinking, learning, solving problems);
  • physical (reaching, rolling, crawling, and walking);
  • social/emotional (playing, feeling secure and happy); and
  • self-help (eating, dressing).

Most children with hearing loss qualify for EI under the “communication” category. Once diagnosed and fit with appropriate amplification (if needed), starting EI services as quickly as possible minimizes delays in developing speech, language and social skills. The sooner a child begins receiving appropriate intervention, the more likely he/she is to stay on track and meet developmental milestones.

How do I get started?

Following confirmation of hearing loss, your audiologist will automatically submit a referral to the public early intervention program based on your county.

The program will then begin to collect documentation and prepare for your child’s EI evaluation. They may request reports and test results from your audiologist to help them determine your child’s eligibility for services.

Be sure to respond to calls and paperwork requests from the EI program staff promptly so that your child's EI evaluation appointment can be scheduled as soon as possible. You cannot begin receiving services until the evaluation is completed and your child is determined to be eligible.

What other EI options are available?

In addition to the public EI options offered through the department of education, there are private EI options as well. Some families choose private EI to supplement or substitute for public EI. Private EI may offer additional services and/or more intense or frequent sessions.

Though the following options are separated by communication mode (auditory or visual), remember that you can explore any communication opportunity until you determine what is right for your child and your family.

Options for families interested in pursuing listening and spoken language (auditory)

Tucker Maxon Oral School: A comprehensive infant-toddler program located in Portland, OR specifically designed to teach children who are deaf or hard-of-hearing to listen and talk. They also offer tele-intervention services.

John Tracy Clinic: Through distance education, curriculum is available to parents by mail or online. Courses are available in English and Spanish and free of charge.

The Moog Center for Deaf Education Teleschool: Through distance technology, the Moog Center (based in St Louis, MO) offers virtually the same curriculum and coaching strategies that have proven to be successful in their Family School Program.

Options for families interested in pursuing signed language (visual)

Parents who have decided to include signed language to their baby's communication options will also need to learn to sign as quickly as possible. Sign language classes are offered at many community colleges, recreational institutions (YMCA), as well as on DVD and online.

Sign With Me: Instructional DVD and workbook help parents learn to sign (ASL) simple but expressive sentences for daily interaction with a deaf or hard-of-hearing child.

Life-Print: Internet-based, free of charge, self-study courses in ASL. Content covers two full semesters of ASL, and offers a searchable video-dictionary.​

Hearing loss can occur alone, but it may also be a red flag for other issues. Follow your provider’s advice about whether to see any other specialists. If you have concerns about any of the areas described below, notify your provider immediately.

Be sure to request specialists who have experience working with families, infants and young children. All notes and reports should be shared among your primary care provider and specialists to ensure each professional has the same information and can treat your child effectively.

Ears: Ear, Nose, Throat (ENT) Physician, Otolaryngologist, or Otologist

  • Check ears for fluid, wax, physical issues
  • Provide medical clearance for hearing aid use
  • Recommend additional testing to assess ear structures
  • Perform ear surgeries, including cochlear implant surgery

Hearing: Audiologist

  • Diagnose hearing loss and monitor hearing sensitivity
  • Fit, program and check hearing aids and/or cochlear implants

Early Intervention: Early Intervention Provider, Special Educator, Teacher of the Deaf

  • Support children who have developmental delays (including hearing loss)
  • Teach families how best to help their child learn during the early years of life

Speech/Language: Speech-Language Pathologist (SLP)

  • Evaluate and treat speech and language disorders
  • Assist in development of auditory skills

Genetics: Geneticist or Genetic Counselor

  • Discuss genetic and non-genetic causes of hearing loss
  • Help you decide whether you want to pursue genetic testing
  • About 50% of infant hearing loss is related to genetics

Eyes: Ophthalmologist

  • Test and treat vision or eye disorders
  • About 20% of children with sensorineural hearing loss also have vision problems

Mental Health: Counselor or Therapist

  • Provide emotional support for children and families
  • Many families want to process their thoughts and feelings after their child is identified with hearing loss

Your Child's Hearing and Next Steps

Understanding Your Audiogram (pdf)
This worksheet will help you to learn about your child’s hearing loss and the various terms used to describe it. Your audiologist will indicate which apply to your child by marking the box for the respective ear next to each.

Guide By Your Side

Guide By Your Side is a Hands & Voices program that matches trained parent guides with families who have recently found out their child has a hearing loss.
Parent guides, who also have a child who is deaf or hard of hearing, provide unbiased support to families, helping each family make decisions that are right for their child. Through direct peer connections, guides promote self-efficacy and reduce isolation by exploring common bond, shared experiences, wisdom and insight.

Resources for Families