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Alabama's Listening! Universal Newborn Hearing Screening

Alabama's ListeningAlabama's Listening! is the Early Hearing Detection and Intervention Program (EHDI) for the Alabama Department of Public Health. The program was initiated in February 2001 to ensure all Alabama birthing facilities were able to screen for newborn hearing loss, which is the most commonly occurring birth disorder in the United States.

In 2008, Universal Newborn Hearing Screening (UNHS) became a mandated part of the Alabama Newborn Screening panel of disorders. The goal of the program is to create and maintain UNHS programs in Alabama to ensure early identification, treatment, and intervention of infants with hearing loss.

If you have a patient who has been identified with hearing loss, they should be referred for Early Intervention services. To utilize Alabama's Early Intervention System, fax a completed referral form to (334) 293-7393.

Congenital Cytomeglovirus (CMV) and Hearing Loss NEW!

Congenital CMV is the most common non-genetic cause of childhood sensorineural hearing loss. According to the CDC, about one out of every 150 babies are born with congenital CMV infection. However, only about one in five babies with congenital CMV infection will be sick from the virus or will have long-term health problems such as hearing loss.

Some babies without signs of congenital CMV infection at birth may have hearing loss.  Hearing loss may be present at birth or may develop later in babies who passed their newborn hearing test. Congenital CMV infection can be diagnosed by testing a newborn baby's saliva, urine, or blood. Such specimens must be collected for testing within two to three weeks after the baby is born in order to confirm a diagnosis of congential CMV infection.  For more information visit the CDC webpage.

EHDI-PALSHearing Loss: New Online Directory for Parents

Early Hearing Detection & Intervention Pediatric Audiology Links to Services (EHDI-PALS) is a new easy-to-use online directory that helps families find the nearest clinic providing the type of hearing service their child needs. Visit EHDI-PALS for more information.

Reporting Requirements for Hearing Screening

Each year, the Centers for Disease Control and Prevention's (CDC) Early Hearing Detection and Intervention Program (EHDI) conducts the Hearing Screening and Follow-up Survey (HSFS). This survey is designed to collect national data on the number of infants screened, diagnosed, and referred to early intervention for hearing loss, in an effort to monitor the state's efforts in meeting the national EHDI goals.

Listed below is some of the data reported by the state to the CDC. For a more comprehensive view of the data provided to the CDC and to see how Alabama compares to other states, please see the Hearing Screening and Follow-up Survey at the CDC website.


Occurent Births/Vital Records

Total # of Infants Screened

Percent Screened

# of Infants with Hearing Loss

Percent Loss to Follow-up













Newborn Hearing Screening Resources

Developmental Milestones in Hearing

Use this as a guide to see how your child is growing and learning.

Birth to three months:

  • Jumps or blinks to loud sounds
  • Wakes up to loud sounds
  • Quiets when he or she hears mom's voice

Three months to six months:

  • Turns eyes or head to search for the sound source
  • Responds to your voice even when you cannot be seen
  • Enjoys toys that make sounds
  • Starts babbling

At six months:

  • Responds to his or her name
  • Turns head to the direction of the sound source
  • Begins to imitate speech sounds

At 10 to 12 months:

  • Understands and follows simple directions
  • Gives a block or toy to you when asked for it without pointing
  • Imitates speech sounds of others

At 13 to 18 months:

  • Follows simple one step directions
  • Uses 3-20 single words
  • Points to 1-3 body parts when asked

At 19 to 24 months:

  • Understands approximately 300 words
  • Puts two words together ("eat cookie") by 24 months of age
  • Points to five body parts
  • Responds to "yes" or "no" questions

Every Baby Should Have a Hearing Screening

Statistics show that between four to six newborns per 1,000 have some degree of hearing loss. Although these statistics indicate that it is unlikely that your baby will have a hearing loss, if there is one, it is important that you know about it as soon as possible.

The first two years of your baby's life are critical for learning speech and language. Because a hearing loss could affect your baby's speech and language development, it is important to diagnose hearing problems early.

Hearing Screening Methods

There are two types of hearing tests that may be used with your baby. Both tests are very safe, take only minutes to perform, and are non-invasive. Most babies sleep though the hearing screening procedure.

  • Auditory Brainstem Response (ABR): Tests the infant's ability to hear soft sounds through miniature earphones. Electrodes measure your baby's brain-wave to determine if the sounds are heard normally. This diagnostic testing is recommended for high-risk newborns admitted to the NICU greater than five days and should be completed as a second test method if an infant is initially tested with ABR.
  • Otoacoustic Emissions (OAE): Measures inner ear function by inserting a miniature microphone in the ear canal via a soft probe tip and measuring tones from the ear by sending responses to a special computer.

Hearing Screening Results

If your baby does not pass the first screen an attempt may be made to repeat the screening before your baby goes home, or it may be scheduled after going home. Although a small percentage of babies who do not pass the first screening actually do not have a hearing loss, it is important to find out for sure. If your baby does not pass the second screening, different types of hearing tests administered by the audiologist will be recommended.

Because early intervention is so important to the development of infants with hearing loss, it is important that the testing not be delayed. It is recommended that all testing be completed by three months of age and that infants with hearing loss be involved in an intervention program as early as possible, but no later than six months of age. Your audiologist and/or physician can provide you with information on early intervention programs in your area, or you may call 1-800-CHILD-FIND (1-800-543-3098).

Retesting May Be Needed

The results of the screening show how your baby is hearing at the time of the test. Some children with recurrent ear infections and other serious infections, chronic illness or family history of hearing loss may develop hearing loss later in life. If you have concerns about your child's hearing ability or speech and language development, you may have your child's hearing tested at any age.

The Developmental Milestones in Hearing above describes normal development for speech and hearing. If you have concerns about your baby's hearing, speech or language development, you should contact your baby's doctor or an audiologist.

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