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Newborn Screening Ontario
Expanded Hearing Screening

Expanded Hearing Screening FAQ

What is hearing screening?

Hearing screening identifies babies at risk for hearing loss as early as possible.  It is considered standard of care for all babies born in Ontario.  Every year about 3 in 1,000 babies are born deaf or hard of hearing in Ontario.  Through hearing screening these babies can be found very early and given the help they need to develop language.  For more information about the Ontario Infant Hearing Program, please visit: http://www.ontario.ca/infanthearing

What is expanded hearing screening?

Expanded hearing screening involves hearing screening plus a blood spot screen for hearing loss risk factors.  The main risk factors are congenital cytomegalovirus (cCMV) infection and inherited predispositions to hearing loss.  Children with these risk factors may be deaf at birth or may develop hearing loss early in life.  Starting in Spring 2018, parents will be offered the opportunity through expanded hearing screening to have their baby screened for cCMV.

What are the potential benefits of expanded hearing screening?

There are benefits to identifying hearing loss early in babies and understanding the reason for the hearing loss.  The result of the hearing loss risk factor blood spot screen gives health care providers information to help them decide what treatment options and services are best for a baby and allows care providers to make sure that babies can get the care they need as quickly as possible. 

As well, babies with cCMV infection who do not have hearing loss identified at birth are eligible to be monitored because they still have a chance to develop hearing loss later in childhood.  Knowing a baby has cCMV would mean that additional monitoring and checkups could be offered to address any concerns that might arise, as early as possible.

Are there any reasons not to have expanded hearing screening?

There is no right or wrong choice when it comes to a parent or guardian’s decision about expanded hearing screening and some parents may decide not to have it.  If a baby is found to have hearing loss, they will get all the services needed to ensure the best outcomes possible, regardless of the parent's decision about expanded hearing screening. 

If a baby has the expanded hearing screen, parents could learn that their baby has cCMV infection.  Most children with cCMV will not develop any health problems related to the infection.  However, at the moment there isn't a good way of knowing if or when a baby with cCMV will develop hearing loss.  This means that some babies with cCMV may get extra monitoring and checkups and no health issues related to the infection would be identified.  Some parents might feel that the extra checkups could give them reassurance. For other parents, they might feel that the extra checkups could make them more worried about their baby’s chance to develop hearing loss.  

Is one hearing screening option better than the other?

Hearing screening in general (either alone or expanded) is strongly encouraged for babies and is considered a medical recommendation and standard of care in Ontario.  Both screening options include hearing screening as the first step.  Remember, babies who pass the hearing screen are not eligible for expanded hearing screening.  If a parent declined expanded hearing screening at first, but then the IHP recommends that follow-up be arranged with an audiologist based on the baby’s hearing screening results, the option of expanded hearing screening (i.e. testing for cCMV) would be offered again. 

Does a parent's decision about expanded hearing screening affect other screening tests for the baby?

No.  Newborn screening is considered standard of care in Ontario. The vast majority of babies born in Ontario get a newborn screen for the purpose of checking for the potential of a variety of rare, but treatable diseases.  The decision about expanded hearing screening is a choice.  The newborn screening sample would be used for the hearing loss risk factor blood spot screen only with parental/guardian consent (and if the baby is eligible). 

Can parents who want expanded hearing screening be confident that a newborn screen was collected in the baby?  

In Ontario, the vast majority of babies have a newborn screen collected within the first week after they are born, typically 24-72 hours (1 to 3 days) after birth. Parents may not recall the sample being collected, but most likely it was taken.  Newborn Screening Ontario also contacts the birthing hospital and/or midwife about one week after a baby’s birth to follow-up on any babies who may not have had a newborn screening sample collected yet for the purpose of the newborn screen.

Parents/guardians who are concerned that a sample was not collected for their baby, can call us at 1-613-738-3222.  While Newborn Screening Ontario will not release results to parents by phone, we can confirm if a sample was received. 

Information on the parent education sheet from the IHP hearing screener about the baby or screening option chosen is incorrect.  What should I do?

Please contact your regional IHP (indicated at the bottom of the information sheet) if you notice that the education/parent information sheet has information on it that you think is incorrect.  Contact information for the regional IHP Lead Agencies can be found here

If a parent changes their mind about hearing screening, who should they contact?

A parent/guardian who picked hearing screening alone but now wants expanded hearing screening should contact their regional IHP to let them know about this change. 

A parent/guardian who picked expanded hearing screening but now does not want the hearing loss risk factor blood spot screen to be done should contact Newborn Screening Ontario directly for information about next steps.   Once we knows that the testing should be done, it usually takes about one week to complete testing and get results.  Therefore, depending upon how much time has passed, it is possible that testing may have already been completed.   To contact us call 1-613-738-3222.

If a parent/guardian who declined hearing screening at birth becomes interested in hearing screening, they should speak to their baby’s health care provider and/or contact their regional IHP for more information.

Can a baby who did not have a newborn screen collected have expanded hearing screening?

No.  The hearing loss risk factor blood spot screen involves using the newborn screening sample for testing.  If newborn screening was declined for a baby, Newborn Screening Ontario would not have a dried blood spot sample to be able to perform the hearing loss risk factor blood spot screen.  Hearing screening by itself remains an option. 

Can a baby who was not born in Ontario have expanded hearing screening?

The hearing loss risk factor blood spot screen needs to be done on a sample that was collected at less than 3 weeks of age in a baby.   If a baby had an Ontario newborn screen collected within the first 3 weeks of age (i.e. <21 days of age), then there could be the possibility of expanded hearing screening for the baby. 

If a baby was more than 3 weeks of age when they arrived in Ontario, expanded hearing screening would not be an option.  However, the baby could still be eligible for hearing screening.  Contact your regional IHP and/or speak to your baby’s health care provider for more information about whether your baby can have hearing screening.

Can a baby without OHIP have expanded hearing screening?

The hearing loss risk factor blood spot screen needs to be done on a sample that was collected at less than 3 weeks of age in a baby.   If a baby had an Ontario newborn screen collected within the first 3 weeks of age (i.e. <21 days of age), then the potential of expanded hearing screening for that baby exists.  Contact your regional IHP or speak to your baby’s health care provider for information about whether hearing screening is available.

How long do results of the hearing loss risk factor blood spot screen take to get back?

Results of the hearing loss risk factor blood spot screen will be available about 1 week after we have received notification to perform the screen.