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Newborn Screening Ontario
Hearing Loss Risk Factor Screening

Primary Care Providers

Newborn Screening Ontario (NSO) is partnering with the Ontario Infant Hearing Program (IHP) to expand Universal Newborn Hearing Screening to include risk factor screening for Permanent Hearing Loss (PHL). This will be done using the dried blood spot sample routinely collected by midwives and hospitals for newborn screening. This screening will be offered as standard of care for babies born on or after July 29, 2019.

There is no need to change the standard discussion you have with families about newborn blood spot screening. Risk factor screening for PHL will be described and offered to parents/guardians by the Infant Hearing Program (IHP) hearing screener at the time the physiologic infant hearing screen is performed, or when it is booked. No extra blood is needed.

If consent is obtained by the IHP, testing for Cytomegalovirus (CMV) and several common genetic risk factors for PHL is performed by Newborn Screening Ontario (NSO). Infants with these risk factors have a higher chance of having PHL at birth or of developing it in early childhood and, when found through screening, can be connected earlier with audiology follow-up through the IHP. 

CMV screen positive infants will require an initial, timely medical evaluation to determine whether symptoms of congenital CMV (cCMV) are present, as treatment may be an option for some symptomatic infants. NSO has recruited a group of Community Pediatricians from across the province, who have received additional education on cCMV and will see CMV positive infants in referral for the initial assessment and developmental follow-up. The role of these Community Pediatricians is not to replace primary care, but rather to provide specialized care related to cCMV.

You may be notified by NSO in the event one of your patients has a positive CMV or genetic risk factor screening result. As with other newborn screen positive results, NSO may ask for your assistance in disclosing the result to the family and explaining the next steps required. In our experience, we have learned that there is often benefit to a family being informed of results initially through a familiar health care provider, and we thank you for your continued support in this regard.

Risk factor screening results for PHL will be reported separately from NSO’s newborn screening results report. They will be routinely sent to the Infant Hearing Program in the region which the baby was screened. Please visit the Request Screening Results page for information about how to request and interpret risk factor screening results for a patient.

If you have any questions about how risk factor screening for PHL might impact you as a primary care provider, please do not hesitate to contact us.


In light of the COVID-19 pandemic and discontinuation of non-essential services, the Infant Hearing Program (IHP) is postponing all audiometric hearing screening and is temporarily unable to obtain consent for risk factor screening for PHL. After careful review by the Ontario Ministries of Health (MOH) and Children Community and Social Services (MCCSS), a decision was made to continue with the risk factor screening program. All specimens from babies born on or after March 26, 2020 will be screened for CMV and genetic risk factors for PHL without the need for additional consent by the IHP. Screen positive results continue to be referred for medical and audiologic follow-up. These are temporary measures, and we will revert to our original consent practice as soon as the IHP returns to regular operations. Please contact NSO if you have any questions.