Birth Hearing Screen

North Dakota’s Early Hearing Detection and Intervention Program (ND EHDI) works to assure a birth hearing screening is provided to all infants birthed in North Dakota.
All birthing hospitals in North Dakota support ND EHDI and offer hearing screenings prior to discharge. Results of an infant’s birth hearing screen are documented in ND EHDI’s data collection system.
How is a baby’s hearing screened?
Staff completes a hearing screening before your baby leaves the newborn nursery. The test is safe, painless and can be done in about 10 minutes. Most babies sleep through the test. The kind of screener used depends on the equipment at the hospital. In North Dakota, your baby will have an AABR screen or an OAE screen:
- Automated auditory brainstem response (AABR)
Electrodes are placed on the baby's head to detect responses. Sounds (soft clicking noises) are played in the baby's ears. This test measures how the brain responds to sounds and can identify babies who need to be tested for possible hearing loss.
- Otoacoustic emissions (OAE)
A miniature earphone and microphone are placed in the ear, sounds are played and a response is measured. If a baby hears normally, an echo is reflected back into the ear canal and measured by the microphone. If a baby has a hearing loss, the echo is not detected by the OAE machine.
In ND, birthing hospitals adhere to the nursery protocols and guidelines recommended by the Joint Committee on Infant Hearing (JCIH).The JCIH has recognized the need for separate protocols and instrumentation technologies to be used between well-baby nurseries and Neonatal Intensive Care Unit (NICU) designations in hospitals. In the well-baby nursery, the JCIH recommends the use of OAE, automated ABR or a combination of the two for screening technologies. In the NICU nursery, ABR technology has been recognized as the only appropriate screening technique. The American Academy of Pediatrics (AAP) supports the JCIH’s recommendations, principles and guidelines for early hearing detection.
Results of the Hearing Screen
Parents should know the results of the birth hearing screen before their baby is discharged from the hospital. The results will be communicated by hospital staff either verbally, in written form (on a certificate or on discharge papers), or both. Call your baby’s hospital nursery or primary care physician with any questions. A contact list can be found on the ND EHDI Partners page.
- A PASS RESULT means that your baby hears within the normal speech range. Screening is complete. It is important to know that even babies who pass can go on to develop hearing loss. Parents are advised to continue to watch for normal hearing and language milestones. If you have any concerns about your child’s speech, language or hearing tell your doctor right away. Hearing tests can be done at any age. See the Typical Auditory Development chart for a starting point.
- A REFER (Did Not Pass) RESULT means that your baby needs further testing to assure your infant is hearing. It is important to schedule an outpatient screen before one month of age. Generally, hospital staff will schedule an outpatient appointment for families prior to discharge. Outpatient screens may be offered at the birth hospital, clinic, or other local program. A contact list can be found on the ND EHDI Partners page.
- If your baby MISSED (was not screened) at the hospital, contact the hospital where your baby was born and make an appointment for an outpatient hearing screening immediately.
In an effort to reduce the number of infants lost to follow-up, ND EHDI sends letters to families whose infant referred (did not pass) or missed their birth hearing screen. This letter encourages families to return for any needed follow-up services. Certain programs are available free of charge and can provide support to families. Programs such as Right Track and Tribal Tracking can provide in-home hearing screenings and answer any other questions parents may have about their child’s development.

