The birth of a baby is such a special and magical time, but it can also be a time filled with stress for parents; stress with the many screenings that take place to ensure that their baby is born healthy. This website is dedicated to North Carolina’s Early Hearing Detection and Intervention Program (EHDI), specifically the pediatric audiologists who participate in the EHDI process.
Undetected hearing loss is a developmental emergency. NC EHDI’s mission is to ensure that every child receives the care and support they need in a timely manner while keeping the Joint Committee on Infant Hearing (JCIH) 1-3-6 goals in mind. Hearing loss can impact a child’s social and emotional development as well as their expressive and receptive speech and language development. Additionally, 95% of children with hearing loss are born to parents with normal hearing. Therefore, parents are not anticipating their baby failing their hearing screen. By the time a family arrives at your office, their baby will have failed at least one, if not two hearing screens.
This page will help you navigate the resources available in North Carolina so that you can help the families you serve to maximize their baby’s fullest potential. Please also contact our NC EHDI Regional Consultants with questions regarding your area of NC.
North Carolina passed legislation (PDF, 106 KB) to require birthing hospitals to screen hearing in 1999 and most hospitals began such screening in 2000. Therefore, the vast majority of infants entering a medical practice in North Carolina will have received a hearing screening at their birthing facility. Results of the Newborn Hearing Screening are sent to the primary care medical practice serving an infant by the birthing facility. Results can also be obtained directly from the NC Early Hearing Detection and Intervention Program office.
NC EHDI Advisory Committee
Mission: The EHDI Advisory Committee is committed to the adoption of Universal Newborn Hearing Screening and Early Hearing Detection and Intervention Programs. Our goal is to facilitate the early identification, diagnosis, amplification and intervention of infants and children with hearing loss in order to maximize developmental outcomes.
Purpose: The purpose of the EHDI Advisory Committee is to guide the development, coordination, and quality evaluation of community-based EHDI programs. Specifically,
- To foster an understanding of the Early Hearing Detection and Intervention (EHDI) process within community settings with families and professionals;
- To encourage the development of efficient programs involved in the EHDI process including screening, re-screening, diagnosis, amplification, habilitation, and intervention within community settings;
- To encourage research of EHDI services within community settings; and
- To review NC State EHDI program performance as compared to the National EHDI quality indicators and outcome measurements for a Universal Newborn Hearing Screening Program and EHDI Tracking and Surveillance System.
Most initial hearing screenings are conducted with an Automated Auditory Brainstem Response (AABR) screener, although some hospitals use an Oto-Acoustic Emission (OAE) screener. Both methods screen mid to high-frequency sounds. An AABR screening tests the responsiveness of the complete auditory system from the ear to the brain whereas an OAE screening results from Outer Hair Cell response in the cochlea. It is possible, although rare, for a baby to pass an OAE screening but still have a condition of hearing loss called Auditory Neuropathy/ Dyssynchrony. In this condition, the auditory signal does not arrive in the brain in a synchronous manner and the child will hear a very distorted signal. Thus, the child may not meet speech and language developmental expectations.
Infants who have received care in the NICU represent 10% to 15% of the newborn population and have been shown to have a higher prevalence of elevated hearing thresholds compared to infants from well-baby nurseries (Robertson et al., 2009; Vohr et al., 2000). For more information see page 9 of the 2019 JCIH Position Statement.
Read questions frequently asked by parents about the newborn hearing screening process and follow-up.
Comparison of Newborn Hearing Screening Equipment
To learn more about the different newborn hearing screening equipment review this table created by the National Center for Hearing Assessment and Management (NCHAM). The table was last updated in 2021. Additional research may be necessary to identify all available hearing screening equipment.
The NC Early Hearing Detection and Intervention (EHDI) Program’s goal is to facilitate the early identification, diagnosis, amplification and intervention of infants and children with hearing loss to maximize developmental outcomes. National EHDI Goals include the following 1-3-6 timeline:
1 - Infants complete screening by one month of age;
3 - Infants needing a diagnostic test have it done by three months of age; and,
6 - Infants with hearing loss receive intervention by six months of age.
Best Practices for Pediatric Audiologists
“Audiologic diagnosis of the infant is the sole purview of the audiologist with specific skills, knowledge, and access to all necessary equipment for infant and early childhood audiologic diagnostic evaluations. It is incumbent upon the audiologist who lacks experience or equipment to refer infants to audiology centers where timely and comprehensive evaluation can be accomplished. Only through consultation with such an audiologist can accurate diagnosis occur, and timely early intervention for the infant and family be assured. Pediatric audiologists and facilities can be discovered through the roster of Pediatric Board Certified audiologists on the ABA website and the Early Hearing Detection and Intervention–Pediatric Audiology Links to Service (EHDI PALS) website.”
Audiologic diagnosis in the infant must be conducted in a timely manner by audiologists skilled in infant assessment with access to all necessary equipment using evidence-based protocols. Testing is performed to quantify frequency-specific thresholds for air- and bone-conduction stimuli, and to determine the type and degree of hearing loss in each ear to guide the fitting of hearing aids.
In keeping with the 1-3-6 EHDI goals, audiologic diagnosis should be completed no later than 3 months of age. This earlier age facilitates the diagnostic process as infants are more likely to sleep for prolonged periods of time required to complete all measures. In children with special health needs, delay in diagnosis of hearing loss may be unavoidable due to attention paid to other health/time-urgent diagnostic and treatment procedures; however, every effort should be made to minimize the delays.
For more information see pages 12-17 of the 2019 JCIH Position Statement.
WCSWeb is a secure web-based data tracking and surveillance system developed and utilized by both NC-EHDI and Sickle Cell programs within the NC Department of Health and Human Services. The EHDI-IS (EHDI Information System) part of this system is referred to as “Hearing Link”. This system is a unique web-based tracking and surveillance system which allows for direct data entry and tracking by providers throughout North Carolina.
Hearing Link currently includes direct data entry from birthing facilities and/or audiologists for:
(1) demographic information for each occurrent birth, (2) hearing screening results, (3) newborn metabolic screening specimen information, (4) diagnostic audiologic evaluation results, (5) amplification selection results, (6) information regarding follow-up appointments, (7) intervention program referral, eligibility and enrollment dates, (8) effective date of Individual Family Service Plan (IFSP) or Individualized Education Plan (IEP), and (9) speech, language and educational assessment results. All this data is individually identifiable.
A Pediatric Audiologist is trained in the evaluation, diagnosis, and fitting of amplification in infants and young children with hearing loss, requiring knowledge of child development, equipment particular to the evaluation of this age group, and the patience, willingness, and effective communicative skills needed to work with parents and other professionals involved with this age group.
You can also use the Early Hearing Detection and Intervention-Pediatric Audiology Links to Services (EHDI Pals) website to locate pediatric audiologists in your area: www.ehdi-pals.org. For information concerning what you should expect from a child's audiological evaluation, please see the North Carolina Pediatric Diagnostic Audiology Protocol.
Read questions frequently asked by parents about the newborn hearing screening process and follow-up.
North Carolina has a support system for families of young children with hearing loss. The first step is to identify and diagnose the hearing loss and to complete any necessary medical treatment.
Any amount of hearing loss can affect a child’s speech, language, social, emotional, and educational development. It’s important to take advantage of early intervention services to help deaf or hard-of-hearing children be as successful and on target as they can be. Many early intervention services are free of charge.
If hearing loss is diagnosed, the following early intervention referrals should be made using the Permission for Referral Form:
The North Carolina Infant-Toddler Program (ITP) provides services for the development of infants and toddlers with special needs and their families. These services are provided through your local Children’s Developmental Services Agencies - CDSA. Evaluation and service coordination are free. A child and family may receive supports and services if the child is up to 3 years old and has a developmental delay or established condition, including hearing loss.
Once CDSA services are accepted, a family can be connected with a teacher of the deaf and hard of hearing through the Early Learning Sensory Support Program for Children with Hearing Impairments (ELSSP-HI). They will work on listening skills and language development. These services are different than speech therapy services. If CDSA services are declined, ELSSP-HI cannot work with the family.
BEGINNINGS for Parents of Children who are Deaf or Hard of Hearing: (birth-21 years old) is a non-profit organization that help parents understand the needs of children who are deaf or hard of hearing. They support families as they make decisions about their child, and they assist parents during the early decision-making stages and throughout their educational career.
Centers for Disease Control and Prevention (CDC) EHDI Annual Data Reports
American Speech-Language-Hearing Association (ASHA) Resource Guide for Educational/Pediatric Audiologists
American Academy of Audiology Training
Early Hearing Detection and Intervention Links to Pediatric Audiology Services (EHDI-PALS) is a web-based searchable national directory. It helps families, healthcare professionals, and state public health organizations to find pediatric audiology expertise for children ages birth to five. The website provides information about childhood hearing to support families and professionals through the process of screening, diagnosis, and intervention.
NC Early Hearing Detection and Intervention Documents:
Family Support Resources in North Carolina: EHDI Program resources and NC family support resources.
Funding Information: Medical care for hearing loss can be expensive. You can explore the resources below to find ways to pay for services and devices.
More Resources: Additional North Carolina resources that may help families navigate their child’s hearing loss.
As a family who is learning about your child's hearing loss, we know you may be feeling many emotions. A valuable resource is Family Support.
Family support is a way to connect with other families who have children with hearing loss. Families often feel empowered when they talk to other families who have been on a similar journey and are able to share their stories and provide unbiased support. We encourage you to learn about family support resources available in North Carolina to support your family's needs.
Family Support Resources in North Carolina
EHDI Regional Consultants and Parent Consultants
EHDI has ten regional consultants and two-parent consultants, one of whom is bilingual in English and Spanish. Our staff can help connect your family to available resources.
NOTE: Parent consultants provide service to the entire state.
The EHDI Parent Support Team
The Early Hearing Detection and Intervention (EHDI) Parent Support Team is a diverse network of parents formed to provide parent-to-parent support for families that have a child who is deaf or hard of hearing. Each parent mentor has been trained to provide support for your family in an unbiased way as you and your child navigate the journey of hearing loss. The role of the parent mentor is to listen, help when asked, and connect you to various parent resources available in our state.
See the Parent Support Team flyers for more information.
The EHDI Family Focus Email
This is a monthly email specifically designed for families who have children that are deaf or hard of hearing. At the beginning of each month, you can receive an email that:
- Spotlights a resource in NC for D/HH kids and their families
- A list of community events for families with D/HH kids
- Facts and information to help you advocate for your child
- Personal Stories of families with D/HH children in NC
If you are interested in receiving this monthly email from NC EHDI - You can Subscribe here.
The email is currently available in English but a Spanish Family Focus Email is under development.
The Care Project
The Care Project is a nonprofit organization dedicated to bringing hope to families who have children and/or adults with hearing challenges through counseling experiences aimed at the processing of the emotional stages of grief. Family retreats are organized, funded, and hosted by The CARE Project.
BEGINNINGS for Parents of Children Who are Deaf or Hard of Hearing
BEGINNINGS assists parents of children who are deaf or hard of hearing, deaf parents with hearing children and professionals serving them from birth through age 21 by providing information and support to empower them as informed decision-makers. Support is provided by helping parents access services, promoting early identification of hearing loss and awareness of early intervention programs and educational services.
Hearing Impaired Toddlers and Children Have Unlimited Potential (HITCHUP)
These groups are organized and led by parents of children with hearing loss and share information and support with other families at several locations across the state.
HITCHUP operates mainly via Facebook.
- NOTE: For Facebook pages, you may be prompted to log in to your personal Facebook account before you are taken to the HITCH-UP page. These are private groups so you will need to submit a request to join the group.
Triunfa Caracol Latino: Este es un grupo de apoyo para los padres que tienen niños con pérdidas auditiva de cualquier tipo. Por éste medio nos podemos aconsejar unos con otros, compartir experiencias o simplemente publicar algún comentario relacionado con el tema.
CODA Connections, Inc.
CODA Connections, Inc. is a 501(c )3 non-profit established to serve Deaf families and Children Of Deaf Adults. They strive to connect Deaf families and children to critical resources to ensure each family member reaches their full potential.
- Camp Cheerio (May)in Glade Valley, NC for deaf and hard-of-hearing children and their families of all ages.
- Camp Dogwood (September)in Sherrills Ford, NC for Deaf-Blind adults and teens.
- Camp Woodbine (October)in Raleigh, NC is for hearing-impaired children age 3 and above and their families. Free.
- Sertoma Deaf Camp (June)in Ellerbe, NC is for children ages 8-16 who are deaf, hard of hearing, or signing.
Support resources for general special needs:
Exceptional Children's Assistance Center (ECAC) is dedicated to empowering families and improving lives, particularly for North Carolina families raising children ages 0 to 26 with disabilities. As a non-profit organization operated by and staffed primarily with parents of children with disabilities, we understand the needs of families as they navigate the special education process.
Family Support Network (FSN) of North Carolina enhances the lives of children who have special needs by providing support, education, and caring connections to their families. Find an FSN affiliate program that services your county.
First Resource Center connects individuals with disabilities and their families with the resources they need to thrive in the community including coordinating with government agencies, schools, or community partners. Serving Buncombe, Henderson, and Madison counties.
Children with Special Health Care Needs Help Line (1-800-737-3028)is a toll-free contact for those living with, caring for, or concerned about a child with special health care needs. Callers can learn about health care programs as well as funding resources available to North Carolina residents.
NCCARE360 is the first statewide network that unites health care and human services organizations with a shared technology that enables a coordinated, community-oriented, person-centered approach for delivering care in North Carolina. NCCARE360 helps providers electronically connect those with identified needs to community resources and allow for feedback and follow-up.