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EBP Compendium: Summary of Clinical Practice Guideline

New York State Department of Health, Early Intervention Program; U.S. Department of Education
Clinical Practice Guideline: Report of the Recommendations. Hearing Loss, Assessment and Intervention for Young Children (Age 0–3 Years)

New York State Department of Health, Early Intervention Program. (2007).
Albany (NY): NYS Department of Health, Publication No. 4967, 354 pages.

AGREE Rating: Highly Recommended


This evidence-based and consensus-based guideline provides recommendations for the assessment and intervention of hearing loss for young children ages birth to three. The guideline targets parents and professionals. Recommendations of interest to audiologists and speech language pathologists include screening, assessment, and management of hearing and assessment of communication.


  • Language Screening/Assessment
    • Assessment of children from birth to 6 months should focus on attainment of communication milestones, cries, babbling, laughing, and smiling.
    • Assessment of children older than 6 months should include: parent report, assessment of functional listening skills, standardized tests, assessment of gesture use and non-verbal communication, language samples, and oral-motor assessment (pp. 87–88).
  • Language Treatment
    • There are various communication approaches that children with significant hearing loss may utilize which vary by level of auditory or visual modality. No one approach has been shown to be best for all children with hearing loss and their families, however some approaches may be more effective than others for achieving specific goals.
    • It is recommended that amplification devices or a cochlear implant be used to maximize auditory input even if a visual communication approach is implemented (pp. 121–125).
  • Hearing/Balance Screening/Assessment
    • Screening
      • It is recommended that all newborns have their hearing screened using a physiologic test before discharge from the hospital.
      • Parents should be informed of screening results.
      • Infants passing a hearing screening should continue to be monitored for possible hearing loss.
      • Infants who do not pass the hearing screening should have follow-up testing using OAE or ABR (pp. 41–44).
    • Assessment
      • Audiologic assessment is recommended for children who fail objective physiologic hearing screening, children identified with a speech/language delay or disorder, significant concern of hearing loss, or history of prolonged or recurrent otitis media with effusion.
      • Components of a hearing assessment should include taking a hearing history, physiologic procedures, and behavioral audiometry (p. 69).
    • Assessment for amplification
      • Provision of amplification should be provided based on physiologic measures alone if behavioral audiologic assessment cannot be completed, however behavioral measures should be completed as soon as possible.
      • Children who use amplification devices should receive ongoing audiologic monitoring every three months (p. 75).
  • Hearing/Balance Treatment
    • Early intervention is recommended.
    • Components of effective interventions include: family education/participation, family support, language development, auditory skill training, speech-language therapy, opportunities for family interaction, and experienced professionals (pp. 106–107).
    • Amplification recommendations
      • Custom earmolds should be made for the child as soon as amplification has been decided.
      • Behavioral responses optimize hearing aid fitting as they provide frequency-specific information.
      • All hearing aids should have safety features (pp. 149–151).
    • Cochlear implants
      • Children should be considered for cochlear implants if they demonstrate little benefit from hearing aids, lack progress in the development of auditory skills and speech, are 12–24 months of age with profound hearing loss or are older than 24 months with severe to profound hearing loss.
      • Cochlear implants should not be placed if the communication approach for the child does not include hearing and spoken language (pp. 159–160).

Keywords: Hearing Loss; Early Hearing Detection and Intervention

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Added to Compendium: November 2010

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