Audiologists are often involved in the design and implementation of newborn hearing screening programs. They help set up protocols for screening in hospitals and birth centers and may participate in the training of screeners to ensure that all babies are screened for hearing loss shortly after birth. Some audiologists also conduct newborn hearing screenings themselves.

Audiologists perform a full diagnostic assessment after a referral from the newborn hearing screening. This assessment includes conducting various tests such as otoacoustic emissions (OAEs), auditory brainstem response (ABR), pure-tone audiometry, and impedance testing. The type of test selected depends on the child’s history and age. These evaluations help determine the type, degree, and configuration of hearing loss (e.g., conductive, sensorineural, or mixed) and guide the intervention decisions. It is imperative that the audiologists who see infants and toddlers are trained to perform these specialty evaluations for the youngest pediatric population. If the audiologist does not feel comfortable performing these tests, then they should make a referral to an audiologist who is well versed in seeing pediatric patients to ensure the best quality of care.

The audiologist interprets diagnostic results and works with other health care providers to establish the child’s needs. This work can include identifying whether the hearing loss is permanent or fluctuating, whether the child might benefit from hearing aids or cochlear implants, and whether the child needs medical treatment.

Based on diagnostic findings, the audiologist often works alongside other professionals—pediatricians, otolaryngologists (also called ear/nose/throat doctors, or ENTs), family-to-family support specialists, early interventionists, and others—to further assess the child’s medical and developmental needs. Then, they make their referrals accordingly.

Audiologists help select and fit hearing aids, cochlear implants, and other assistive listening devices based on the child’s type and degree of hearing loss. They provide detailed guidance to families on how to use and care for these devices. For children with severe-to-profound hearing loss, audiologists assess whether the child is a candidate for cochlear implantation.

Audiologists help parents and caregivers understand the nature of their child’s hearing loss, including what the diagnosis means for their child’s development and communication.

Audiologists introduce families to the continuum of communication opportunities that are available: from listening and spoken language to sign language. Audiologists provide resources and support that align with family values, goals, and culture.

After a child is fitted with a hearing device, the audiologist provides regular follow-up care—approximately every 3 months—to monitor the effectiveness of the devices, check for any changes in hearing levels, and adjust the devices as the child’s needs evolve. Apart from adjusting the hearing device, the audiologist also makes sure that the earmolds used with the hearing aids are still an appropriate size. Children grow quickly—and so do their ears! So, making sure that their earmolds continue to fit well makes a big difference for the quality of sound that the hearing device provides.

The audiologist monitors the child’s auditory milestones over time to ensure that the hearing aids or implants still meet the child’s needs.

Audiologists may also be involved in training and supporting other professionals in the EHDI systems such as newborn hearing screeners, educators, social workers, and health care providers—to ensure that they understand the needs of children with hearing loss.

While SLPs are not typically the ones conducting newborn hearing screenings, they play a critical role in the follow-up process when a child does not pass the screening. They may be involved in referring the child to an audiologist or a specialist for further evaluation. SLPs who are involved in early intervention may also be the first provider to notice that a child may not be meeting developmental milestones and/or express concerns about the child’s responses to sound. Even a baby who passes their newborn hearing screening can develop hearing loss later in early childhood. When an SLP notices signs of hearing loss, a referral for a follow-up hearing screening is imperative. The SLP may also do a hearing screening as part of their evaluation process—and if a child does not pass the hearing screening, then the SLP can refer the child for a diagnostic evaluation by an audiologist. To find a pediatric audiologist in your area, refer to the Early Hearing Detection and Intervention Pediatric Audiology Links to Service (EHDI PALS) directory.

SLPs assess children who have been diagnosed with hearing loss or who show signs of communication delays. Assessing an infant or a toddler means using observation, interview, and criterion-referenced assessments to look at speech, language, and social communication as well as overall development. SLPs in early intervention collaborate with audiologists and other providers to connect assessment results with communication access.

Once a hearing loss is confirmed, SLPs play a key role in developing and implementing an individualized treatment plan for the child. This often involves any or all of the following:

• Language development: Helping children develop language skills (both spoken and/or sign language) depending on the family’s goals and the child’s needs.

• Speech therapy: Supporting speech development, production, and intelligibility.

• Monitoring of hearing aids’ or cochlear implants’ effectiveness: As part of their role in supporting children in the use of their hearing devices, sometimes SLPs may conduct listening checks to make sure that the devices are working properly. SLPs may also note certain sounds that a child is having difficulty with and can share their findings with the child’s audiologist, who can make certain adjustments to give the child the best access to sound. It is important for SLPs who work in early intervention with young children who are deaf or hard of hearing to have working knowledge of hearing technology and troubleshooting. SLPs should understand that there is a link between (a) the child’s development and productions and (b) the child’s acoustic access.

• Family education and support: Educating and coaching families on how to support their child’s language development at home, including ways to (a) embed language and communication throughout daily routines as well as (b) foster and optimize listening environments.

• Monitoring of progress: SLPs regularly monitor the child’s progress and adjust therapy plans as needed. They record language milestones and communicate with other team members to ensure that the child’s development is on track.

• Collaboration with the EHDI Team: SLPs work as part of a multidisciplinary team, collaborating with audiologists, pediatricians, early interventionists, and educators to provide a holistic approach to the child’s development. They participate in team meetings, share insights, and contribute to the development of comprehensive care plans.