High-Risk Indicators for Hearing Loss

Checklist of high-risk indicators for hearing loss in children from birth to 24 mo of age. These indicators are red flags and may assist physicians in referring children for audiologic testing.
Birth to 28 d
_ Family history of sensorineural hearing loss (SNHL), presumably congenital
_ In utero infection associated with SNHL (eg, toxoplasmosis, rubella, cytomegalovirus, herpes, syphilis)
_ Ear and other craniofacial anomalies
_ Hyperbilirubinemia at levels requiring exchange transfusion
_ Birth weight less than 1500 g
_ Bacterial meningitis
_ Low Apgar scores: 0–3 at 5 min; 0–6 at 10 min
_ Respiratory distress (eg, meconium aspiration)
_ Prolonged mechanical ventilation for more than 10 d
_ Ototoxic medication (eg, gentamicin) administered for more than 5 d or used in combination with loop diuretics
_ Physical features or other stigmata associated with a syndrome known to include SNHL (eg, Down syndrome, Waardenburg syndrome)
29 d to 24 mo
_ Parental or caregiver concern about hearing, speech or language, and/or developmental delay
_ Any of the newborn risk factors listed above
_ Recurrent or persistent OME for at least 3 mo
_ Head trauma with fracture of temporal bone
_ Childhood infectious diseases associated with SNHL (eg, meningitis, mumps, measles)
_ Neurodegenerative disorders (eg, Hunter syndrome) or demyelinating diseases (eg, Friedreich ataxia, Charcot-Marie-Tooth syndrome)
  • Adapted with permission from Joint Committee on Infant Hearing. Year 2000 position statement: principles and guidelines for early hearing detection and intervention. Pediatrics. 2000;106:798–817.