Newborn Hearing Screening Milestones and Guidelines

Hearing screening in a child’s first few months can be essential for setting the child up for success with early intervention if there is a problem. If not addressed, hearing loss can lead to delayed speech, language, and brain development, social isolation, reduced academic achievement, and more.

If you have questions, your baby’s doctor or audiologist are the best people to ask. If you need help finding a professional to talk to in your community, call the South Dakota Newborn Screening Program at 1-800-738-2301.

Children who pass their newborn hearing screening can develop hearing loss at any point after birth. The impact of hearing loss can be reduced when identified and appropriate intervention is provided early.

Babies have a higher risk of developing hearing loss if they experience any of the following:

  • A NICU stay longer than five days
  • In-utero infections, including CMV, Herpes, Rubella
  • Head trauma
  • Disorders such as Huntington’s Syndrome
  • Chemotherapy
  • Low birth weight
  • Head and face anomalies
  • Family history of hearing loss

Access Additional Guidance for Parents and Caregivers

Red Flags for Hearing Loss

Birth to 3 Months

  • Doesn’t startle at loud sounds

4 to 6 Months

  • Doesn’t babble or babbling discontinues after 6 months of age

7 to 12 Months

  • Doesn’t respond to familiar voices
  • Doesn’t notice toys that make sounds
  • Doesn’t bounce to music

1 to 2 years

  • Doesn’t acknowledge name called
  • Doesn’t imitate simple words
  • Doesn’t respond to television

2 to 3 Years

  • Doesn’t follow simple commands

Learn About the Hearing Screening Program

Milestones and Guidelines by Month

All infants should have their hearing screened no later than 1 month of age.

Your baby's hearing can be screened soon after birth and before leaving the hospital. In South Dakota, all of the hospitals that deliver babies regularly have hearing screening equipment. The screening does not hurt and takes only minutes to screen each ear with immediate results. Most babies sleep through the screening. The screening does not confirm a definite hearing loss - rather it determines how the baby is hearing at that time and identifies if further diagnostic evaluations are needed.

CLICK HERE for more information on the screening process.

If the baby does not pass the first hearing screening:

It is important to follow up with a second screening, called a re-screening. The re-screening should be done before the baby is one month of age. This will ensure that there is not a delay in any further evaluations that may be needed.

All infants who don’t pass the initial screening should receive a diagnosis no later than 3 months of age.

Audiological Evaluation: An audiologist determines if a baby has a definite hearing loss. These healthcare professionals have the background and the appropriate equipment to detect permanent hearing loss.

Audiology Clinics in South Dakota


  • Genetic - 50% of all infant hearing loss cases may be attributed to genetics
    • Family history of permanent childhood hearing loss
    • Syndrome commonly associated with hearing loss (accounts for 1/3 of genetic cases)
  • Environmental
    • Admitted to the Neonatal Intensive Care Unit (NICU)
    • Contact with certain infections while the mother is pregnant -
      • Cytomegalovirus (CMV) - a virus from the same family as herpes. There is no immunization against CMV. It is spread in the air and in droplet form. To prevent exposure, pregnant women should avoid sharing food, utensils, and cups with a child, and wash hands after changing diapers, to reduce contact with saliva and urine from babies and young children.
      • Toxoplasmosis - an infection found in people, cats, birds, and other animals. Most people with toxoplasmosis have no symptoms. To prevent exposure, pregnant women should avoid cat litter or dirt and should not eat uncooked meat.
      • Group B Strep (GBS)
      • Syphilis
      • Rubella (German Measles)
      • Herpes Simplex Virus (HSV)
  • Physiological
    • Extreme jaundice
    • Contact with certain types of medications
  • Physical
    • Low birth weight
    • Head, face, and ear irregularities

Delayed-onset hearing loss is when a child passes their newborn hearing screening as an infant but develops hearing loss by the age of 3. Delayed-onset hearing loss can happen at any time to a child who was born with a risk factor like those listed above.

All infants identified with hearing loss should receive early intervention services no later than 6 months of age.

Many decisions will need to be made and it is important to know which professional is best prepared to answer questions and provide helpful information. These professionals may include:

  • South Dakota Birth to Three Service Coordinator - A professional who provides organization for the early intervention team and focuses on ensuring a family's needs are being met
  • South Dakota School for the Deaf Outreach Consultant - A professional that provides information to families on hearing level, assistive technology, language development, and communication options
  • Pediatric Audiologist - a professional who specializes in testing the hearing of babies and children and can recommend hearing instruments and options
  • Speech-Language Pathologist - a professional who specializes in speech and speech development
  • Otolaryngologist - a professional who specializes in problems of the ear, nose, and throat; also called an ear, nose, and throat (ENT) doctor
  • Pediatrician or Family Practitioner - a doctor who provides primary health care for babies and children

The main goal of these professionals is to work together to limit the effects of hearing loss on the baby's development. Appropriate services must begin as soon as possible, preferably before six months of age, so speech and language development is not delayed. These delays can negatively impact a child's social and emotional growth and academic achievement.