Infant Hearing Program

What is the Infant Hearing Program?

The Infant Hearing Program provides hearing screening for all Ontario newborns in hospital or community settings and:

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Why do we screen babies for hearing loss?

Two out of 1,000 babies have hearing loss at birth. Two more develop hearing loss by the age of five. These children may hear some sounds but miss others, making it harder to learn speech and language. This can lead to behavioral and emotional challenges. It is important to detect hearing loss as early as possible.

It is not possible for parents or most doctors to test a baby’s hearing accurately as this requires special training and equipment.

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How is my baby’s hearing screened?

Hearing screening identifies infants who should have more detailed testing for hearing loss as early as possible. The technology used for the hearing screen is safe and will not hurt your baby. The tests are reliable, quick and give results right away. They measure the ear’s or brain’s response to soft sounds played in your baby’s ear and, if needed, may use small stickers placed on your baby’s head.

How to prepare for your baby’s hearing screen

  • Avoid lotion on your baby’s head on the day of the screen
  • Feed your baby just before the appointment
  • Bring your baby sleeping or resting quietly in a car seat
  • And don’t forget to bring:
    • Baby’s Ontario health card number (if available)
    • Blanket and other items to calm your baby
    • Extra diapers and clothes

Possible results from hearing screening


Most babies will pass the hearing screen. This means that their hearing is fine at that time.

Pass but at risk

Some babies will pass the hearing screening but have a higher risk to develop hearing loss at a later age. If your baby has been identified with one of these risks, follow-up with an Infant Hearing Program audiologist (a professional that has the skills and equipment needed to test your baby’s hearing) will be booked when your baby is 15 to 18 months old. It is also important to watch for signs of hearing loss as your baby grows.


Some babies will receive a refer result. This means further testing is needed. Your baby may need to repeat the hearing screening at a later time or see an audiologist for a detailed hearing assessment. It does not always mean that your baby has hearing loss but the only way to know for sure is to attend any follow-up appointments. So, if your baby needs follow-up, it is very important that you go to the appointment.

No result

The hearing screen is incomplete and another hearing screen is needed. An appointment will need to be scheduled for a hearing screen at a community clinic. It is very important that you go to the appointment.


A very small number of babies will bypass the hearing screen and be referred directly to an Infant Hearing Program audiologist for a full hearing assessment.

What if my baby does not pass the hearing screen?

Your baby will be referred to an Audiologist with the Infant Hearing Program who has the training and equipment needed for a full hearing assessment.

How to prepare your baby for the hearing assessment

Your baby must sleep during the assessment. They should arrive for the appointment tired and hungry or it may need to be rebooked. Please:

  • Avoid lotion on your baby’s head on the day of the test
  • Keep your baby awake a few hours before and while travelling to the appointment
  • Be prepared to feed your baby at the clinic just before testing begins
  • Bring blanket and items to feed or calm your baby and extra diapers and clothes

What if your baby has hearing loss?

The audiologist will explain:

  • How the hearing loss may affect your baby
  • How technology may help your baby hear more
  • What services/technologies are available to help your baby

Finding children who are at risk for hearing loss

Because finding babies who have hearing loss is so important, those with certain risks for hearing loss can also have their hearing monitored to watch for any change. Some of these risks can be identified through a risk factor screen. Newborn hearing screening in Ontario includes both the hearing screen that happens in a hospital or community-based setting and the risk factor screen.

The risk factor screen is performed by Newborn Screening Ontario using the same sample collected by the hospital or midwife for the newborn blood spot screening (heel prick test). The screen can detect cytomegalovirus (CMV) infections and some common genetic changes that can cause hearing loss.

CMV is a common virus. When a pregnant woman is infected there is a risk of infection of the baby. When this happens, it is called congenital CMV (cCMV) infection. Most babies with cCMV will show no symptoms at birth but may develop hearing loss because of the infection either at birth or in early childhood. Babies who inherit one of the genetic changes from both parents have a high chance of hearing loss in early childhood. These babies usually don’t have anyone with hearing loss in their family.

If the results of the risk factor screen indicate that your baby is at risk for hearing loss, you will be contacted to talk about the results and to arrange any recommended follow-up.

This test can also pick up babies who inherit a genetic change from only one parent but, since this does not cause hearing loss, these results are not reported to the Infant Hearing Program for any follow-up. These results are available on request through Newborn Screening Ontario.

If you choose to decline the risk factor screen, these tests will not be completed. Any changes in hearing may not be found right away and could delay speech and language development.

For additional information about the risk factor screen, please visit Newborn Screening Ontario.

Can hearing loss happen later in my child’s life?

Hearing loss can develop during early childhood. It is important to pay close attention to your baby’s speech and language development as any issues may be a sign of hearing loss.

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Developmental milestones

These developmental milestones show some of the skills that mark the progress of young children as they learn to communicate. There are also some tips on how you can help your child develop speech and language skills. It’s never too early to help your child learn language.

If your child is not meeting one or more of these milestones, please contact your local Preschool Speech and Language Program and have your baby’s hearing tested by an audiologist:

By 6 months
  • turns to source of sounds
  • startles in response to sudden, loud noises
  • makes different cries for different needs – I’m hungry, I’m tired
  • watches your face as you talk
  • smiles and laughs in response to your smiles and laughs
  • imitates coughs or other sounds – ah, eh, buh
By 9 months
  • responds to his/her name
  • responds to the telephone ringing or a knock at the door
  • understands being told “no”
  • gets what he or she wants through sounds and gestures, for example, reaching to be picked up
  • plays social games with you, for example, peek-a-boo
  • enjoys being around people
  • babbles and repeats sounds – babababa, duhduhduh
By 12 months
  • follows simple one-step directions – “sit down”
  • looks across the room to something you point to
  • uses three or more words
  • uses gestures to communicate – waves “bye bye”, shakes head “no”
  • gets your attention using sounds, gestures and pointing while looking at your eyes
  • brings you toys to show you
  • "performs" for attention and praise
  • combines lots of sounds as though talking – abada baduh abee
  • shows interest in simple picture books
By 18 months
  • understands the concepts of “in and out”, “off and on”
  • points to several body parts when asked
  • uses at least 20 words
  • responds with words or gestures to simple questions – “Where’s teddy?”, “What’s that?”
  • demonstrates some pretend play with toys – gives teddy a drink
  • makes at least four different consonant sounds – b, n, d, g, w, h
  • enjoys being read to and looking at simple books with you
  • points to pictures using one finger
By 24 months
  • follows two-step directions – “Go find your teddy bear and show it to Grandma”
  • uses 100 or more words
  • uses at least two pronouns – “you”, “me”, “mine”
  • consistently combines two or more words in short phrases – “daddy hat”, “truck go down”
  • enjoys being with other children
  • begins to offer toys to peers and imitates other children’s actions and words
  • people can understand his or her words 50 to 60 percent of the time
  • forms words and sounds easily and effortlessly
  • holds books the right way up and turns pages
  • “reads” to stuffed animals or toys
  • scribbles with crayons
By 30 months
  • understands the concepts of size (big/little) and quantity (a little, a lot, more)
  • uses some adult grammar – “two apples”, “bird flying”, “I jumped”
  • uses more than 350 words
  • uses action words – run, spill, fall
  • begins taking short turns with other children, using both toys and words
  • shows concern when another child is hurt or sad
  • combines several actions in play – feeds doll then puts her to sleep; puts blocks in train then drives train and drops blocks off
  • puts sounds at the start of most words
  • produces words with two or more syllables or beats – “ba-na-na”, “com-pu-ter”, “a-pple”
  • recognizes familiar logos and signs – stop sign
  • remembers and understands familiar stories
Babies like it when you:
  • Get down to their level so they can see your face. This tells them that you’re interested in what they’re doing and saying. It makes it easier to interact with you.
  • Repeat the sounds they make. Babies enjoy making noises, and like it when you imitate them over and over.
  • Sing and laugh, especially when you are feeding, bathing, and changing them. Remember to talk to your baby throughout the day about things you do and see – “Mommy’s putting on her coat”, “That’s a big truck”.
  • Tell them the names of the objects they are looking at and playing with. Babies are interested in exploring and learning about new things and like to hear what things are called.
Toddlers like it when you:
  • Let them touch and hold books while you point to and name the pictures.
  • Use real words instead of baby talk – “give me” instead of ta ta or “water” instead of wawa.
  • Take the time to listen to them – they want you to hear all of their new sounds, words and ideas.
  • Give them simple directions to follow – “Go find your red boots”.
  • Use lots of different words when you talk to them – opposite words like up/down, in/out; action words like “running”, “splashing”, and descriptive words like “happy”, “big”, “little”, “clean”, “dirty”.
  • Encourage them to play with other children – at the library, play groups, park.

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Infant Hearing Program Locations

Hamilton, Niagara, Brant and Haldimand-Norfolk

Central South Infant Hearing Program
Affiliated Services for Children and Youth
905-385-7927 or 1-866-826-4327

Dufferin, Halton, Peel, Waterloo and Wellington

Central West Infant Hearing Program
ErinoakKids Centre for Treatment and Development
905-855-2690 or 1-877-374-6625

Manitoulin-Sudbury, Algoma, Cochrane and Nipissing-Timiskaming

Northeast Ontario Infant Hearing Program
North Bay Regional Health Centre

Kenora and Rainy River District

Kenora-Rainy River Infant Hearing Program
Northwestern Health Unit

Ottawa, Renfrew County and Eastern counties of Prescott-Russell & Stormont, Dundas and Glengarry

Eastern Ontario Infant Hearing Program
Pinecrest Queensway Community Health Centre
613-688-3979 or 1-866-432-7447
TTY (613) 820-7427

Simcoe County and Muskoka-Parry Sound

Simcoe Muskoka Parry Sound Infant Hearing Program
Royal Victoria Regional Health Centre
705-739-5696 or 1-800-675-1979

Kingston and counties of Frontenac, Lennox & Addington, Leeds, Grenville, Lanark, Hastings and Prince Edward

Southeastern Region Infant Hearing Program
Kingston, Frontenac and Lennox & Addington Public Health
613-549-1232 ext. 1145 or 1-800-267-7875 ext. 1145
TTY (613) 549-7692 or 1-866-299-1136

Middlesex, London, Oxford, Elgin-St. Thomas, Sarnia-Lambton, Huron-Perth and Grey Bruce Owen Sound

South West Region Infant Hearing Program
Thames Valley Children's Centre
519-663-0273 or 1-877-818-8255

Thunder Bay

Thunder Bay Infant Hearing Program
Children's Centre Thunder Bay
807-343-5000 or 1-866-343-5020

City of Toronto

Toronto Infant Hearing Program
Toronto Public Health
TTY (416) 338-0025

York, Durham, Peterborough, Northumberland, Haliburton & Kawartha Lakes

Tri-Regional Infant Hearing Program
Markham Stouffville Hospital
1-888-703-5437 ext. 4
TTY (905) 773-7282

Windsor-Essex and Chatham-Kent

Essex-Kent Infant Hearing Program
"Talk 2 Me"
Connections Early Years Family Centre

For more information, contact:
1-866-821-7770 TTY 1-800-387-5559

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Additional resources

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