Infant Hearing Surveillance Pathway
The Infant Hearing Surveillance program is for babies who passed their first hearing check but have certain risk factors for hearing loss which may develop later on.
In the Infant Hearing Program, Surveillance means your baby will get regular hearing check-ups because they have a risk factor that could cause hearing loss later on.
Our team will monitor their hearing over time to catch any changes as soon as possible and help you get the right support you need as quickly as possible.
What Does Surveillance Entail?
IHP Surveillance is designed as a safety net to keep track of these babies’ hearing over time and make sure any problems are found and treated early.
Here’s what happens during Surveillance:
- Regular hearing tests: Your child will have hearing check-ups at certain ages (usually around 15–18 months old, and sometimes later) even if they passed the first test. How often they need these check-ups depends on their risk factor. Some children need just one hearing test at 15-18 months, but others may need more tests over a few years to make sure their hearing stays healthy.
- Specialized pediatric audiology: All surveillance hearing tests are done by trained pediatric audiologists (hearing professionals for children). They know how to work with children and use gentle, kid-friendly methods to do the tests based on your child’s age and needs.
- Graduating from the program: If all the follow-up tests show normal results, your child will be finished with the surveillance program and your file will be closed.
Back to the top ▲
Risk Factors For Hearing Loss
Risk factors are conditions or events that are known to increase the chance that a child might develop permanent hearing loss, even if their hearing was normal as a newborn.
Some common risk factors that require hearing surveillance in infants include:
- Meningitis
- Cytomegalovirus (CMV) infection
- Certain genetic conditions
- Atresia or microtia (small or missing outer ear, or the ear canal did not form normally)
- CHARGE Syndrome
- ECMO/ECLS treatment
- Very high jaundice levels after birth that needed special treatment
- TORCHES infections (like toxoplasmosis, rubella, herpes simplex virus, or syphilis)
- Other syndromes that may linked to hearing loss (your doctor will tell you if this applies to you)
Back to the top ▲
What Happens Next?
If your child meets the criteria, they will get an appointment for a hearing check when they are older, usually between 15 and 18 months of age, depending on their specific risk factor.
Your appointment may be at one of the three main ErinoakKids locations or at one of our partner clinics, depending on where you live:
You will be contacted closer to the time to book the appointment.
Back to the top ▲
How to Prepare for the Appointment
Please keep your contact information up to date with ErinoakKids, as we are the Lead Agency for the Central West Region of the IHP.
If you move anywhere within Ontario, we can make sure your baby is referred to your new local IHP Region for your planned Surveillance check-up.
Make sure your child is well-rested and has eaten before the test and feel free to bring comfort items and snacks.
If your child is sick, please call to reschedule as this can affect test results.
Back to the top ▲
What to Expect at the Appointment
Schedule
The timing and number of visits depends on your child’s risk factors.
Your child’s plan may include:
- One visit with an audiologist at around 15-18 months of age, or
- Several visits over time. Your audiologist will explain your schedule to you.
Testing Type
Depending on your child’s age, testing may include:
1. Auditory Brainstem Response (ABR)
- Used for most babies for up to 6 months.
- Done while your baby is sleeping naturally.
- Works best if your baby arrives ready for a feed and a nap.
2. Visual Reinforcement Audiometry (VRA)
- Used for most children 6 months to about 2 years.
- Your child learns to turn toward a puppet or toy when they hear a sound.
- Works best when your child is rested and ready to play.
3. Conditioned Play Audiometry (CPA)
- Used for children about 2 to 5 years old.
- Your child plays a simple game (like putting a peg in a board) each time they hear a sound.
- Works best when your child is rested and ready to play.
Back to the top ▲
What if my Child Shows No Hearing Loss?
If no hearing loss is detected, your child’s hearing is likely on track and the audiologist will discuss whether any further follow-up is needed.
- If your child only needs one visit and passes, they will be discharged and their file will be closed from the IHP Surveillance program.
- If your child is on the multivisit plan and passes, they will continue to come back to see us until the end of their scheduled follow-ups.
- If you ever have concerns after your child’s file is closed, please speak with your doctor or look for a registered audiologist at publicregister.caslpo.com to book a follow up appointment.
Back to the top ▲
What if my Child Shows Hearing Loss?
If the tests show that your child has some degree of hearing loss, the audiologist will discuss this in detail with you and outline immediate next steps.
You will likely be scheduled for further evaluation to confirm the results and determine the exact type and extent of the hearing loss.
More information on these services and supports can be found here.
Back to the top ▲
