If a baby does not pass the newborn hearing screening at the hospital or birthing site, it is very important to return for a follow-up hearing screening. Not passing the hearing screening does not mean your baby has a hearing loss, but follow-up screening is a step closer to identifying if a baby has a hearing loss. Some babies are born with certain high risk factors for developing a hearing loss. Your baby may pass the hearing screening before discharge from the hospital or birthing site, but if your baby was born with high risk factors, it is important for your baby to get a diagnostic audiological evaluation (DAE) by 6 months of age or sooner, if recommended by your doctor.

Procedure for Initial Newborn Hearing Screening

Step 1

Newborn hearing screening is conducted using a special equipment called Otoacoustic Emissions (OAE). A sensitive microphone is placed in baby’s ear canal while baby is sleeping or very quiet. The equipment records the ear’s response to sounds. This procedure is quick,easy, and does not hurt the baby. No further testing is needed if the baby passes the OAE hearing screen.

Step 2

If baby does not pass the OAE Screening, An Automated Auditory Brainstem Response (AABR) Screening Equipment is used. Sensors are placed on the baby’s forehead, back of the neck, and shoulder. Earcups are used to deliver sounds to the baby’s ears. The AABR device records the brain’s response to sound. No further testing is needed if the baby passes the AABR hearing screen.

Step 3

If a baby does not pass the AABR, the child will receive a referral to Guam Early Intervention System, and is given an outpatient hearing re-screen appointment. It is important that your child is seen in a timely manner to determine if more testing is necessary.

Follow-up Screenings: Importance of Follow-Up Hearing Screening

Newborn hearing screening is a procedure conducted before an infant is discharged from the hospital or birthing center. This is a standard of care for all babies born on Guam. Newborn hearing screening identifies if a baby might have a hearing loss.

Some babies are born with certain high risk factors for developing a hearing loss. Your baby may pass the hearing screening before discharge from the hospital or birthing site, but if your baby was born with high risk factors, it is important to bring him back for a follow-up testing by 6 months of age.

»View Risk Factors for Hearing Loss

»Newborn Hearing Screening Brochures

Conductive Hearing Loss

Occurs when sound is not conducted efficiently through the outer ear canal to the eardrum and the tiny bones, or ossicles, of the middle ear. It usually involves a reduction in sound level, or the ability to hear faint sounds. This type of hearing loss can often be medically or surgically corrected.

Sensorineural Hearing Loss

Occurs when there is damage to the inner ear (cochlea) or to the nerve pathways from the inner ear (retrocochlear) to the brain. It cannot be medically or surgically corrected and is a permanent loss. This type of loss not only involves a reduction in sound level, or the ability to hear faint sounds, but it also affects the ability to hear clearly and understand speech.

Mixed Hearing Loss

Sometimes a conductive hearing loss occurs in combination with a sensorineural hearing loss. This means that there may be damage in the outer or middle ear and in the inner ear (cochlea) or auditory nerve.

Early intervention services are family-centered services and supports that help families meet the overall developmental needs of an infant or toddler (birth to three years old). The Guam Department of Education Guam Early Intervention System (GEIS) provides diagnostic, family support, and intervention services to infants, toddlers, and their families.

Steps to Receiving Early Intervention Services

• Referral
• Information is gathered about the child, and parents’ consent is obtained.
• Evaluation / Assessment is conducted to determine if the child is eligible for services. The family is involved with the evaluation process.
• Eligibility
• The evaluation(s) will be reviewed and eligibility for the program will be determined with the family.

For more information about the Guam Early Intervention System please call 300-5776 / 5816, or visit their website at sites.google.com/a/gdoe.net/geis/.

What is a developmental milestone?

Developmental milestones are a set of functional skills or age-specific tasks that most children can do at a certain age range. Your pediatrician or primary health care provider uses milestones to help check how your child is developing. Every child is unique. Therefore, although each milestone has an age level, when a developmental milestone is achieved varies from child to child.

Download CDC’s Free Milestone Tracker App from the Apple App Store, and Google Play. Learn more at cdc.gov/MilestoneTracker.

The Guam EHDI Family Support Group is made up of parents with children ages 2-10 who are deaf or hard of hearing and their families. The Group has been meeting since 2004 and has been sharing joys and tribulations of the challenges they face.

For more information or to join the group, contact one of the family leaders below:

Joyce Tejeresas
Mobile: (671) 838-4215
Email: flores.joyricha.joyce816@gmail.com

Ann Marie Cruz
Mobile: (671) 777-7991
Email: amdcruz@teleguam.net

Family Support Group Brochure

What is Cytomegalovirus?

• Cytomegalovirus is a common virus that infects people of all ages.
• In the United States one in three children is already infected with CMV by age five.
• Over half of adults have been infected with CMV by age 40. Most people infected with CMV show no signs or symptoms.
• Once CMV is in a person’s body, it stays there for life and can reactivate.
• People can also be re-infected with a different strain (variety) of the virus.
• When a baby is born with cytomegalovirus (CMV) infection, it is called congenital CMV (cCMV) infection.
• About one out of every 200 babies, or approximately 2,500 babies are born with congenital CMV (cCMV) infection each day.
• About one in five babies with congenital CMV infection will have long-term health problems such as hearing loss, vision loss, small head size, lack of coordination, and in rare cases, death.

Signs and Symptoms

Babies who have congenital CMV appear healthy at birth.

A few babies who have CMV who appear healthy at birth develop signs over time, sometimes not for months or years after birth.  The most common of these late-occurring signs are hearing loss and developmental delay.  A small number of babies may also develop vision problems.

The more common signs and symptoms in babies who have congenital CMV and who are sick at birth include:

• Premature birth
• Low birth weight
• Yellow skin & eyes (jaundice)
• Enlarged and poorly functioning liver
• Purple skin splotches or a rash or both
• Abnormally small head (microencephaly)
• Enlarged spleen
• Pneumonia
• Seizures

Adults with weakened immune systems, might experience serious problems that affect your:

• Eyes
• Lungs
• Liver
• Esophagus
• Stomach
• Intestines
• Brain

Healthy adults who are infected with CMV may experience few if any symptoms.  When first infected, some adults may have symptoms similar to infectious mononucleosis, including:

• Fatigue
• Fever
• Sore throat
• Muscle aches

When to see a doctor

See your doctor if:

• You have a weakened immune system and are experiencing symptoms of CMV infection. CMV infection can be serious or even fatal for people with weakened immune systems.  People who have undergone stem cell or organ transplants appear to be at greatest risk.
• You develop a mononucleosis-like illness while you are pregnant.
• You know you were infected with CMV during pregnancy. The doctor will likely assess your baby for hearing or vision problems.

Causes

CMV is related to the viruses that cause chickenpox, herpes simplex and mononucleosis. CMV may cycle through periods when it lies dormant and then reactivates. If you’re healthy, CMV mainly stays dormant.

When the virus is active in your body, you can pass the virus to other people. The virus is spread through body fluids — including blood, urine, saliva, breast milk, tears, semen and vaginal fluids. Casual contact doesn’t transmit CMV.

Ways the virus can be transmitted include:

• Touching your eyes or the inside of your nose or mouth after coming into contact with the body fluids of an infected person.
• Sexual contact with an infected person.
• The breast milk of an infected mother.
• Organ, bone marrow or stem cell transplantation or blood transfusions.
• An infected mother can pass the virus to her baby before or during birth. The risk of transmitting the virus to your baby is higher if you become infected for the first time during pregnancy.

Prevention

Careful hygiene is the best prevention against CMV. You can take these precautions:

• Wash your hands often.Use soap and water for 15 to 20 seconds, especially if you have contact with young children or their diapers, saliva or other oral secretions. This is especially important if the children attend child care.
• Avoid contact with tears and saliva when you kiss a child.Instead of kissing a child on the lips, for instance, kiss on the forehead. This is especially important if you’re pregnant.
• Avoid sharing food or drinking out of the same glass as others.Sharing glasses and kitchen utensils can spread CMV.
• Be careful with disposable items.When disposing of diapers, tissues and other items that have been contaminated with bodily fluids, wash your hands thoroughly before touching your face.
• Clean toys and countertops.Clean any surfaces that come in contact with children’s urine or saliva.
• Practice safe sex. Wear a condom during sexual contact to prevent spreading CMV through semen and vaginal fluids.