The Missouri Newborn Hearing Screening Program strives to assure all newborns are screened for hearing loss by 1 month of age, all newborns who fail the hearing screening are evaluated by an audiologist by 3 months of age, and all infants diagnosed with a permanent hearing loss are enrolled in a program of early intervention by 6 months of age. The purpose of Missouri’s Newborn Hearing Screening Program is to screen babies for hearing loss by 1 month of age, schedule testing to identify hearing loss by 3 months of age, and enroll the child and family in an early intervention program by 6 months of age. These goals are known as the 1-3-6 Plan.

To achieve optimal language outcomes, regardless of mode of communication, follow the 1-3-6 Plan.

Number 1

Number 3

Number 6


By 1 Month

  • Obtain a newborn hearing screening in the hospital or by your pediatrician.

By 3 Months

  • Obtain a diagnostic hearing evaluation from an audiologist if your child failed the newborn hearing screening.
  • Obtain a referral to the Missouri First Steps early intervention program immediately upon diagnosis of hearing loss.
  • Obtain an Ear, Nose, & Throat (ENT) physician evaluation.
  • Obtain an assessment for amplification (hearing aid) within one month of diagnosis.

By 6 Months

  • Begin early intervention services.
Primary Care Providers/Health Professionals
Early Intervention Specialists

What is Missouri First Steps?

Missouri First Steps is an early intervention program that provides services to families with children, birth to three years of age, with disabilities or developmental delays. First Steps is designed to meet the needs of families to enhance their child's development, learning, and participation in family and community life.

Missouri First Steps Contact Information

To refer an infant to the Missouri First Steps program, call (866) 583-2392 or use this link.

What is known

Children with any degree of hearing loss, involving one or both ears, need early intervention and services by six months of age to develop language, social skills and academic levels comparable to their peers with typical hearing. This is true regardless of the type of hearing loss (conductive, sensorineural, mixed or auditory neuropathy), and the communication mode chosen (e.g. sign language, listening and spoken language or some combination of the two). Early access to specialized interventions and services results in improved outcomes for children with hearing loss.

(The efficacy of Early Identification and Intervention., Downs and Yoshinago-Itano; 1999, Ped Clinics of North America, 46-1.)