# COMAR Title 10 — Maryland Department of Health

## Subtitle 11 — Maternal and Child Health

### Chapter 02 — Early Hearing Detection and Intervention Program

#### Regulation .04 High Risk Factors.

*COMAR 10.11.02.04*

Any of the following high risk factors are considered relevant in determining the possibility of a newborn or infant developing a permanent hearing status that affects speech-language skills under this chapter:

A. Caregiver concern regarding hearing, speech, language, or developmental delay;

B. Family history of a permanent hearing status that affects speech-language skills occurring during childhood;

C. Medical risk factors:

  (1) Neonatal intensive care for more than 5 days;

  (2) Extracorporeal membrane oxygenation;

  (3) Assisted ventilation;

  (4) Hyperbilirubinemia that requires exchange transfusion of the blood;

  (5) Exposure to ototoxic medications, such as gentimycin and tobramycin; and

  (6) Exposure to loop diuretic medications, such as furosemide and lasix;

D. In utero infections, such as cytomegalovirus, herpes, rubella, syphilis, and toxoplasmosis;

E. Craniofacial anomalies;

F. Physical findings associated with a permanent hearing status that affects speech-language skills;

G. Diagnosis of a syndrome associated with a congenital or progressive change in hearing status that affects speech-language skills;

H. Neurodegenerative disorders, including:

  (1) Hunter syndrome; and

  (2) Sensory motor neuropathies, such as Friedrich’s Ataxia and Charcot-Marie-Tooth disease;

I. Culture-positive postnatal infections associated with a permanent change in hearing status that affects speech-language skills, including bacterial and viral meningitis;

J. Head trauma, including basal skull and temporal bone fracture, that require hospitalization; and

K. Chemotherapy.