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:

1. A. Caregiver concern regarding hearing, speech, language, or developmental delay;
2. B. Family history of a permanent hearing status that affects speech-language skills occurring during childhood;

3. C. Medical risk factors:

   1. (1) Neonatal intensive care for more than 5 days;
   2. (2) Extracorporeal membrane oxygenation;
   3. (3) Assisted ventilation;
   4. (4) Hyperbilirubinemia that requires exchange transfusion of the blood;
   5. (5) Exposure to ototoxic medications, such as gentimycin and tobramycin; and
   6. (6) Exposure to loop diuretic medications, such as furosemide and lasix;
4. D. In utero infections, such as cytomegalovirus, herpes, rubella, syphilis, and toxoplasmosis;
5. E. Craniofacial anomalies;
6. F. Physical findings associated with a permanent hearing status that affects speech-language skills;
7. G. Diagnosis of a syndrome associated with a congenital or progressive change in hearing status that affects speech-language skills;

8. H. Neurodegenerative disorders, including:

   1. (1) Hunter syndrome; and
   2. (2) Sensory motor neuropathies, such as Friedrich’s Ataxia and Charcot-Marie-Tooth disease;
9. I. Culture-positive postnatal infections associated with a permanent change in hearing status that affects speech-language skills, including bacterial and viral meningitis;
10. J. Head trauma, including basal skull and temporal bone fracture, that require hospitalization; and
11. K. Chemotherapy.

Authority: Health-General Article, §§13-601—13-605, Annotated Code of Maryland

Effective date: January 20, 1992 (19:1 Md. R. 32)

Regulations .01—.09 repealed and new Regulations .01—.09 adopted effective June 22, 2015 (42:12 Md. R. 762)

Regulation .03B amended effective March 30, 2026 (53:6 Md. R. 291)