This report is an update of a 2007 report. Permanent congenital hearing impairment / loss (PCHI/PCHL) is one of the most common congenital anomalies found at birth which can lead to delays and deficits in the development of speech, language, cognition, and learning, as well as secondary effects on the child and the family. Early identification and subsequent appropriate intervention (within the first 6 months) in infants with PCHL can minimize these effects. The report also compares the cost effectiveness of various strategies used in the universal screening of newborn hearing (UNHS).