Purpose: Routine spoken language outcome monitoring is one component of Early Hearing Detection and Intervention (EHDI) programs for children who are hard-of-hearing and learning a spoken language. However, there is no peer-reviewed research that documents how spoken language outcome monitoring may be achieved, or what processes EHDI programs can use to develop these procedures. The present paper describes the process used by a Canadian EHDI program, and the final recommendations that were developed from this process.

Methodology: Through consultation with the program’s stakeholders, consideration of the Joint Committee on Infant Hearing’s recommendations, and drawing on our own expertise in spoken language assessment, we developed an overall framework for monitoring spoken language. Based on the needs of the EHDI program, we conducted a scoping review and critical appraisal of norm-referenced tests to identify candidate tests to use within this framework.

Results: We recommended a two-pronged assessment approach to measuring spoken language outcomes, including program-level assessment and individual vulnerability testing. We identified several tests that have been previously used to measure spoken language outcomes. There was little consistency in how tests were used across studies with no clear indicators as to which tests are the most appropriate to accomplish for which outcome monitoring purposes.

Conclusions: This paper reports on the framework and tests used by a Canadian EHDI program to accomplish spoken language outcome monitoring. We highlight different factors that need to be considered when designing spoken language outcome monitoring procedures and the complexity in doing so. Future work evaluating the effectiveness and feasibility of our recommendations is warranted.