Although it is widely accepted that early identification of hearing loss and immediate intervention are extremely important, the average age of identification in the United States is about 2Vi years, and involvement in intervention programs is much later. Given the crucial importance of the first 3 years of life for speech, language, academic, and social/emotional development, late identification puts hearing impaired children at significant risk. Recently the Rhode Island Hearing Assessment Program (RIHAP) has demonstrated that universal hearing screening of infants is feasible, valid, and cost-efficient using the measurement of transient evoked otoacoustic emissions (TEOAE). This article describes how RIHAP implemented a universal newborn hearing screening program and how it currently delivers appropriate intervention services to infants and families.