Hearing is at the heart of language development and school readiness; increasing numbers of Early Head Start programs have come to rely on otoacoustic emissions (OAE) technology to screen all infants and toddlers for hearing loss. Successful identification of hearing health needs is dependent not only on an appropriate screening method, but also on adherence to an evidence-based follow-up protocol that includes referral to health care providers and specialists. Tools and resources are available to help programs make the most of their OAE hearing screening process and these can further inform other heath and developmental screening efforts.