Newborn hearing screening

In the U.S, nearly all newborn babies receive a hearing screening while still in the hospital. This ensures that hearing loss in infants is caught and treated early. 

If your baby happens to fail her hearing screening, it’s important to consult a pediatric audiologist as soon as possible. They will conduct further tests to determine if your child has hearing loss and, if so, to what extent.

Why newborn hearing screening is important

Your baby’s sense of hearing is a crucial piece to the development puzzle. According to the American-Speech-Language Hearing Association (ASHA), untreated hearing loss can cause delays in speech and language communication skills which affect academic achievement and may lead to social isolation and poor self-concept. Studies show hearing loss even affects infant babble.

Children who receive treatment and/or learn American Sign Language (ASL) are statistically better equipped to develop the language skills they need to succeed in school and the work environment.

The earlier hearing loss is detected, the sooner your family can enroll in age-appropriate intervention programs. Fortunately, all 50 states fund Early Hearing Detection and Intervention (EHDI) programs designed to screen all babies for hearing loss by one month of age. Follow-up screenings by three months of age confirm whether a baby is deaf or hard of hearing and provide enrollment into early intervention programs by 6 months of age. And, thanks to the Individuals with Disabilities Education Act (IDEA), all children who have hearing loss are entitled to receive free services throughout their education to age 21.

In the U.S., all children who have hearing loss are entitled to receive free services throughout their education up to age 21.

How newborn hearing screening works

Babies can cry a lot during routine medical procedures, but rest assured, newborn hearing screenings are safe and comfortable. Many infants sleep through the entire procedure, which usually only takes a few minutes.

Here’s a quick description of the two most common tests your newborn may experience:

• Otoacoustic emissions (OAE) measures your baby’s response to sound by placing a miniature earphone and microphone in the ear. Normal hearing triggers an echo into the ear canal, which is measured by the microphone. If your baby has hearing loss, no echo is recorded. The screening is done on each ear and a passing result confirms that the infant’s inner ears are receiving sounds.
• Auditory brainstem response (ABR) measures how the auditory nerve responds to sound through small electrodes placed on your baby’s head. This screening is a more complete test of the auditory system, and it requires small electrodes to be taped to the baby's scalp. The screening is again done for each ear and a passing result confirms that the infant’s brain is receiving sound.

Your baby may have both tests together, one at a time, or the ABR only if they fail the OAE. Hospitals determine which tests they use based on costs, personnel and the number of babies born.

Failed hearing test? Follow up is key

A significant number of infants fail their first hearing screening due to fluid that may still be present in the ear canal right after birth. If your infant doesn't pass the initial hearing screening, schedule a follow-up screening with a pediatric audiologist within a couple of weeks. The majority of infants will pass the second screening quite easily. For those who do not pass the second newborn screening, a diagnostic hearing test from your pediatric audiologist will investigate further.  

If your infant fails their newborn hearing screening, it’s important to follow up as soon as possible to determine whether or not they have hearing loss and, if so, when to begin treatment or services. Experts encourage parents to meet with an audiologist who specializes in infants, a pediatric ear, nose and throat doctor (ENT), and a pediatric eye doctor since some babies with hearing loss also have problems with their vision. You may also want to meet with a geneticist to determine if your baby’s hearing loss is hereditary.

Most likely, your pediatrician can recommend a hearing healthcare professional who specializes in children.

Treating hearing loss in babies

If your child is deaf or diagnosed with hearing loss, there are many different ways your child can learn to communicate. Your child's audiologist and pediatrician can help you decide which hearing loss treatment option, or combination of options, is best for your child and your family.

Hearing devices

One of the most common ways to treat hearing loss is with pediatric hearing aids or a cochlear implant. Hearing aids can be used for mild to severe hearing loss, while cochlear implants are used for those with profound hearing loss. A hearing health professional can help you determine which option is for your child.

Language and communication

In addition to hearing devices, your child may learn language and communication with one of the following methods:

• American Sign Language is a rich, distinct language with its own syntax and grammar which uses hand signs, gestures, body movements and facial expressions.
• Cued speech combines hand movements with mouth shapes to make the sounds of traditional spoken language look different.
• Auditory-oral learning uses your child’s natural hearing ability along with lipreading and hearing devices.

Assistive listening devices

Other assistive listening devices can help your child communicate at home and school and enjoy many normal childhood experiences.

• Personal FM amplifiers use a microphone and receiver to reduce background noise and improve poor acoustics in the classroom. When a teacher speaks into the microphone, the speech is converted into radio waves which are transmitted directly to the child’s receiver.
• Closed captioning is available on almost all televisions. More and more movie theaters are also offering this service for their deaf and hard of hearing patrons.
• Induction loop systems, found in many churches, schools and auditoriums, work with your child’s hearing aids to improve acoustics and speech clarity.