All newborns should be screened for hearing loss. Make sure your newborn’s hearing is screened before leaving the hospital. If your baby is born at home or not in a birthing center, make a plan with your baby’s pediatrician to have their hearing screened and schedule a follow up consultation with an audiologist if needed.
What Are Newborn Hearing Screenings?
Newborn hearing screenings are a safe and painless way to determine whether your baby has a significant hearing loss. There are two ways that hearing can be screened in babies: otoacoustic emissions (OAEs) and automated auditory brainstem response (AABR).
Otoacoustic Emissions (OAEs): OAEs measure responses coming from the inner ear organ (the cochlea). For this test a small earbud is placed in the child’s ear, which contains a microphone and earphone. Sounds are played through the earbud and echo responses, coming from the inner ear organ are measured. If a baby hears normally or near-normally, an echo is reflected back into the inner ear which is measured by the microphone. If the baby has a significant hearing loss, no echo or a reduced echo is measured.
Automated Auditory Brainstem Response (AABR): AABR testing measures responses coming from the inner ear organ (the cochlea) as well as the auditory brainstem, as sound travels up to the brain. For this screening, sticker electrodes are placed on the baby’s head and small earphones are placed in or around the child’s ear. Sounds are played through the earphones and the electrodes measure whether there is a response coming from the baby’s ear and auditory brainstem. If a baby hears normally, a response will be detected. If the baby has a significant hearing loss, no response will be detected.
If my baby successfully completes the newborn hearing screening the results will be notated as: pass
If my baby does not pass the newborn hearing screening and further testing is needed to demonstrate healthy hearing, results will be notated as: refer, fail, or did not pass
Why Screen Newborns?
Newborn hearing screenings are extremely important. From the moment a baby is born they begin learning language by hearing language around them. If a baby is not hearing, this will hinder the baby’s ability to pick up spoken language and learn to talk. When newborns have hearing loss and are diagnosed early, effective intervention is available to help them achieve normal or near-normal speech, language, and hearing milestones.
Timely completion of a newborn hearing screening is an important first-step to determining whether hearing loss is present.
- Approximately 3-6 of every 1,000 newborns have significant hearing problems.
- More than 95 percent of newborns who are born deaf have parents with normal hearing.
- Hearing loss is invisible; it cannot be seen by examining your newborn’s ears.
- Most newborns with hearing loss have no signs or symptoms.
What Should I Know About the Newborn Hearing Screening?
- Hearing screenings are fast, safe, and painless.
- Sometimes newborns are screened once or twice.
- Hearing screenings take about 10 minutes.
- Most babies sleep through the hearing screening. If your baby is noisy or restless during screening this can influence the results.
- You will receive the hearing screening results before you leave the hospital.
What if My Newborn Does Not Pass the Hearing Screening?
If your baby does not pass the newborn hearing screening, a follow-up screening or hearing test will be needed in the days or weeks after leaving the birthing hospital. This is a crucial step in determining whether your baby has hearing loss. Some newborns who need a follow-up hearing screening or a hearing test have normal hearing—BUT some have hearing loss.
If your newborn does not pass the hearing screening, it is important to make an appointment with an audiologist for a complete infant hearing test.
What if My Newborn Passes the Hearing Screening?
Most newborns who pass the hearing screening have normal hearing. However, some newborns might hear well enough to pass a screening, even though their hearing is not perfectly normal. It is a screening and not a diagnostic test, and so the newborn hearing screening cannot properly identify 100 percent of babies with hearing loss.
Additionally, some newborns may pass the screening at birth, yet they can lose hearing from illness, medications, or genetic reasons. This hearing loss can come on suddenly or gradually over time.
Because of these factors, it is important that, even if your newborn passes the screening, you contact your child’s pediatrician and get a referral to an audiologist for hearing testing if you have any concerns for your child’s hearing.
Other Warning Signs of Hearing Loss
Your newborn might be at risk for delayed onset hearing loss if any of the following applies to your baby:
- You or another caregiver have concerns for hearing
- There is a family history of childhood hearing loss
- Your child had a Neonatal Intensive Care Unit (NICU) stay of longer than 5 days
- Your child has a history of jaundice requiring blood transfusion
- Your child has undergone chemotherapy or been treated with an intravenous antibiotic known to be toxic to the hearing and/or balance organs
- Your child suffered from perinatal asphyxia
- Your child received extracorporeal membrane oxygenation (ECMO) therapy
- Your child was exposed to infections that occur before and after birth (including CMV, bacterial, and viral meningitis, herpes, rubella, syphilis, toxoplasmosis).
- Your child has a syndrome, genetic disorder, or craniofacial condition known to be associated with hearing loss.
If one or more of the above circumstances applies to your newborn, routine hearing monitoring is advised. Speak with your child’s pediatrician about their recommendations for hearing monitoring and for a referral to an audiologist for routine hearing testing.
Once an appointment with an audiologist has been made for your newborn’s next hearing test, make sure you have the following information:
- Audiologist’s Name
- Office Name
- Office Phone Number
- Appointment Date
- Appointment Time
- Appointment Location/Address
If your baby did not pass the newborn hearing screening or you think your newborn may have hearing loss, use the “Find an Audiologist” tool to set up an appointment to get your baby’s hearing checked.
Speech, Language, and Hearing Skills: Expectations as Your Infant Grows
How a child is progressing with speech, language, and hearing milestones can be a good indicator of whether there should be concerns for hearing. An infant with normal hearing should be able to:
Around two months of age
- Startle to loud sound
- Quiet to familiar voices
- Make vowel sounds such as “ohh”
Around four months of age
- Look for sound sources
- Start babbling
- Make squeals and chuckles
Around six months of age
- Turn head toward loud sounds
- Begin to imitate speech sound
- Babble sounds such as “ba-ba”
Around nine months of age
- Imitate speech sounds of others
- Understand “no-no” or “bye-bye”
- Turn head toward soft sounds
Around 12 months of age
- Correctly use “ma-ma” or “da-da”
- Give toy when asked
- Respond to singing or music
If you have concerns for the speech, language, and hearing milestone development of your child, speak with your child’s pediatrician and use the “Find an Audiologist” tool to set up an appointment for hearing testing.