
Hearing tests are routinely performed on newborns before they leave the hospital. In the US, nearly all newborns receive a hearing screening. This is important because hearing is critical to a child's speech-language and social-emotional development. If left untreated, hearing loss can cause delays in these areas and may lead to academic issues, social isolation, and poor self-esteem. However, it is normal for some newborns to fail their first hearing screening due to fluid or debris in the ears, movement or crying during the test, or too much noise in the room. If your newborn fails their initial hearing screening, it is important to arrange a follow-up test as soon as possible to determine whether hearing loss is present and, if so, the degree and type of hearing loss.
Characteristics | Values |
---|---|
Percentage of newborns with hearing loss | 1-3 newborns per 1,000 |
Percentage of newborns with medical conditions that put them at greater risk for hearing loss | Significantly higher than 1-3 newborns per 1,000 |
Percentage of babies that fail their first hearing screening | 2-10% |
Percentage of babies that have permanent hearing loss out of those that fail their first hearing screening | Very few |
Reasons for failing the hearing screening other than hearing loss | Fluid or debris in the ears, movement or crying during the test, too much noise in the room |
Tests used for hearing screening | Auditory Brainstem Response (ABR), Otoacoustic Emissions (OAE), Brain Audiometry Evaluation |
What You'll Learn
Hearing is critical to a child's development
Hearing plays a critical role in a child's development, particularly in terms of communication, language acquisition, and social-emotional development.
Babies start hearing sounds before they are born, and after birth, they watch their parents' faces and hear them speak. This process of development continues daily, with babies smiling when spoken to at three months old, and beginning to babble and imitate certain sounds at six months old. If a baby cannot hear, this process will be slowed down, which can negatively impact their cognitive development.
Untreated hearing loss can cause delays in speech and language communication skills, affecting academic achievement and leading to social isolation and poor self-concept. Research shows that children with hearing loss who receive early intervention develop better language skills and have fewer developmental delays.
Hearing loss can make it difficult for children to distinguish certain parts of speech, such as the "speech banana" on an audiogram. This refers to the ability to understand certain speech sounds that are high-pitched but have no problem with low-pitched sounds, known as high-frequency hearing loss.
Additionally, children with hearing loss may struggle with reading and math, and fall behind their peers in school. They may also have trouble making friends and experiencing social isolation.
Therefore, it is crucial to have your child's hearing tested if you suspect any hearing difficulties. Early detection and intervention are key to ensuring your child receives the support they need to reach their full potential.
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Hearing tests are quick and painless
It is quite common for newborns to fail their hearing tests, and there are many reasons why this might happen. Fluid in the ear, vernix in the ear canal, or the baby moving or crying during the test can all lead to a failed hearing test. In fact, between 2 and 10 percent of all babies in the US do not pass their first hearing screen. However, very few of these babies have permanent hearing loss.
If your baby fails their hearing test, it is important to follow up with a pediatric audiologist as soon as possible to determine whether your baby has hearing loss and, if so, the extent of the loss.
Hearing tests for newborns are quick and painless. The tests usually take about 10 minutes, and most babies sleep through the entire procedure. There are two common tests used to screen for hearing loss in babies: Otoacoustic Emissions (OAE) and Auditory Brainstem Response (ABR).
The OAE test uses a tiny earphone and microphone placed in the baby's ear. The earphone sends sounds to the baby's ear, and the microphone detects if there is a response from the inner ear. If the baby has normal hearing, an echo will be reflected back into the ear canal and measured by the microphone. If there is no echo, it could indicate hearing loss.
The ABR test measures how the auditory nerve and brainstem respond to sound. Small electrodes are placed on the baby's head, and earphones send sounds to the baby's ears. The electrodes detect the brain's response to the sounds. If the baby's brain does not respond to the sounds, it could indicate hearing loss.
These tests are safe and comfortable for newborns and can be performed while the baby is resting or sleeping. They are also usually completed within a few minutes, making them quick and convenient for parents.
It is important to remember that even if your baby passes the hearing screening, you should still monitor their hearing as they grow older. Hearing loss can develop later in childhood due to illness, medication, or genetic reasons. If you have any concerns about your baby's hearing, it is always best to consult with a healthcare professional.
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What to do if your newborn fails the hearing screening
Follow up with a pediatric audiologist
If your baby fails their initial hearing screening, it's important to schedule a follow-up screening with a pediatric audiologist within a few weeks. Most babies will pass the second screening, but if your baby doesn't, the audiologist will conduct further diagnostic tests to determine the presence and extent of hearing loss.
Consult relevant specialists
Experts recommend that parents meet with a pediatric audiologist, an ear, nose and throat doctor (ENT), and a pediatric eye doctor, as some babies with hearing loss may also have vision problems. Consulting a geneticist to determine if your baby's hearing loss is hereditary is also advised. Your pediatrician can refer you to a hearing healthcare professional who specializes in children.
Treatment options
If your baby is diagnosed with hearing loss, there are various treatment options available. Hearing aids or cochlear implants are commonly used to treat mild to severe hearing loss. Your baby's audiologist and pediatrician will help determine the best treatment plan for your child.
Language and communication
In addition to hearing devices, your child may learn language and communication through methods such as American Sign Language (ASL), cued speech, or auditory-oral learning. Early intervention services are crucial for helping children with hearing loss develop important speech, language, and social skills.
Monitor for signs of hearing loss
Even if your baby passes their hearing screening, it's important to remain vigilant for signs of hearing loss as they grow. Some signs to look out for include not responding to loud noises, not turning towards a sound source, and not saying single words by one year of age. If you notice any of these signs, consult your baby's doctor immediately.
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Types of newborn hearing screening tests
It is normal for newborns to fail their first hearing screening, and this can be due to fluid in the ear canal, the baby moving or crying during the test, or too much noise in the room. In the US, nearly all newborn babies receive a hearing screening while still in the hospital, and 2-10% of all babies do not pass their first hearing screen. However, very few of these babies have permanent hearing loss.
Otoacoustic Emissions (OAE)
This test determines if certain parts of the baby's ear respond appropriately to sound. During the test, a miniature earphone and microphone are placed in the baby's ear. The earphone sends sounds to the baby's ear, and the microphone detects if there is a response from the inner ear. When a baby has normal hearing, an echo is reflected back into the ear canal and measured by the microphone. If the microphone doesn't receive the echo, the baby may have hearing loss.
Auditory Brainstem Response (ABR)
This test evaluates the auditory brain stem (the nerve that carries sound from the ear to the brain) and the brain's response to sound. Miniature earphones are placed in the baby's ear and sounds are played. Band-Aid-like electrodes are placed on the baby's head to detect the brain's response to the sounds. If the baby's brain does not respond to all the sounds, this could indicate hearing trouble.
Brain Audiometry Evaluation
This test evaluates whether all parts of the ear are working correctly. The audiologist will play a sound into the baby's ear and then watch for changes in the baby's behaviour. A baby with full hearing will generally respond by sucking a pacifier, quieting, or searching for the sound.
Automated Auditory Brainstem Response (AABR)
AABR testing measures responses from the inner ear organ (the cochlea) and the auditory brainstem as sound travels up to the brain. Sticker electrodes are placed on the baby's head, and small earphones are placed in or around the baby's ear. Sounds are played through the earphones, and the electrodes measure whether there is a response from the baby's ear and auditory brainstem. If a baby hears normally, a response will be detected. If the baby has significant hearing loss, no response will be detected.
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Importance of newborn hearing screening
Early detection and intervention
Newborn hearing screening is important because it allows for early detection and intervention for hearing loss. One to three newborns per thousand are born with hearing loss, and this number is much higher for children with certain medical conditions. Early detection enables babies to receive the support and intervention they need to reach their full potential. Research has shown that children identified with hearing loss who begin intervention services before 6 months old develop language skills (spoken or signed) on par with their hearing peers.
Impact on development
Hearing is critical to a child's speech-language and social-emotional development. Untreated hearing loss can cause delays in speech and language communication skills, which can affect academic achievement and lead to social isolation and poor self-concept. Studies show that hearing loss even affects infant babble.
Benefits of newborn screening
Newborn hearing screening is quick and painless, and it is recommended that it is carried out in the first 4 to 5 weeks of a baby's life. The tests are safe and comfortable, and many infants sleep through the procedure, which usually only takes a few minutes.
Access to support and treatment
If hearing loss is detected, parents can get the support and advice they need right from the start, and babies can be referred to an audiologist for further testing and treatment.
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Frequently asked questions
It's not uncommon for newborns to fail their first hearing test. In the US, between 2 and 10 percent of all babies do not pass their initial hearing screening. There are several reasons why a newborn might fail a hearing screening, including fluid or debris in the ears, crying or moving during the test, or too much noise in the room.
If your newborn fails their hearing test, it's important to arrange a follow-up test as soon as possible. An audiologist will be able to conduct further tests to determine whether your baby has hearing loss and, if so, to what extent.
If your baby is diagnosed with hearing loss, there are many treatment options available. Your baby's doctor and audiologist can work together to create the best plan for your child, which may include hearing aids, cochlear implants, or early intervention services to help develop important speech, language, and social skills.
Even if your baby passes their hearing test, it's important to monitor them for any signs of hearing loss as they grow. Some signs to look out for include not starting at loud noises, not turning towards a source of sound, not saying single words by one year of age, or seeming to hear some sounds but not others. If you notice any of these signs, be sure to contact your baby's doctor immediately.