Newborn Infant Hearing Screening
Medical Author: Jillyen E. Kibby, MA, CCC-A
Medical Editors: James K. Bredenkamp, MD, FACS
& William C. Shiel Jr., MD,
FACP, FACR
What is a newborn infant hearing screening program?
Newborn infant hearing screening programs are designed to identify hearing
loss in infants shortly after birth. Many states across the country have
implemented these screening protocols within hospitals and birthing clinics.
Typically, nurses or medical assistants are trained extensively on how to
operate automated equipment for testing infants. Prior to discharge, each
newborn has his/her hearing tested. If, for some reason, the newborn does not
pass the screen, a re-screen is usually done. If the infant still does not pass
the second hearing test, he/she is referred to a specialist for further testing.
Specialists who are experts at testing hearing are called audiologists.
Audiologists have had training that emphasizes diagnostic hearing testing
techniques as well as hearing rehabilitation of children and adults. Their
postgraduate academic training requires a minimum of a Masters degree.
Why is it important to screen for hearing loss in all newborn infants?
Several national committees, including the National Institutes of Health, the
American Academy of Otolaryngology/Head and Neck Surgery, and the American
Academy of Pediatrics, have recommended that hearing loss in infants be
identified, and when possible treated, prior to six months of age. This
recommendation is based on studies that have shown that children identified with
hearing loss prior to six months of age have a better chance of developing
skills equivalent to their peers by the time they enter kindergarten. Children
not identified until later (for example, it is very common to first identify
hearing impaired children at age 2 to 3 years) may ultimately suffer from
irreversible and permanent impairments in speech, language, and cognitive
abilities when compared to their peers.
Prior to the implementation of hearing screen programs, it was customary to
only test those newborns who had known significant risk factors for hearing
loss. This group included infants whose mothers suffered from illness during
pregnancy, those who had a family history of hearing loss, or those who were
exposed to drugs known to affect hearing. In addition, infants with the
following conditions were included for hearing screening:
- low birth weight
and/or prematurity, or oxygen deprivation or breathing difficulties at birth;
- high bilirubin levels (yellow color)
- syndromes associated with hearing
loss
- abnormal head or face structures
- infections such as
cytomegalovirus, syphilis, herpes, or toxoplasmosis; or
- low Apgar scores
(which assess several health factors at one and again at five minutes after
birth).
However, despite the testing of all infants who fell into this
"high risk registry," over half of all newborns with hearing loss were
missed!
In order to identify this large group of hearing impaired infants not
identified with current testing protocols, it is now recommended that all
newborns have a hearing test prior to discharge from the hospital. The
goal of this program is to identify all hearing impaired infants at an early
age, thereby increasing these children's chance at healthy and more productive
lives.
Next: How common is hearing loss in infants? »
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