Newborn Infant Hearing Screening
Medical Authors: Jillyen E. Kibby, MA, CCC-A and John Mersch, MD, FAAP
Medical Editors: James K. Bredenkamp, MD, FACS
and 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. All states have implemented these screening protocols within hospitals and birthing clinics.
About 95% of hearing screening tests are done prior to discharge from the hospital or 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 rescreen 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 master's degree.
Why is it important to screen for hearing loss in all newborn infants?
Significant hearing loss is the most common disorder at birth. Approximately 1%-2% of newborns are affected.
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 6 months of age. This
recommendation is based on studies that have shown that children identified with
hearing loss prior to 6 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? »
- Detecting Hearing Loss in Children - Read about tests used for identifying hearing loss in children, treatment information, causes, risk factors and signs of hearing impairment, and learn about degrees of hearing loss.
- Pregnancy Planning - The goals of pregnancy planning are to create a healthy environment for the fetus and to prevent birth defects and other pregnancy related problems.
- Deafness, Hearing Loss - Hearing loss (deafness) may be present at birth or it may manifest later in life. Deafness may be genetic or due to damage from noise. Treatment of deafness depends upon its cause.
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