Newborn Infant Hearing Screening - Experience

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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.

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