Hearing screening for infants

Baby Hearing Screening | CDC

The best way to find out if your baby may be deaf or hard of hearing is by a hearing screening. Early diagnosis and intervention will help them reach their full potential.

Thousands of babies are born deaf or hard of hearing each year in the United States. Babies diagnosed early with hearing loss and begin intervention early are more likely to reach their full potential. The best way to find out if your baby may be deaf or hard of hearing is by a simple hearing test, also called a hearing screening.

Why is a hearing screening important for my baby?

Learn more about outcomes associated with early hearing detection and intervention:

Reading Proficiency Trends Following Newborn Hearing Screening Implementation

Frequency of Early Intervention Sessions and Vocabulary Skills in Children with Hearing Loss

Starting from day 1, babies begin to learn language skills by listening to and interacting with those around them. If babies miss these opportunities, their language development can be delayed. Many times, children’s hearing loss is not obvious and can go unnoticed for months or even years.

Hearing screening at birth can determine if your baby may have a hearing loss and if more tests are needed. An early diagnosis is essential to help babies who are deaf or hard of hearing reach their full potential, and allows families to make decisions about the intervention services that are best for their baby’s needs. Early diagnosis of hearing loss and beginning intervention helps to keep children’s development on track and improve their future language and social development.

Your baby probably had a hearing screening

Almost all states, communities, and hospitals now screen newborns for hearing loss before the babies leave the hospital. The hearing screening is easy and painless, and it can determine if more testing is needed. In fact, many babies sleep through the hearing screening, and the test usually takes just a few minutes.

What if my baby did not pass the hearing screening?

Additional testing is the next step to tell if your baby has hearing loss and what type of loss it is. A healthcare professional trained to test hearing, such as an audiologist, will be able to perform more detailed hearing tests. Your baby’s doctor (or an ear, nose, and throat doctor) should perform or order any medical tests needed to find out the cause of the hearing loss.

Making sure your baby gets this additional testing quickly is also important. CDC-funded research shows just how important it is. Children with hearing loss who are identified before 3 months of age, and receive services before 6 months of age, have better vocabularies than those identified or receiving services later. For more information about this research, visit Giving Every Child the Gift of Words

If my baby passed the hearing screening, is everything fine?

Because a newborn baby can pass the hearing screening and still develop a hearing loss later, your baby’s doctor should routinely follow your baby’s general health and development.

For more information, visit CDC’s Early Hearing Detection and Intervention (EHDI) website.

View large image and text description

Where can I go for help?

Every state has a program that works to help make sure that babies who are deaf or hard of hearing are diagnosed early. If you have any concerns about your baby’s hearing, ask the doctor for a hearing test or screening as soon as possible. To learn more about this topic, you can also call toll free 1-800-CDC-INFO or visit the CDC EHDI Program site.

The Centers for Disease and Control and Prevention’s (CDC’s) Early Hearing Detection and Intervention (EHDI) program works with your state to ensure that all babies are screened for hearing loss and receive any needed follow-up tests and services. CDC’s EHDI program supports the ongoing search for new ways to improve services. To learn more about CDC’s important role in helping children who are deaf and hard of hearing, download a fact sheet [439 KB, 2 Pages, 508] and watch a video in American Sign Language.

Your Baby's Hearing Screening and Next Steps

On this page:

Why is it important to have my baby’s hearing screened early?
When will my baby’s hearing be screened?
How will my baby’s hearing be screened?
What should I do if my baby’s hearing screening reveals potential hearing loss?
The follow-up exam revealed that my baby’s hearing is fine. Does that mean we don’t need to check his or her hearing again?
How can I help my child with hearing loss develop language skills?
What devices could help my child hear and communicate better?
What language and communication approaches are available for my child?
Will my child be successful in school?
Baby’s hearing screening and next steps: Timeline for parents
Where can I find more information about hearing screening and communication approaches?

Most children hear and listen to sounds at and even before birth. They learn to talk by imitating the sounds they hear around them and the voices of their parents and caregivers. But that’s not true for all children. In fact, about two or three out of every 1,000 children in the United States are born with detectable hearing loss in one or both ears. More lose hearing later during childhood. Children who have hearing loss may not learn speech and language as well as children who can hear. For this reason, it’s important to detect hearing loss as early as possible.

Because of the need for prompt identification of and intervention for childhood hearing loss, universal newborn hearing screening programs currently operate in all U.S. states and most U.S. territories. With help from the federal government, every state has established an Early Hearing Detection and Intervention Program. As a result, about 98% of babies have their hearing screened before 1 month of age.

Why is it important to have my baby’s hearing screened early?

The most important time for a child to learn language (spoken or signed) is in the first 3 years of life, when the brain is developing and maturing. In fact, children with typical hearing begin learning speech and language in the first 6 months of life. This is why it is so important to screen and start interventions for hearing loss as early as possible. Research shows that children with hearing loss who get help early develop better language skills than those who don’t.

When will my baby’s hearing be screened?

Your baby’s hearing should be screened before he or she leaves the hospital or birthing center. If not, make sure the baby is tested during the first month of life. If your baby’s hearing was not tested within 1 month of birth, or if you haven’t been told the results of the hearing screening, ask your child’s doctor today. Quick action will be important if the screening shows potential hearing loss.

How will my baby’s hearing be screened?

A newborn undergoes a hearing screening.

Two different tests are used to screen for hearing loss in babies. Your baby can rest or sleep during both tests.

Otoacoustic emissions (OAE) tests whether some parts of the ear respond to sound. During this test, a soft earphone is inserted into your baby’s ear canal. It plays sounds and measures an "echo" response that occurs in ears with normal hearing. If there is no echo, your baby might have hearing loss.
The auditory brain stem response (ABR) tests how the auditory nerve and brain stem (which carry sound from the ear to the brain) respond to sound. During this test, your baby wears small earphones and has electrodes painlessly placed on his or her head. The electrodes adhere and come off like stickers and should not cause discomfort.

What should I do if my baby’s hearing screening reveals potential hearing loss?

If the results show that your baby may have hearing loss, make an appointment with a pediatric audiologist—a hearing expert who specializes in the assessment and management of children with hearing loss. This follow-up exam should be done as soon as possible, ideally by the time the baby is 2 to 3 months old. The audiologist will conduct tests to determine whether your baby has a hearing problem and, if so, the type and extent of that problem.

If you need help finding a pediatric audiologist, ask your pediatrician or the hospital staff who conducted your baby’s screening. They may even be able to help you schedule an appointment. You can also try the directories provided by the American Academy of Audiology or the American Speech–Language–Hearing Association. If the follow-up examination confirms that your baby has hearing loss, he or she should begin receiving intervention services as soon as possible, ideally by the age of 3 to 6 months. See our Baby’s hearing screening and next steps: Timeline for parents (below) for a guide to follow.

The pediatric audiologist may recommend that your baby visit a pediatric ear, nose, and throat (ENT) physician who specializes in conditions affecting the ear, known as a pediatric otologist. A pediatric otologist can determine possible causes of hearing loss and recommend intervention options. If your child has siblings, the audiologist or otologist may also recommend that their hearing be tested.

The follow-up exam revealed that my baby’s hearing is fine. Does that mean we don’t need to check his or her hearing again?

Not necessarily. Hearing loss can occur at any time of life. Some inherited forms of hearing loss don’t appear until a child is older. If your baby was exposed to certain infections before being born, they are more likely to have gradual hearing loss during childhood. Other factors, such as childhood illness, ear infection, head injury, certain medications, and loud noise are also linked to hearing loss in children. Use Your Baby’s Hearing and Communicative Development Checklist to monitor and track your child’s communication milestones through age 5. If you have concerns about your child’s hearing at any age, talk to your pediatrician right away.

How can I help my child with hearing loss develop language skills?

When interventions begin early, children with hearing loss can develop language skills that help them communicate freely and learn actively. The Individuals with Disabilities Education Act ensures that all children with disabilities have access to the services they need to get a good education. Your community may also offer additional services to help support your child.

Your baby’s health care team will help you find services and methods to overcome communication barriers. You may also be referred to a speech-language pathologist or a teacher who is experienced in working with children with hearing loss. Talk to and communicate with your child often and stay up-to-date with all health care appointments.

What devices could help my child hear and communicate better?

Depending on your baby’s hearing loss and communication needs, some of these devices and tools may help to maximize his or her communication skills.

Hearing aids. Worn behind the ear, hearing aids help make sounds louder and clearer. Hearing aids can be used for different degrees of hearing loss in babies as young as 1 month. A pediatric audiologist who is experienced in treating infants and children can help you choose the best hearing aid and make sure that it fits securely and is properly adjusted. Read the NIDCD fact sheet Hearing Aids for more information.
Cochlear implants. If your child cannot benefit from a hearing aid, your doctor or audiologist may suggest a cochlear implant. This electronic device can provide a sense of sound to people who are profoundly deaf or hard-of-hearing. The device converts sounds into electrical signals and carries them past the nonworking part of the inner ear to the brain. Cochlear implants can be surgically placed in children as young as 12 months, or sometimes earlier.
With training, children with cochlear implants can learn to recognize sounds and understand speech. Studies have also shown that many eligible children who receive a cochlear implant early (before 18 months of age) can develop spoken language skills at a rate comparable to children with normal hearing, and many succeed in mainstream classrooms. Some doctors now recommend the use of two cochlear implants, one for each ear. An audiologist or otolaryngologist who specializes in cochlear implants can help you decide if a cochlear implant is appropriate for your child. Read the NIDCD fact sheet Cochlear Implants for more information.
Assistive devices. As your child grows, other devices may be useful. Some devices help children hear better in a classroom. Others amplify one-on-one conversations or make talking on the phone or watching TV and videos easier. Read the NIDCD fact sheet Assistive Devices for People with Hearing, Voice, Speech, or Language Disorders for more information.

What language and communication approaches might be available for my child?

Children who are deaf or hard-of-hearing can learn to communicate in several ways. Find out as much as you can about the communication choices and ask your health care team to refer you to experts if you want to know more. Because language development begins early, regardless of the communication mode you choose, you should engage with your child and begin intervention as soon as possible.

Common approaches used to help children with hearing loss communicate and interact with others include:

Listening and spoken language (also known as auditory-verbal): works to strengthen listening, talking, and reading skills through the use of natural hearing and hearing devices such as hearing aids and cochlear implants, without the use of manual communication.
Auditory-oral: emphasizes residual natural hearing in combination with amplification devices and technology to help children develop speech and spoken-language skills. It includes the use of speech reading and natural gestures in the communication process.
Cued speech: is a system of specific hand shapes and placements that represent groups of consonants and vowels and that are used in combination with natural lip movements.
American Sign Language: is a visual-manual, natural language that is used in the American Deaf community.
Combined approaches: use aspects of various communication approaches, some of which are listed above, to expose children who are deaf or hard-of-hearing to many ways to communicate with others.

Will my child be successful in school?

Like all children, children who are deaf or hard-of-hearing can develop strong academic, social, and emotional skills and succeed in school. Find out how your school system helps children with hearing loss. With your input, your child’s school will develop an Individualized Education Program (IEP) or Individualized Family Service Plan (IFSP) for your child, and you should ask if an educational audiologist is available to be part of the academic team. Explore programs outside of school that may help you and your child and talk with other parents who have already dealt with these issues. The Individuals with Disabilities Education Act ensures that children with hearing loss receive free, appropriate, early-intervention services from birth through the school years. Contact the U.S. Department of Education, along with resources listed in our directory of organizations.

An educator teaching a young boy.

Baby’s hearing screening and next steps: Timeline for parents

Use this timeline to get started.

Make sure that your baby’s hearing is screened either before you leave the hospital or immediately afterward. After the screening, find out the results. If your newborn was not screened in the hospital, schedule a screening to occur by the time your baby is 1 month old.

	If your baby did not pass the hearing screening, immediately schedule a follow-up appointment with a pediatric audiologist. Ask your doctor or hospital for a list of pediatric audiologists, or use the directories provided by the American Academy of Audiology and the American Speech–Language–Hearing Association.
	If you must cancel the follow-up appointment, reschedule it! Make sure you take your baby to a follow-up examination. This can occur as early as 2 months after birth, and by age 3 months at the latest.

If the follow-up exam shows that your baby has hearing loss, start your baby in some form of intervention as soon as possible. Your baby can start receiving intervention services as early as 3 months after birth and no later than 6 months. Interventions can include hearing devices, such as hearing aids or cochlear implants, and various language and communication approaches. Ask your health care team about the options.

	Remain active and involved in your child’s progress.
	If you move or change your contact information, make sure to tell your child’s doctors and specialists.
	Even if the follow-up exam found no sign of hearing loss in your child, continue to monitor his or her communication development. If you have concerns, speak with your child’s doctor. If your child has risk factors for childhood hearing loss, speak with an audiologist about how often his or her hearing should be monitored.

Where can I find more information about hearing screening and communication approaches?

The NIDCD maintains a directory of organizations that provide information on the normal and disordered processes of hearing, balance, taste, smell, voice, speech, and language.

For more information, contact us at:

NIDCD Information Clearinghouse
1 Communication Avenue
Bethesda, MD 20892-3456
Toll-free voice: (800) 241-1044
Toll-free TTY: (800) 241-1055
Email: [email protected]

NIH Publication No. 21–4968
October 2021

*Note: PDF files require a viewer such as the free Adobe Reader.

Hearing tests for children

The hearing test helps to determine if there is a hearing loss, whether it affects one or both ears, what degree and type of hearing loss, and whether the hearing loss can be treated or corrected by technical means (for example, hearing aids, cochlear implants and assistive devices). technologies) and how this hearing loss will affect the child and their ability to communicate.

Various types of hearing tests

Audiological screening

Audiological screening usually only detects the presence of a hearing loss in a child. Screening procedures are fast, reliable and painless. If the child does not pass the screening test, they are referred to a specialist for a more detailed examination.

Objective hearing tests

These methods do not require the child to react or participate when they hear a sound. They are usually performed on infants and young children, children with developmental disabilities or non-contact children; in cases where the results of other tests are inconsistent or unreliable, as well as to confirm the results of behavioral testing.

Acoustic stem evoked potential (ASEP): the sound is reproduced through headphones, the reaction to sound stimuli is recorded. The analysis of the obtained recordings makes it possible to assess the sensitivity of hearing.
Otoacoustic emission method (OAE): The OAE method provides information about the functioning of sensory hair cells inside the organ of hearing (cochlea). Sound signals are fed into the already through a miniature speaker, and the microphone records the reaction of the snail to the sound.
Tympanometry: This test method provides information on the functional state of the tympanic membrane and middle ear. An air jet is directed into the ear under a small pressure, and the intensity of the tympanic membrane vibrations is recorded in response to a change in air pressure. This test helps to determine if there is a hole in the eardrum, as well as to detect the presence of fluid in the middle ear.

Behavioral hearing tests

Behavioral tests provide information about how a child hears sounds of different frequencies and reacts to them. Sound signals are given through headphones or speakers. The audiologist monitors and records the child's reaction to the quietest of the reproduced sounds and, based on the data obtained, builds a graph called an audiogram.

How hearing loss is measured

Sounds have different pitches, called frequency, and different volume levels, called sound intensity. The unit of sound frequency is hertz (Hz), the unit of sound intensity is decibel (dB). The range of frequencies we hear includes both low (250 Hz) and high frequencies (8000 Hz). The range of sound intensity levels we perceive ranges from 0 dB (very quiet sound) to 120 dB (very loud sound). A hearing test is a determination of how quiet sounds in each frequency range we can hear.

Audiogram

The results of a hearing test are recorded on a graph called an audiogram (a visual representation of a child's hearing sensitivity). An audiogram shows the quietest sounds a child hears. Sounds are quiet and loud, as well as low-frequency and high-frequency. The graph shows both the volume and the frequency of the sound. The area of very quiet sounds is at the top of the graph, and the area of very loud sounds is at the bottom of the graph. Low frequencies are located on the graph on the left, high frequencies on the right.

Degrees of hearing loss

Degree of hearing loss refers to the severity of hearing loss. In children, hearing sensitivity is usually described as an average.

Normal hearing: 0 to 20 dB
Mild hearing loss: 21 to 40 dB
Moderate hearing loss: 41 to 65 dB
Severe hearing loss: 66 to 90 dB
Profound hearing loss: 91 dB or more

Hearing loss often affects the ability to understand speech. In particular, a person stops hearing consonant sounds /p/, /k/, /f/, /x/ or all sounds like /t/, /sh/ and /s/.

Frequently Asked Questions about Hearing Tests

Why does my child need a hearing test?

Your child may need a hearing test for several reasons:

Your child did not have an audiological newborn screening or an audiological screening at school
You, your loved ones, or your child's teacher are concerned that your child is having trouble hearing or following directions
Your child reported hearing problems
Your child is having ear surgery
Your child is about to undergo medication that could affect hearing

How often should my child have a hearing test?

Your child's hearing may change over time. Some forms of hearing loss are transient and treatable, while others are irreversible. In addition, the severity of some forms of hearing loss can change (both for better and for worse), while other forms of hearing stay the same over time. Therefore, it is recommended that children diagnosed with hearing loss be screened at least once a year to be able to monitor for possible changes. If the child is small, or the hearing test was previously incomplete or did not give an unambiguous result, then several visits to the doctor for a hearing test may be required during the year.

Who will test my child's hearing?

A pediatric audiologist with expertise in infants and young children will perform a comprehensive hearing examination. He will discuss the test results with you, answer your questions, and explain the next steps to evaluate and, if necessary, correct your child's hearing loss.

How do children hear

hearing loss

Help your child

How to check the hearing of a newborn and a child in the first years of life? It won't work at home.

Need a professional diagnosis

We check the most important points when it is necessary to test the child's hearing. How does this happen and what to do if some stage was skipped? What to look for at home?

Let's see the ears

In the first days of life

Absolutely all newborns in Russian maternity hospitals should undergo audiological screening on the 3rd–5th day. Of course, in practice this is not the case: somewhere the devices failed, the nurse fell ill, or other reasons interfered. Ask if your baby had a hearing screening at the hospital.

This is a quick and painless test.

A probe is placed in the child's ear (shallow and absolutely no discomfort).
The sensor sends signals, and healthy cells of the inner ear, in simple terms, "respond".
If there is a pathology, the specialist will understand this according to the readings of the device. True, what kind of pathology, it will be unclear.
Is everything all right? Let's move on to the next age point.

This is the first hearing test for a newborn. If the test is successfully passed, then nothing threatens development at this stage. How the child hears, we will understand later: at home or at the next examinations. Or perhaps circumstances intervene. After all, hearing loss can occur in any year of growing up and life. Causes: injuries, infections, genetic abnormalities that do not appear immediately.

If a problem is nevertheless identified, the cause may be:

presence of fluid in the tympanic cavity - amniotic fluid or due to otitis media;
ear canal cerumen;
incorrectly performed screening (this also happens), because the sensors are very sensitive to noise;
hearing loss.

More tests needed!

In the first month - audio screening (UAE). In fact, the same examination as in the maternity hospital, but already “double 2”, from b to more attention.
Until the end of the second month - in-depth examinations:

ABR is the “gold standard” for an objective study of hearing acuity in patients of any age with suspected hearing loss;
and others - whatever the doctor prescribes.

Read more about children's audiometry in the MasterSluh network at the link. You have the right to be examined in a private center or children's clinic under the policy.

In case of detection of hearing loss, hearing correction is critically important to start no later than four months to six months. Otherwise, the development of the child will be greatly affected.

“Yes, they didn't do it to many acquaintances, and nothing. What will happen if we don’t check?” - this question is asked very often. The answer is: the decision is up to you. But if for some reason the first test in the maternity hospital was not carried out, do not wait until the baby grows up, rather go through the diagnosis, even if nothing bothers you. Making sure everything is fine is a matter of a few hours. And you can “miss” a pathology and not know about it for several years.

How to test a child's hearing at three months

By this age, the baby already knows how to respond to loud sounds. Parents can see how he shudders or freezes. Attention is drawn to musical toys. A good signal if the child turns his head towards the source of the sound.

Doesn't it? Talk to your pediatrician or specialist at your scheduled appointment. If there is still a long time before the visit to the doctor (who is in a hurry to the hospital?), make an appointment yourself. Delay is undesirable, it is better, as they say, to overdo it.

Diagnostics is the same - according to the appointment of a specialist. It will accurately determine whether the crumbs have hearing loss.

1 +: do not relax, develop

During the first 12 months of life, the baby must gain a minimum supply of sounds and words understandable to others. For example, “av-av” (dog), “bi-bi” (car), “ba” (grandmother), etc. And in general, it’s great if the baby speaks his first words clearly and understandably.

By 24 months, a child's vocabulary can already reach 100-200 words. The kid builds sentences, communicates with family and friends.

If the baby has a hearing loss, even a very small one, then there are no conditions for the normal development of speech. Therefore, any lag behind the given average indicators at the age of one to two years should be a reason for contacting a pediatrician, ENT specialist, deaf teacher, or audiologist.