Infant hearing screener

Newborn Hearing Screening - The American Academy of Audiology

All newborns should be screened for hearing loss. Make sure your newborn’s hearing is screened before leaving the hospital. If your baby is born at home or not in a birthing center, make a plan with your baby’s pediatrician to have their hearing screened and schedule a follow up consultation with an audiologist if needed.

What Are Newborn Hearing Screenings?

Newborn hearing screenings are a safe and painless way to determine whether your baby has a significant hearing loss. There are two ways that hearing can be screened in babies: otoacoustic emissions (OAEs) and automated auditory brainstem response (AABR).

Otoacoustic Emissions (OAEs): OAEs measure responses coming from the inner ear organ (the cochlea). For this test a small earbud is placed in the child’s ear, which contains a microphone and earphone. Sounds are played through the earbud and echo responses, coming from the inner ear organ are measured. If a baby hears normally or near-normally, an echo is reflected back into the inner ear which is measured by the microphone. If the baby has a significant hearing loss, no echo or a reduced echo is measured.

Automated Auditory Brainstem Response (AABR): AABR testing measures responses coming from the inner ear organ (the cochlea) as well as the auditory brainstem, as sound travels up to the brain. For this screening, sticker electrodes are placed on the baby’s head and small earphones are placed in or around the child’s ear. Sounds are played through the earphones and the electrodes measure whether there is a response coming from the baby’s ear and auditory brainstem. If a baby hears normally, a response will be detected. If the baby has a significant hearing loss, no response will be detected.

If my baby successfully completes the newborn hearing screening the results will be notated as: pass

If my baby does not pass the newborn hearing screening and further testing is needed to demonstrate healthy hearing, results will be notated as: refer, fail, or did not pass

Why Screen Newborns?

Newborn hearing screenings are extremely important. From the moment a baby is born they begin learning language by hearing language around them. If a baby is not hearing, this will hinder the baby’s ability to pick up spoken language and learn to talk. When newborns have hearing loss and are diagnosed early, effective intervention is available to help them achieve normal or near-normal speech, language, and hearing milestones.

Timely completion of a newborn hearing screening is an important first-step to determining whether hearing loss is present.

Approximately 3-6 of every 1,000 newborns have significant hearing problems.
More than 95 percent of newborns who are born deaf have parents with normal hearing.
Hearing loss is invisible; it cannot be seen by examining your newborn’s ears.
Most newborns with hearing loss have no signs or symptoms.

What Should I Know About the Newborn Hearing Screening?

Hearing screenings are fast, safe, and painless.
Sometimes newborns are screened once or twice.
Hearing screenings take about 10 minutes.
Most babies sleep through the hearing screening. If your baby is noisy or restless during screening this can influence the results.
You will receive the hearing screening results before you leave the hospital.

What if My Newborn Does Not Pass the Hearing Screening?

If your baby does not pass the newborn hearing screening, a follow-up screening or hearing test will be needed in the days or weeks after leaving the birthing hospital. This is a crucial step in determining whether your baby has hearing loss. Some newborns who need a follow-up hearing screening or a hearing test have normal hearing—BUT some have hearing loss.

If your newborn does not pass the hearing screening, it is important to make an appointment with an audiologist for a complete infant hearing test.

What if My Newborn Passes the Hearing Screening?

Most newborns who pass the hearing screening have normal hearing. However, some newborns might hear well enough to pass a screening, even though their hearing is not perfectly normal. It is a screening and not a diagnostic test, and so the newborn hearing screening cannot properly identify 100 percent of babies with hearing loss.

Additionally, some newborns may pass the screening at birth, yet they can lose hearing from illness, medications, or genetic reasons. This hearing loss can come on suddenly or gradually over time.

Because of these factors, it is important that, even if your newborn passes the screening, you contact your child’s pediatrician and get a referral to an audiologist for hearing testing if you have any concerns for your child’s hearing.

Other Warning Signs of Hearing Loss

Your newborn might be at risk for delayed onset hearing loss if any of the following applies to your baby:

You or another caregiver have concerns for hearing
There is a family history of childhood hearing loss
Your child had a Neonatal Intensive Care Unit (NICU) stay of longer than 5 days
Your child has a history of jaundice requiring blood transfusion
Your child has undergone chemotherapy or been treated with an intravenous antibiotic known to be toxic to the hearing and/or balance organs
Your child suffered from perinatal asphyxia
Your child received extracorporeal membrane oxygenation (ECMO) therapy
Your child was exposed to infections that occur before and after birth (including CMV, bacterial, and viral meningitis, herpes, rubella, syphilis, toxoplasmosis).
Your child has a syndrome, genetic disorder, or craniofacial condition known to be associated with hearing loss.

If one or more of the above circumstances applies to your newborn, routine hearing monitoring is advised. Speak with your child’s pediatrician about their recommendations for hearing monitoring and for a referral to an audiologist for routine hearing testing.

Once an appointment with an audiologist has been made for your newborn’s next hearing test, make sure you have the following information:

Audiologist’s Name
Office Name
Office Phone Number
Appointment Date
Appointment Time
Appointment Location/Address

If your baby did not pass the newborn hearing screening or you think your newborn may have hearing loss, use the “Find an Audiologist” tool to set up an appointment to get your baby’s hearing checked.

Speech, Language, and Hearing Skills: Expectations as Your Infant Grows

How a child is progressing with speech, language, and hearing milestones can be a good indicator of whether there should be concerns for hearing. An infant with normal hearing should be able to:

Around two months of age

Startle to loud sound
Quiet to familiar voices
Make vowel sounds such as “ohh”

Around four months of age

Look for sound sources
Start babbling
Make squeals and chuckles

Around six months of age

Turn head toward loud sounds
Begin to imitate speech sound
Babble sounds such as “ba-ba”

Around nine months of age

Imitate speech sounds of others
Understand “no-no” or “bye-bye”
Turn head toward soft sounds

Around 12 months of age

Correctly use “ma-ma” or “da-da”
Give toy when asked
Respond to singing or music

If you have concerns for the speech, language, and hearing milestone development of your child, speak with your child’s pediatrician and use the “Find an Audiologist” tool to set up an appointment for hearing testing.

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.

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

Audioclinic Hearing Center - Newborn Audiological Screening

Early diagnosis of hearing in children with hearing loss is of fundamental importance for the full development of the child's brain and speech.

In the old days, hearing impairments were often diagnosed only at the age of 2 years or more, although, obviously, they were congenital or acquired in the first months of life. This was largely due to the lack of reliable, objective research methods that could be applied to newborns. Meanwhile, studies show that children with 3-4 degrees of hearing loss, prosthetized at the age of up to 6 months, are no different from their peers. Whereas children who have been put on hearing aids after 6 months, despite the most advanced correction methods, still lag behind a little in speech development.

There are many causes of hearing loss in children. Genetic factors, infectious and viral diseases, use of drugs with ototoxic effect, pregnancy toxicosis, severe ante and intranatal fetal hypoxia, prematurity, postmaturity, low birth weight, congenital pathology of the maxillofacial skeleton, intraspecific cranial trauma, hemolytic disease of the newborn, acute toxic otitis, adenitis, sinusitis and head trauma. All this can lead to hearing loss in a child. That is why audiologic screening of newborns is so important. And if earlier it was shown to kids at risk, today everyone is doing it.

The first audio screening is done at the maternity hospital on the fourth day. Sometimes, for various reasons, for example, a small weight of a child or an infectious disease, screening is carried out not in the maternity hospital, but in a children's clinic during the first month of life. Repeated studies are done at the age of 4 and 6 months.

There is a “gold standard” for diagnosis and rehabilitation for hearing-impaired newborns.

All audiological screening procedures must be completed within the first month.
An accurate audiological diagnosis must be made before three months.
Hearing rehabilitation must be started before six months.

Otoacoustic Emissions

OAE (Otoacoustic Emissions) is a mandatory objective audiological screening method. Otoacoustic emission is sound generated in the external auditory canal by vibrations of the outer hair cells of the cochlea. In hearing diagnostics, evoked OAE is used, in which a sound signal is fed into the auditory canal, and at the end of stimulation, a sound response is recorded. This is done using a special device. Through a probe resembling an earpiece, a signal is sent to the ear of a calm (or better sleeping) child, and the response of the cochlea is recorded. It is a fast, precise, painless and discomfort-free procedure. The OAE method can detect even a slight hearing loss, regardless of whether it is conductive or sensorineural hearing loss.

Thanks to modern technologies and correction methods, even children with severe hearing loss can learn to hear and speak. But for this it is necessary to detect violations as early as possible.

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