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13:06 PM

Does My Baby Need a Hearing Screen?

A Cook Children's audiologist on identifying hearing loss

Have you ever wondered why they do hearing screens on babies? 

Let's begin by looking at the facts:

  • About one to three babies out of every 1000 will be born with a permanent hearing loss.
  • Infant hearing loss is the most common health condition identified through routine newborn screens.
  • Nine out of 10 cases of genetic hearing loss occur in families where both parents have normal hearing.

The earlier children with hearing loss are identified and start getting help, the more likely they will reach their full potential. Hearing loss can cause children to fall behind their peers in speech, learning, reading, and social-emotional development, which can result in lower educational and employment levels into adulthood.

1-3-6 Goal

In fact, the Centers for Disease Control recommend the following 1-3-6 Goal:

1 — All infants get a hearing screen before 1 month of age.

3 — Hearing loss is confirmed before 3 months of age.

6 — Hearing loss intervention begins before 6 months of age.

So now that we know it’s better to identify hearing loss as a baby, just how are babies tested anyway? There are two types of tests used to screen hearing in babies and both are safe and painless.

Types of Hearing Screens

Otoacoustic Emissions (OAE)

For this test, a small earphone and microphone are placed in the ear, sounds are played, and a response is measured in the ear canal. If a baby hears normally, an echo is reflected back and measured by the microphone. When a baby has a hearing loss, no echo can be measured on the OAE test.

Auditory Brainstem Response (ABR)

For this test, sticker electrodes are placed on the baby's head to detect responses while sounds are played in the baby's ears. This test measures how the hearing nerve responds to sounds and can identify babies who have a hearing loss.

The two tests can be used separately or together. Both tests require a quiet, if not sleeping baby. If a problem is found, follow-up testing should happen as soon as possible.

What if My Baby Fails a Hearing Screen?

If your baby fails a hearing screen, you will be referred to an outpatient facility where an Audiologist will complete a more in depth ABR. It will measure the softest level that the ear responds to sounds using different pitches or tones. If testing is done before a baby is 4 months old, the baby can usually sleep naturally for the testing. For older or very active babies, sedation may be needed to help them sleep during testing. It is important that babies are sleeping for ABR testing.

The newborn hearing screen is one of the most important first tests your newborn takes. Babies start learning how to use sound as soon as they are born and listening prepares them to speak. Therefore, if a baby has hearing loss it is important that services begin right away. If you have any questions or concerns about your child’s hearing, contact your Pediatrician and ask about seeing an Audiologist.

See below for additional resources on newborn hearing screening:


About the author

Christina Graham is an audiologist at Cook Children's. Cook Children's audiologists focus on diagnosing specific types of hearing loss for kids. They work closely with the child, his/her family, speech pathologists, school personnel, specialists, and physicians to create a plan that will enhance a child's functional hearing and help them learn and develop. To learn more, click here. To make an appointment, click here.

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