Newborn hearing screening is a universal practice in hospitals, typically performed shortly after birth. This quick, non-invasive assessment aims to identify potential hearing issues early for timely intervention. The screening process is generally painless for the baby, often conducted while they are asleep.
Understanding Initial Test Results
Approximately 1 to 3 out of every 100 babies may not pass their initial newborn hearing screening. This initial “refer” result does not automatically mean a baby has permanent hearing loss. Several common factors can lead to a baby not passing the first screening.
Fluid or debris, such as amniotic fluid or vernix, in the ear canal or middle ear is a frequent reason for a failed test. This temporary blockage often resolves on its own within the first few months of life. Baby movement, crying, or environmental noise during the test can also interfere with accurate readings. Additionally, technical issues with the equipment or the baby being too deeply asleep for clear responses can affect results.
Two main types of screening tests are used: Otoacoustic Emissions (OAEs) and Automated Auditory Brainstem Response (AABR). OAEs involve placing a small probe in the ear to measure echoes produced by the inner ear in response to sounds, indicating normal function. AABR tests use electrodes placed on the baby’s head to measure the auditory nerve’s response to sounds, providing information about how the brain processes sound. Both methods are rapid and do not require a behavioral response from the infant.
Next Steps After a Failed Screening
If a baby does not pass the initial hearing screening, a re-screening is almost always recommended. This re-screening is often performed within a few weeks, sometimes even before discharge from the hospital. Follow up on these re-screening appointments promptly.
If the baby does not pass the re-screening, the next step is a referral for diagnostic testing by a pediatric audiologist. This specialist will conduct evaluations, such as a diagnostic ABR, to determine if hearing loss is present, its type, and its extent. These diagnostic tests are ideally scheduled by the time the baby is two to three months old.
Distinguishing Screening Failure from Diagnosed Hearing Loss
Failing a screening test does not mean a baby has permanent hearing loss. The actual prevalence of confirmed permanent hearing loss in newborns is lower than initial screening rates, affecting about 1 to 3 out of every 1,000 babies born. This highlights that many initial “refer” results are false positives.
Early detection and intervention benefit babies diagnosed with hearing loss. Identifying hearing loss early allows for support and intervention, which can improve speech, language, and cognitive development. Children with hearing loss who receive timely intervention show improvements in communication, academic performance, and social well-being. Intervention services should ideally begin by six months of age to support a child’s development.