The Universal Newborn Hearing Screening is a standard procedure performed shortly after birth, typically while the baby is still in the hospital. The primary purpose of the screening is to confirm that the newborn’s hearing mechanisms are functioning correctly, providing a foundation for healthy development. Identifying any potential hearing issues as soon as possible allows for timely medical and intervention services.
The Necessity of Early Screening
Early detection of hearing loss is important because it is one of the most common conditions present at birth, affecting approximately one to three out of every 1,000 live births. Hearing loss can interfere with a child’s ability to develop speech and language skills if not addressed promptly. The brain’s most sensitive period for developing these auditory and language pathways occurs during the first few years of life.
Health professionals follow the “1-3-6 rule,” which emphasizes swift action. This guideline recommends that all newborns should be screened for hearing loss by one month of age at the latest. If the screening suggests a hearing issue, the baby should receive a full diagnostic evaluation by three months of age. Finally, any necessary intervention services should begin no later than six months of age to support the child’s development.
How the Screening Tests Work
The newborn hearing screening uses objective physiological measures that do not require the baby to consciously respond to sounds. Two main technologies are used for this assessment. They are often performed while the infant is sleeping or resting quietly, as movement or crying can interfere with the results. These tests are fast, usually taking only a few minutes to complete for each ear.
Otoacoustic Emissions (OAE) Test
One common method is the Otoacoustic Emissions (OAE) test, which assesses the function of the inner ear’s cochlea. A small probe containing a miniature speaker and microphone is placed gently into the baby’s ear canal. The speaker introduces a soft sound, and the microphone then records a tiny “echo” produced by the cochlea’s healthy outer hair cells. If a clear echo is not detected, it may indicate a hearing issue affecting the cochlea.
Automated Auditory Brainstem Response (AABR) Test
The Automated Auditory Brainstem Response (AABR) test evaluates the auditory pathway from the ear to the brainstem. This test uses small electrodes placed on the baby’s head, neck, or shoulder to measure electrical activity in the auditory nerve and brainstem. Sounds are delivered through small earphones or a probe placed in the ear. The AABR records how the auditory nerve and the brainstem respond to these sounds, checking the integrity of the neural pathways. The AABR is often considered a more comprehensive check as it assesses more of the hearing system than the OAE test does.
Understanding Results and Follow-Up Steps
The result of a newborn hearing screening is typically reported as either a “Pass” or a “Refer” for each ear. A “Pass” result indicates that the baby’s hearing is likely within the normal range for the sounds tested. Some forms of hearing loss can develop later, so parents should monitor their child’s hearing milestones as they grow.
A “Refer” result means the baby did not pass the screening and requires further testing. A “Refer” does not automatically mean the baby has permanent hearing loss. Temporary factors frequently cause this result, such as fluid in the ear canal after birth, or the baby moving or crying during the test.
If a baby receives a “Refer” result, a repeat screening is scheduled, usually before the baby leaves the hospital or within the first few weeks of life. If the baby refers again, the next step is a referral to a pediatric audiologist. This specialist will conduct comprehensive diagnostic hearing tests to determine if hearing loss is present, the type of loss, and its severity. Following the 1-3-6 guidelines, this diagnostic process should be completed by three months of age.