Newborn Hearing Screening in Kids

At birth, most children hear and listen, and will start to respond to sounds. However, 1-3 of every 1000 children born in the United States have some level of hearing loss. Early screening and diagnosis help us identify children as early as possible. Every state and nearly all US territories have a universal newborn hearing screening. We screen more than 95% of babies by their first month.

We screen babies' hearing in the hospital or birthing center. There are two different screening methods. Both are quick (5-10 minutes). Also, they can be done while your baby is sleeping or resting. Both help rule out significant hearing loss.

1) Automated Auditory Brainstem Response (AABR or ABR)

This measures how the hearing nerve and brain respond to sound. We place electrodes (much like stickers) on the forehead and behind the ear. Then, we place soft earbuds and play clicks or tones into the baby's ears.

2) Otoacoustic Emissions (OAE)

We place soft earbuds and play a soft sound. If the inner ear is working correctly, and there is no fluid, we can get a good response ("echo back") that we can measure.

What happens if my baby "refers" on a newborn hearing screening?

"Refer" means that we could not reliably obtain conclusive hearing information. However, it does not mean that the baby is deaf/hard of hearing. Many times, it may be due to external factors, such as excess noise in the room, or fluid in the external or middle ear space, or too much movement during the screening. If the child again refers on the second screening, then we will recommend a full hearing test with a pediatric audiologist.

The next step will be to try to do a "sleep ABR", where the baby does the test during natural sleep (before 3 months of age). We place an earbud in the ear, with electrodes behind the ear and on the forehead. Then, we play differently pitched sounds at different volumes. We record responses from the hearing nerve and brain stem to find the softest level to which the baby will respond.

If we confirm hearing changes on the follow-up ABR, then a team of providers including pediatric audiologists and pediatric otolaryngologists (ENTs) will come together to discuss treatment and possible early intervention. Remember, our overall goal is to identify hearing loss as soon as possible and to offer amplification/tools for hearing success as needed.

Follow-Up Screenings

If there are no risk factors at birth, (and the baby passes the screening), then a follow-up hearing screening by 3 years of age is often recommended, unless parents have any hearing concerns before then.
Many kids will have a hearing screening through their pediatrician (i.e., well visits), and will have periodic screening around speech and language acquisition. Most children will have a repeat hearing screening by the time they are in Pre-K or kindergarten. The AAP (American Academy of Pediatrics) recommends children get screened again at ages 4, 5, 6, 8, and 10. They recommend additional screenings sometime between ages 11-14, 15-17, or any time there is a concern.

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