How Does Newborn Hearing Test Work

Will My Child Be Successful In School

My baby has a Hearing Test in hospital

Like all children, children who are deaf or hard-of-hearing can develop strong academic, social, and emotional skills and succeed in school. Find out how your school system helps children with hearing loss. With your input, your childs school will develop an Individualized Education Program or Individualized Family Service Plan for your child, and you should ask if an educational audiologist is available to be part of the academic team. Explore programs outside of school that may help you and your child and talk with other parents who have already dealt with these issues. The Individuals with Disabilities Education Act ensures that children with hearing loss receive free, appropriate, early-intervention services from birth through the school years. Contact the U.S. Department of Education, along with resources listed in our directory of organizations.

An educator teaching a young boy.

Failed Hearing Test Follow Up Is Key

A significant number of infants fail their first hearing screening due to fluid that may still be present in the ear canal right after birth. If your infant doesn’t pass the initial hearing screening, schedule a follow-up screening with a pediatric audiologist within a couple of weeks. The majority of infants will pass the second screening quite easily. For those who do not pass the second newborn screening, a diagnostic hearing test from your pediatric audiologist will investigate further.

If your infant fails their newborn hearing screening, its important to follow up as soon as possible to determine whether or not they have hearing loss and, if so, when to begin treatment or services. Experts encourage parents to meet with an audiologist who specializes in infants, a pediatric ear, nose and throat doctor , and a pediatric eye doctor since some babies with hearing loss also have problems with their vision. You may also want to meet with a geneticist to determine if your babys hearing loss is hereditary.

Most likely, your pediatrician can recommend a hearing healthcare professional who specializes in children.

What Does The Screening Involve

A trained hearing screener carries out the hearing screening test. Two main tests are done to screen a newborn:

ABR The tester attaches leads to your baby’s forehead, back of their neck and behind their shoulder, using sticky pads. Small earphone ‘cups’ are then placed over the baby’s ears. The earphones make soft clicking sounds and the leads measure the response from your baby’s ears.

OAE A small soft-tipped earpiece is placed in the outer part of your baby’s ear, which sends clicking sounds down the ear. When an ear receives sound, the inner part, known as the cochlea, usually produces an echo. The screening equipment can pick up a response.

These tests only take a few minutes and do not hurt your baby. The hearing screening test will usually be done while your baby is asleep or settled. You can stay with your baby while the screening test is done.

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When Does Newborn Screening Happen

The timing of newborn screening is very important. Babies need screening during the first few days of life, because some of the conditions found by screening require treatment or intervention right away.

NBS happens after birth, usually when your baby is between 24 and 48 hours old. If a baby is tested before 24 hours, they may need to be retested.

Some babies who have had treatments such as transfusions or dialysis may be tested later or may need further testing after their blood has returned to normal. In addition, babies who are born too early, or who receive nutrients or medicines before screening, may need further testing.

There are two models that states use to screen all newborns: the one-screen model or the two-screen model.

To learn more about the differences in NBS across different states, visit the State pages.

All Babies Should Have A Hearing Screening Before They Are One Month Old

Get Your Little One For Baby

Hearing screening is easy and is not painful. In fact, babies are often asleep while being screened. It takes a very short time usually only a few minutes. Sometimes the screening is repeated while the babies are still in the hospital or shortly after they leave the hospital.

Babies who do not pass hearing screening should be tested by an audiologist. An audiologist is a person trained to test hearing. This person will do additional testing to find out if there is a hearing loss. There are many kinds of tests an audiologist can do to find out if a baby has a hearing loss, how much of a hearing loss there is, and what type it is.

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If An Infant Does Not Pass A Hearing Screen In The Hospital What Happens Next

Most hospital screening programs will refer infants who failed the initial screening test to a secondary center that specializes in more complete testing for diagnosis.

  • Sometimes, simple problems, such as too much residual amniotic fluid and vernix in the ear canal, will resolve prior to the rescreen and the infant will pass the second test.
  • The rescreen is an important step in determining whether the infant is able to hear, so it should not be taken lightly.
  • If an infant does not pass the rescreen, then a full diagnostic test will be necessary.
  • This test may be completed at the rescreen site or at another facility, depending on several factors.

How Does Nbs Happen

Newborn screening has three different parts:

  • Blood spot screening, which determines if a baby might have one of many serious conditions
  • Pulse oximetry screening, which determines if a newborn might have certain heart conditions
  • Hearing screening, which determines if a newborn might be deaf or hard of hearing
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    What Should I Do To Prepare For A Hearing Test

    Usually very little preparation is needed for a hearing test. If you are known to have wax in your ears you may have to have this removed before the test, so that it does not interfere with the results.

    Let the person doing the test know if you have had, or the child being tested has had, a recent cold or ear infection, as this may interfere with the results.

    How Are Hearing Problems Diagnosed

    Newborn Hearing Testing Screening (OAE and ABR)

    There are a few ways to detect hearing loss very early in life. The oto-acoustic emission test is the most common one . A specialist will put a small microphone in your babys ear, which sends a sound. The echo that comes back is sent to a portable computer. The computer can tell whether the baby heard the sound. The test, which takes 10 to 15 minutes, can often be done before your newborn baby leaves the hospital or at a designated hearing screening unit after leaving the hospital.

    The Canadian Paediatric Society recommends that all newborns have their hearing tested. Many Canadian provinces and territories have universal newborn hearing screening programsmeaning all babies are tested at birth. Families of babies who screen positive should follow up with a full hearing evaluation.

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    What Is An Oae Evaluation

    An otoacoustic emission test measures an acoustic response that is produced by the inner ear , which in essence bounces back out of the ear in response to a sound stimulus.

    • The test is performed by placing a small probe that contains a microphone and speaker into the infant’s ear.
    • As the infant rests quietly, sounds are generated in the probe.
    • Once the cochlea processes the sound, an electrical stimulus is sent to the brainstem.
    • In addition, there is a second and separate sound that does not travel up the nerve but comes back out into the infant’s ear canal. This “byproduct” is the otoacoustic emission.
    • The emission is then recorded with the microphone probe and represented pictorially on a computer screen.
    • The audiologist can determine which sounds yielded a response/emission and the strength of those responses.
    • If there is an emission present for those sounds that are critical to speech comprehension, then the infant has “passed” the hearing screen.
    • Testing generally takes about five to eight minutes.

    How Is The Newborn Hearing Test Done

    The newborn hearing test is called the automated otoacoustic emission test. It takes just a few minutes.

    A small soft-tipped earpiece is placed in your baby’s ear and gentle clicking sounds are played.

    It’s not always possible to get clear responses from the 1st test. This happens with lots of babies, and does not always mean your baby has permanent hearing loss.

    It could mean:

    • your baby was unsettled when the test was done
    • there was background noise
    • your baby has fluid or a temporary blockage in their ear

    In these cases, your baby will be offered a 2nd test. This may be the same as the 1st test, or another type called the automated auditory brainstem response test.

    The AABR test involves placing 3 small sensors on your baby’s head and neck. Soft headphones are placed over your baby’s ears and gentle clicking sounds are played. This test takes between 5 and 15 minutes.

    These tests will not harm your baby in any way.

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    What If The Follow

    Getting a passing screen in a follow-up exam can help ease your mind. Just remember that depending on your family history or any other underlying conditions that could impact your babys hearing, it doesnt mean you no longer have to focus on potential hearing loss.

    While AABR and OAE tests are considered the standard and most effective options for newborn hearing screenings, theyre not 100 percent perfect. Its possible for some tones to be missed by the test. This would mean your baby could potentially have partial hearing loss.

    And if you have a family history of hearing loss, your babys doctor or audiologist will generally recommend continued hearing monitoring. This is proactive designed to prevent any hearing deficiencies from delaying your babys developmental journey.

    Even if you dont have any family history or known hearing concerns, your child should continue to have their hearing periodically checked.

    Who Runs The Screening Programme And How Is It Evaluated

    Hearing loss still a challenge for kids

    The National Screening Unit of the Ministry of Health is jointly responsible for newborn hearing screening with the Ministry of Education. The National Screening Unit are also responsible for breast screening, cervical screening, newborn metabolic screening and antenatal screening for Down syndrome and other conditions.

    Locally your DHB runs newborn hearing screening and reports to the National Screening Unit. The National Screening Unit website has more information

    All aspects of the programme are continually monitored. For example:

    • data from the screen is routinely checked by a programme coordinator against National Screening Unit protocol
    • screeners have to pass an annual competency assessment
    • the performance of the programme and each DHB is monitored against a set of indicators and monitoring reports are published on the National Screening Unit website
    • services for the programme in each DHB are audited by the National Screening Unit.

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    What Is Newborn Hearing Screening

    Most babies are born with normal hearing and experience the beauty of sound from the beginning but 1-3 out of 1000 are born with hearing loss. Those children cannot properly hear their parents speak, sing or read to them which delays speech and language learning. Newborn hearing screening identifies babies at risk for hearing loss so they can be evaluated and treated early.

    The hearing screening is performed in the hospital by a nurse or outside of the hospital by a health professional. Many countries have implemented Universal Newborn Hearing Screening so that every baby has access to hearing screening soon after birth.

    Do Children With Hearing Problems Develop The Same As Other Children

    It depends on how early the problem is diagnosed. Children who are diagnosed laterespecially after 2 years of agemay have lifelong problems with language, speech and literacy. If the hearing loss begins at a later age, especially after the child has started to talk, your childs language development may be less affected.

    Success in school is linked to literacybeing able to read and write effectively. And literacy is linked to the hearing and speech areas in the brain. To be able to speak, children need to hear. Children who hear and speak learn to read and write more easily.

    The first few months of life are critical for developing the speech and language area of the brain. Studies show that the earlier a baby can hear, the better their language skills will be. Deaf children who are diagnosed early and get the right kind of help can develop just like other children their age.

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    Hearing Tests For A Toddler

    A toddler’s hearing assessment may include the tests mentioned above, along with these:

    • Play audiometry. A test that uses an electrical machine to send sounds at different volumes and pitches into your child’s ears. The child often wears some type of earphones. This test is changed slightly in the toddler age group and made into a game. The toddler is asked to do something with a toy every time the sound is heard. This test relies on the child’s cooperation, which may not always be possible.

    • Visual reinforcement audiometry . A test where the child is trained to look toward a sound source. When the child gives a correct response, the child is rewarded through a visual reinforcement. This may be a toy that moves or a flashing light. The test is most often used for children between 6 months to 2 years old.

    When Will We Get The Results

    Natus Newborn Care: Hearing Screening

    You’ll be given your baby’s hearing test results as soon as the test is done. If your baby has a clear response in both ears, they’re unlikely to have permanent hearing loss.

    But the newborn hearing test does not pick up all types of permanent hearing loss. Children can also develop permanent hearing loss later on, so it’s important to check your child’s hearing as they grow up.

    If you have any concerns about your child’s hearing, tell your health visitor or GP.

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    Why Is Early Screening So Important

    The push for early hearing screening is critical since babies learn by being immersed in the world around them. And being able to hear is an essential component for building speech skills.

    Catching potential hearing loss early allows you to work with your babys care team on solutions. This makes it more likely your baby wont fall behind developmentally.

    Testing In Older Children And Adults

    In older children and adults testing mainly uses a technique called pure tone audiometry. This uses a machine called an audiometer to play a series of tones through headphones. The tones vary in pitch and loudness .

    The health professional conducting the test will control the volume of a tone and reduce its loudness until you can no longer hear it. Then the tone will become louder until you can hear it again. You signal by raising your hand or pressing a button every time you hear a tone, even if the tone you hear is very faint. The health professional will then repeat the test several times, using a higher-pitched tone each time. Each ear is tested separately.

    The results of the test are plotted on a special graph called an audiogram which helps to show the pattern of any hearing loss.

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