Does Your Baby Need a Hearing Screening?

Hearing and speech are an important part of your child’s life. Hearing appears early in fetal development and is necessary for proper progression of speech and language. Monitoring your child’s ability to hear and speak is an important part of the health of your growing child.

Children develop speech, language, and hearing skills at different ages. However, hearing loss can lead to delays in your child’s ability to make sounds, learn to speak, and communicate. Most hearing loss is congenital (present at birth). About one to three out of every 1,000 babies are born with some hearing impairment. However, some babies develop hearing loss after they are born. Hearing loss is more likely in premature babies and babies with infections or respiratory problems requiring long-term use of breathing machines.

Because of these risks, many health organizations including the National Institutes of Health and the American Academy of Pediatrics now recommend universal infant hearing screening. Today, nearly all newborns are screened for hearing loss, which allows earlier treatment to prevent delays in language and development.

There are two primary types of hearing screening methods for newborns. These may be used alone or together.

• Evoked otoacoustic emissions (EOAE): A test that uses a tiny, flexible plug that is inserted into the baby’s ear. Sounds are sent through the plug. A microphone in the plug records the otoacoustic emissions (responses) of the normal ear in reaction to the sounds. There are no emissions in a baby with hearing loss. This test is painless and is usually completed within a few minutes, while the baby sleeps.

• Auditory brainstem response (ABR): A test that uses electrodes (wires) attached with adhesive to the baby’s scalp. While the baby sleeps, clicking sounds are made through tiny earphones in the baby’s ears. The test measures the brain’s activity in response to the sounds. As in EOAE, this test is painless and takes only a few minutes.

Evaluating an infant’s hearing may include the use of the above mentioned EOAE and ABR tests. Also, the following may be used:

• Behavioral audiometry: A screening test used in infants to observe their behavior in response to certain sounds. Additional testing may be necessary.

If the screening tests identify that your child has a hearing loss, further testing is needed. It is recommended that all babies with hearing loss be identified by 3 months of age so that treatment can begin before the baby is 6 months old, an important time for speech and language development.

Consult your child’s physician if you’re concerned about your child’s hearing or speech, or if you notice any of the following:

• Doesn’t startle to loud noises by 1 month or turn in the direction of the sound by 3-4 months

• Doesn’t notice you until he sees you

• No babbling by the time the infant is 9 months old

• No words spoken by age 12-15 months

• Does not follow simple commands by 2 years old

• Stuttering continues past 5 years old

• Poor voice quality at any age

• Seems to hear some sound but not others

• Concentrates on gargling noises rather than vowels or consonants