Hearing loss can affect your baby's ability to learn and develop speech and language appropriately. Fortunately, early detection of hearing loss can lead to preventive steps or treatment that will help your child reach these important developmental milestones.

All states have established Early Hearing Detection and Intervention (EHDI) programs to detect hearing loss in newborns before the age of three months and to provide intervention before the age of six months. Newborn hearing screening takes place prior to your newborn's discharge from the hospital.

What Is The Infant Hearing Screening?

The primary measure for detecting hearing loss in newborns is the automated auditory brainstem response (ABR) test and the otoacoustic emission screening (OAE’s). These screening tests take approximately five minutes to administer and do not cause any discomfort.

The hospital reports all results to the Virginia Newborn Screening Program for evaluation and follow-up purposes.

Possible Infant Hearing Screening Outcomes

Following screening, you'll receive one of the following results:

  1. Pass with no risk factors: A pass result means your baby passed the newborn hearing screening and has no risk factors for progressive or late-onset hearing loss, and therefore won’t require further testing.
  2. Pass with risk factors: If your baby passes the newborn hearing screening but has risk factors for progressive or late onset hearing loss, they will be rescreened one more time before 24 months of age.  Risk factors for hearing loss in newborns include:
    • Family history of hearing loss that began in early childhood.
    • Postnatal infections associated with sensorineural hearing loss such as bacterial or viral meningitis.
    • Medications that is toxic to the ears, such as chemotherapy drugs.
    • Stigmata or other findings associated with a syndrome known to include sensorineural hearing loss and or permanent/conductive hearing loss (i.e.: CHARGE association, NOONAN, Trisomy 21,18,13,9,8, Williams, or Zellweger.
    • In Utero infections such as: cytomegalovirus, herpes, rubella, syphilis, or toxoplasmosis.
    • Head trauma requiring hospitalization during or after birth.
    • Craniofacial conditions, such as cleft lip and palate, pinna deformity, temporal bone deformity, microtia or atresia of the ear.
    • Neonatal indicators such as: intensive care greater than 5 days, assisted ventilation, hyperbilirubinemia requiring exchange transfusion, or extracorporeal membrane oxygenation.
    • Syndromes associated with progressive sensorineural hearing loss such as neurofibromatosis, osteopetrosis, Usher syndrome, Jervell, Alport, white forelock, Waardenburg, Pendred, Lange-Nielson.
    • Neurodegenerative disorders such as Hunter syndrome, Friedreich’s ataxia, or Charcot-Marie-tooth syndrome.
  3. Fail: A fail result means that the hearing screening didn't provide a clear indication of your baby's level of hearing. This doesn't necessarily mean that your baby has hearing loss but it does mean that he or she will need rescreening within the next three months.

Follow-up Screening

A follow-up diagnostic hearing screening is done at an approved facility, such as Virginia ENT where an audiologist performs a more thorough evaluation of your baby's hearing using the threshold ABR test. This test may take up to an hour and is best conducted with the baby sleeping. Electrodes are placed on the scalp and ears while   tiny earphones are inserted into the canal.

The results of this test are reported as follows:

  1. Pass with no risk factors: A pass result means that the ABR test has revealed a hearing threshold equivalent to a hushed whisper in both ears. If no risk factors for hearing loss are present, your baby won't require rescreening.
  2. Pass with risk factors: If your baby passes the ABR test but has risk factors for hearing loss, he or she will need rescreening before they are 2 years old. Rescreening involves performing a behavioral assessment, such as visual reinforcement audiometry in a sound isolation booth or OAE screening.
  3. Fail: A fail result means that the ABR test has revealed an elevated hearing threshold in one or both ears. This is confirmation that your baby has hearing loss.

Treatment for Hearing Loss in Infants

If your baby fails the threshold ABR hearing rescreening and indicates hearing loss, he/she will be referred to an ENT physician for a complete medical evaluation. If the hearing loss is medically treatable, the ENT will treat the underlying medical condition as needed. If the hearing loss is deemed not medically treatable then the baby will be referred to the audiologist for further follow up including a hearing aid evaluation.

Hearing loss due to damage to the inner ear or to the nerves that relay sound to the brain requires early intervention with therapies and services designed to help your baby learn to recognize sounds and develop speech and language appropriately. The audiologist may recommend hearing aids, a cochlear implant evaluation, and/or a referral to the county early intervention program that includes speech and language therapy.

Early detection of hearing loss in newborns is important in preventing learning and developmental delays.

If you're concerned about your newborn's hearing, please contact us to schedule an appointment.