Hearing screening

A hearing loss can happen when any part of the ear is not working in the usual way. This includes the outer ear, middle ear, inner ear, hearing (acoustic) nerve, and auditory system.

Who is at risk

Causes of late onset or progressive hearing loss in children can include genetics, frequent ear infections, other infections like measles or meningitis, a head injury, exposure to damaging levels of loud noises, and secondhand smoke. Newborns who need an extended period of neonatal intensive care may also be at an increased risk for hearing loss.

Symptoms

Talk with your pediatrician if your child:

• Doesn't startle at loud noises by 1 month or turn toward sounds by 3-4 months of age.
• Doesn't notice you until he sees you.
• Concentrates on vibrating noises more than other types of sounds.
• Doesn't seem to enjoy being read to.
• Is slow to begin talking, hard to understand, or doesn't say single words such as "dada" or "mama" by 12 to 15 months of age.
• Doesn't always respond when called, especially from another room.
• Seems to hear some sounds but not others. (Some hearing loss affects only high-pitched sounds; some children have hearing loss in only one ear.)
• Has trouble holding his or her head steady or is slow to sit or walk unsupported. (In some children with sensorineural hearing loss, the part of the inner ear that provides information about balance and movement of the head is also damaged.)
• Wants the TV volume louder than other members of the family.

What you can do

• Have a healthy pregnancy.
• Make sure your child gets all the regular childhood vaccines.
• Keep your child away from high noise levels, such as from very loud toys.

Preventive service at no cost

Hearing screening for all newborns; and for children once between 11 and 14 years, once between 15 and 17 years, and once between 18 and 21 years,

Why screening is important

Hearing loss can affect a child’s ability to develop communication, language, and social skills. The earlier children with hearing loss start getting services, the more likely they are to reach their full potential.

What the screening is

Hearing screening is a test to tell if people might have hearing loss. Hearing screening is easy and not painful. In fact, babies are often asleep while being screened. It takes a very short time — usually only a few minutes.

Newborns:

• Automated Auditory Brainstem Response (AABR)—This screen measures how the hearing nerve and brain respond to sound. Clicks or tones are played through soft earphones into the baby's ears. Three electrodes placed on the baby's head measure the hearing nerve and brain's response.
• Otoacoustic Emissions (OAE)—This screen measures sound waves produced in the inner ear. A tiny probe is placed just inside the baby's ear canal. It measures the response (echo) when clicks or tones are played into the baby's ears.

Older Babies and Children:

• If you think a child might have hearing loss, ask the doctor for a hearing screening as soon as possible.
• Children who are at risk for acquired, progressive, or delayed-onset hearing loss should have at least one hearing test by 2 to 2 1/2 years of age. Hearing loss that gets worse over time is known as acquired or progressive hearing loss. Hearing loss that develops after the baby is born is called delayed-onset hearing loss. Find out if a child may be at risk for hearing loss.

If a child does not pass a hearing screening, it’s very important to get a full hearing test as soon as possible. Often, the screening shows that your child has hearing loss, but the full hearing test shows that they do not. However, if the full hearing test shows that there is hearing loss, talk to your doctor as soon as possible about treatment.

Treatment

No single treatment or intervention is the answer for every person or family. Good treatment plans will include close monitoring, follow-ups and any changes needed along the way.

There are many kinds of tests an audiologist can do to find out if a person has a hearing loss, how much of a hearing loss there is, and what type it is. The hearing tests are easy and not painful.

In addition to an audiologist, your child’s pediatrician may recommend that he or she be seen by a pediatric otolaryngologist who specializes in the mechanics of the ear or speech language pathologist to help with speech and language skills.

Technology does not “cure” hearing loss but may help a child with hearing loss to make the most of their residual hearing. For those parents who choose to have their child use technology, there are many options, including:

• Hearing aids
• Cochlear implants
• Bone-anchored hearing aids
• Other assistive devices

Questions You May Want to Ask Your Child’s Audiologist

Questions You may Want to Ask Your Child’s Speech Language Pathologist

Additional tips

Schedule your baby’s first well-baby checkup 2 to 3 days after coming home from the hospital. Schedule your child’s well visits.

Well-child Visit Schedule

Additional Resources

• Do You Need a Hearing Test?
• Decision Guide to Communication Choices (English) (en Espanol)