Newborn Hearing Screenings
In the United States over the past ten years every state has adopted a universal newborn hearing screening program. This means that every baby born in the US in a hospital setting has their hearing screened at birth. When a baby is screened at a hospital typically an automated system is used. Some of the time an infant fails the screening and it is attempted again. Whenever an infant is tested and fails they are referred for follow up assessment. Other times infants pass the screening but there is some other concern regarding the infants hearing and they are referred for follow up assessment. They are always referred to an audiologist for assessment.
When an infant is referred for follow up hearing assessment typically an otoacoustic emission (OAE) or an auditory brainstem response (ABR) test is completed. Sometimes both will be completed depending on several factors. All of the testing completed on infants is painless and harmless. During OAE testing a small probe is placed in the ear canal and a specialized computer and microphone listen for responses from the inner ear to assess the function of the hearing mechanism. It is important that the infant remain quiet during this type of assessment and it is typically completed while the infant is sleeping. It is very important NOT to wake up a sleeping baby when this type of testing is being performed or is going to be performed. If your child is sleeping in a car seat and the seat is portable we ask that you bring the infant in the seat and do not disturb the child while they are sleeping.
Auditory brainstem response (ABR) testing is another assessment of the hearing mechanism and lower brainstem that utilizes insert earphones and some small electrodes on the infant’s forehead and earlobes (or just behind the ear). Sounds are sent to the ear and the computer records the ear and brain activity for that infant. Again, it is usually easier to record these measurement when the child is asleep so it is very important to let an infant continue to sleep when bringing them in for assessment. Their participation is not necessary for any of the assessment procedures that are completed.
After OAE and/or ABR testing is completed a test of the middle ear and reflexes of the middle ear is usually completed. This consists of placing another small probe in the ear that is completely painless. This test does use some louder sounds that can wake infants from sleep and it is done last so that if the infant wakes testing is completed.
When all testing is done it is common and frankly normal for infants to move around and not be receptive to having anything placed in their ear. Most infants accept the probe after a few attempts and again if they are sleeping during the procedure it is much easier for them to accept this small probe. It is not uncommon to have to test an infant over a period of a few visits due to circumstances that interfere with testing such as collapsing ear canals, debris in the ear canal, middle ear fluid or a noisy infant (awake or breathing loudly, stuffy nose, etc.)
After the assessment the audiologist will give the parents information regarding the assessment immediately and schedule any follow up assessments and/or medical referrals.