Help! My baby didn’t pass the hearing screening

November 24, 2014


Now what do I do?


The first time that you hold your newborn baby in your arms you feel a rush of emotion. Moms are often overwhelmed with feelings of love, relief, pride, dreams of their child’s future and perhaps some anxiety around their baby’s development in the weeks and years to come.


 Facts about Newborn Hearing Screening:

It is available for babies as soon as 24 hours after birth and only takes a few minutes. Results are not dependent on the baby’s response to sound and are available immediately. The testing is done while baby is sleeping or feeding and is painless. Your Paediatrician and Ear, Nose and Throat Specialist would recommend having the screening done. In countries such as the USA, UK, Australia it has to (by law) be conducted within the first few weeks of life.


 Hearing loss in infants

Significant hearing loss is present in 2-4 out of 1000 births in private hospitals. This number is higher (4-6%) for babies with higher risk factors such as those admitted to Neonatal ICU. The average age of identification of hearing loss in South Africa is 2-3 years if babies do not receive screening shortly after birth. Hearing loss that is not detected early could cause speech, language, social, emotional and learning developmental delays. However, if a hearing loss is detected and treated early enough (before 6 months), normal development could potentially be obtained.


 How does the Screen Test work?

There are two types of tests currently in use for newborn hearing screening:

1- Otoacoustic emissions (OAE) screening is used by placing a small rubber probe in your baby’s ear and soft sounds are presented.  An echo that reflects back from your baby’s inner ear hair cells is measured.  A pass or refer result is obtained in this way.

2- Auditory brainstem response (ABR) screening:  gel is placed on your baby’s forehead and ears and an earphone presents soft click-like sounds.  Responses/waves from the auditory nerve are measured which provide a pass or refer result.


 What does a pass or refer result indicate?

A pass result on OAE screening indicates normal functioning outer hair cells in the inner ear (cochlea) at the time of the test.  A follow-up test at the age of one year is recommended if no other risk factors are present.

A refer result on OAE screening does not necessarily indicate a hearing loss.  It means that we have to retest with OAE and/or ABR immediately or within the next six weeks.  The most common reasons for a refer result are:

- an ear canal blocked with vernix from the birth process;

- fluid in the middle ear;

- permanent hearing loss.


A refer result on ABR screening indicates the need to conduct a diagnostic ABR test within the next six weeks.

If your baby is diagnosed with a hearing loss after diagnostic testing, and this is done before the age of 6 months, he/she will have the potential to develop normal language and cognitive abilities with appropriate amplification and treatment.


Why is hearing testing important?

Untreated hearing loss can cause speech and language delays. This will impact your child’s ability to speak, learn to read and thrive at school. Because hearing loss is an invisible impairment, it is essential that a diagnostic hearing test is administered if you suspect that anything is amiss.[1] Speech development is not something that you wish to delay – language acquisition is easier at a young age and can become progressively more difficult with age [Consider how easy it was to learn different languages when you were young as opposed to now as an adult.]


Even if your baby does not present hearing loss at first, it’s important to monitor development

In some cases, children develop hearing loss later in life. This is why it is critical to monitor your child’s development even if their initial hearing screen shortly after birth was normal. Observe your child’s speech development and their reaction to sound. If you have any doubts or concerns it is important to have a diagnostic hearing test administered by an audiologist.


[1] http://www.asha.org/


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