Determining if your baby has hearing loss

Mother kissing baby's head

Determining if your baby has hearing loss

September is Newborn Screening Awareness Month. When babies are born, a standard battery of tests is run, including vision, hearing and blood tests to make sure the newborn is healthy and on the road to correct development.

Hearing development starts before birth
Fetuses can start hearing sounds before they are born. The outer ear, middle ear, inner ear, hearing (acoustic) nerve and auditory system (which processes sound as it travels from the ear to the brain) are all important parts of how children hear. If any of these parts are not functioning properly, hearing loss can occur.

Hearing loss can affect a child's ability to develop speech, language and social skills, since most children learn to speak through mimicking what they hear, and auditory cues can also drive social context. By having a hearing test done, any complications with hearing can be identified through newborn screening and plans made to meet such challenges or avoid them.

Initial newborn hearing screenings
Most hospitals will perform the newborn hearing screen before discharge from the hospital. You can ask your doctor to ensure the test has been done. If your baby was born at home or in another setting where screening is not immediately available, you can request a newborn hearing screening from your child's pediatrician.

If your baby's newborn hearing screen was out of the normal range, additional testing will be made available. An out-of-range result doesn't mean there is certainly hearing loss, as several factors can cause an infant to "fail" the initial screening.

Vernix in the ear canal, fluid in the middle ear or movement or crying during the test can cause an out-of-range result. The confirmatory test can help determine if your baby has hearing loss or not. A certified audiologist can determine if hearing loss is present and if so, the degree and type of hearing loss.

Typical confirmatory hearing tests for newborns
If your baby has an out-of-range test result for the newborn screening, your audiologist may perform any of the following to confirm whether or not there is any hearing loss:

  • The Auditory Brainstem Response (ABR) Test evaluates the part of the nerve that carries sound from the ear to the brain (the auditory brain stem) and the brain's response to sound.
  • The Otoacoustic Emissions (OAE) Test determines if certain parts of your baby's ear respond appropriately to sound by testing to see if an echo will reflect back into the ear canal.
  • The Brain Audiometry Evaluation Test evaluates if all parts of the ear are working correctly by playing sounds in your baby's ear and watching for changes in your baby's behavior.

The audiologist may also recommend your baby for a genetics evaluation and take a small sample of your baby's blood for genetic testing to help confirm if there is a genetic reason for any hearing loss. According to a University of Iowa study, 1 in 500 people have congenital hearing loss.

If hearing loss is confirmed, your audiologist will work closely with your pediatrician and early intervention specialists, and your child may be fitted with a hearing aid to help them hear better.

September is Newborn Screening Awareness Month. When babies are born, a standard battery of tests is run, including vision, hearing and blood tests to make sure the newborn is healthy and on the road to correct development.