Every 45 minutes, a baby is born with hearing loss in the United States. Without early detection, the child’s lifelong communication and speech skills could be permanently impaired.
To help minimize communication deficits and improve hearing abilities, 37 states, including Texas, have implemented Early Hearing Detection and Intervention (EHDI) programs that can detect hearing loss in newborns. There are two quick and painless hearing screenings that can be conducted on a newborn before being released from the hospital:
- The otoacoustic emissions (OAE) test records an infant’s inner ear’s response to sound.
- The auditory brainstem response (ABR) test (pdf) is typically done on infants who do not pass the OAE. During this test, electrodes are placed on the infant’s head that measure the hearing nerve’s activity in response to sound.
“It’s not terribly uncommon for an infant to fail a hearing screening in the hospital. It’s often due to the presence of debris in the baby’s ear canal or just because the baby wasn’t still and quiet during the recording of a response,” explained Anna McCraney, Au.D., a senior audiologist at Texas Children’s Cy-Fair Health Center and Woodlands Pediatric Associates. “However, the baby may have failed because of hearing loss so diligent follow-up is essential. Standard protocol is to rescreen the baby a week or two after discharge. If the newborn fails a second time, diagnostic testing should be ordered immediately.”
Early detection can lead to diagnosis and treatment of the youngest newborns. “We can fit a hearing aid on a newborn as soon as the diagnosis and treatment regimen are determined,” said McCraney. “I once fit a preemie who was born at only 27 weeks gestation. He was just a couple weeks old at the time of the fitting and still weighed no more than a few pounds, so even the smallest ears can be fit with a hearing aid.”
In general, the goal is to have the child fit with hearing aids by the time he or she is two months old.
Hearing loss, including that which is hereditary, can develop at any time during a child’s life. A newborn that passes the EHDI screening still may have a genetic condition that can cause hearing loss or develop hearing loss through non-genetic means such as illness.
Parents should be listening to the sounds their infants make and observing their responses to sound. “All infants, including those with hearing loss, will coo but for the hearing-impaired infant, the cooing generally doesn’t progress to repetitive babble or sound imitation,” said McCraney.
As a child matures, so should their responsiveness to sound. Initially, a baby’s response to sound is as subtle as eye widening or quieting of movement; but by six months of age, the baby should be able to localize to a sound by turning towards the sound source. It’s also important to note that just because an infant startles to a loud sound, such as a dog barking or a door slamming, it doesn’t guarantee the infant has normal hearing.
The first three years of a child’s life are the most critical for language development, with the first six months being the most crucial. “When babies are born, neurologically they are very immature and if they are not getting auditory simulation, the neural pathways for hearing will not develop correctly,” said McCraney. “The younger an infant is when hearing loss is diagnosed and treated, the better the chance for normal neural development and avoidance of hearing-related problems such as speech delay.”
If you’re concerned that your child may have a hearing loss, make an appointment with your pediatrician or audiologist to discuss your concerns and need for an examination. To find a pediatrician near you, visit www.texaschildrenspediatrics.org.
