Newborn Hearing Screening
All newborns should have their hearing screened soon after birth, while still in the hospital. For the best developmental outcomes, hearing should be screened for all infants by one month of age, hearing loss should be confirmed by three months of age, and intervention should be completed by six months of age, or sooner if possible.1
Why Screen Newborns?
Newborn hearing screenings are very important for a child’s development. When hearing loss goes undiagnosed, children can fall behind their peers in communication, cognition, reading, and social-emotional development. When newborns with hearing loss are diagnosed early, they can receive effective intervention to help them achieve normal or nearly normal developmental milestones4.
What Should I Know About the Hearing Screening?
- Hearing screenings are fast, safe, and painless.
- The infant will listen to soft sounds and the equipment used will measure their ear’s response.
- Most babies sleep through the hearing screening.
- You will receive the hearing screening results before you leave the hospital.
What If My Newborn Does Not Pass the Hearing Screening?
If a newborn does not pass the hearing screening, a second screening may be completed a few hours later, before they leave the hospital.
Some newborns who do not pass the screening may have hearing loss. Because the test is a screening and not a full diagnostic evaluation, the test results do not provide information about what their hearing levels may be or what may be causing a hearing loss. If your newborn does not pass the screening, it is important to make an appointment with an audiologist for a complete hearing test to get more information.
What If My Newborn Passes the Hearing Screening?
A passing result usually indicates that hearing is normal or very close to normal. A hearing screening typically rules out a significant hearing loss, therefore, there is a chance that the screening does not detect a slight hearing loss. Also, some infants can develop hearing loss as they get grow due to genetics, illness, or medications. A child may miss developmental milestones if they develop hearing loss later in life. It is important to monitor your child’s milestones and communicate with your healthcare team if you have new concerns for hearing as time goes on.
Speech, Language and Hearing Skills
Communication development should be continuously monitored by their healthcare providers throughout childhood, even if your child passes their hearing screening5. A child with normal hearing should be able to do the following6:
Birth to three months:
- Startles to loud sound
- Calms down or smiles when spoken to
- Has a special way of crying for different needs
Four to six months:
- Follows sound with their eyes
- Responds to changes in the tone of your voice
- Notices that toys make sound
- Babbles with different sounds like /p/, /b/, /m/
Seven months to one year:
- Turns and looks in the direction of sounds
- Listens when spoken to
- Understands words for common items “cup”, “shoe”, “juice”
- Responds to requests “come here”
- Babbles with groups of sounds “tata” “up-up” “bi-bi”
- Communicates with gestures like holding up arms or waving
- Has one or two words
One to two years:
- Knows a few parts of the body and can point to them when asked
- Understands simple questions “where is your shoe?”
- Enjoys stories, songs, and rhymes
- Points to pictures, when named
- Acquires new words on a regular basis
- Puts two words together “more milk”
Two to three years:
- Has a word for almost everything
- Uses 2 to 3-word phrases
- Speaks in a way that is understood by friends and family
Three to four years:
- Hears the television at the same volume as other family members
- Talks about activities at daycare, preschool, or with friends
- Uses sentences with 4 or more words
Four to five years:
- Pays attention to a short story and answers simple questions about it
- Uses sentences with many details
- Tells stories that stay on topic
- Communicates easily with children and adults
- Names letters and numbers
- Says most sounds correctly, except for a few (/l/, /s/, /r/, /v/, /z/, /ch/, /sh/, /th/)
Other Warning Signs of Hearing Loss
Your newborn might be at risk for delayed onset of hearing loss if any of the following applies7:
- You or another caregiver has concerns.
- Family history of childhood hearing loss
- Neonatal intensive care stays of more than five days
- In utero infections (cytomegalovirus, herpes, rubella, syphilis, toxoplasmosis)
- Hyperbilirubinemia (jaundice) requiring transfusion
- ECMO therapy at the hospital
- Chemotherapy for the infant
- Craniofacial malformations for the infant
- Nervous system disorders
- Syndromes associated with hearing loss
If one or more apply to your newborn, request a hearing test with an audiologist.
Visit an Audiologist
Once an appointment has been made for your newborn’s next hearing test, make sure you have the following information:
- Audiologist's Name
- Office Name
- Office Phone Number
- Appointment Date
- Appointment Time
- Appointment Location/Address
If your infant is not able to sit upright on their own for a hearing test, their hearing test may be done while they are sleeping. Prior to going to your appointment, communicate with the audiologist about what kind of test they are getting. If they are testing the baby’s hearing while they are asleep, consider feeding the child just before the test and keeping the child awake on the car ride over, if possible, so they sleep soundly during their appointment.
If you think your newborn may have hearing loss, "Find an Audiologist" and set up an appointment to get your baby's hearing checked.
1Year 2019 Position Statement: Principles and guidelines for early hearing detection and intervention programs. The Joint Committee on Infant Hearing. The Journal of Early Hearing Detection and Intervention 2019; 4(2): 1-4.
2Centers for Disease Control and Prevention (CDC). Identifying infants with hearing loss - United States, 1999-2007. MMWR Morb Mortal Wkly Rep. 59(8): 220-223.
3Blackwell DL, Lucas JW, Clarke TC. Summary health statistics for U.S. adults: National Health Interview Survey, 2012. National Center for Health Statistics. Vital Health Stat 10(260). 2014.
4Tomblin, J. B., Oleson, J. J., Ambrose, S. E., Walker, E., & Moeller, M.P. (2014). The influence of hearing aids on the speech and language development of children with hearing loss. JAMA Otolaryngology Head and Neck Surgery. 140(5), 403–409.
52017 Recommendations for preventative pediatric health care. American Academy of Pediatrics Committee (2017). Pediatrics April 2017, 139 (4) e20170254; DOI: https://doi.org/10.1542/peds.2017-0254
6Speech and Language Developmental Milestones. National Institute on Deafness and Other Communication Disorders. March 6, 2017. NIH Publication No. 13-4781
7Year 2007 Position Statement: Risk indicators associated with permanent congenital, delayed onset, or progressive hearing Loss in childhood. The Joint Committee on Infant Hearing.