The 2021 World Report on Hearing from the World Health Organization estimates that by 2050, nearly 2.5 billion people will have some degree of hearing loss, and 700 million will require rehabilitation. Hearing-related disabilities can be prevented if the condition is detected early and appropriate interventions are implemented.
Hearing Tests for Newborns
Newborn hearing screening is a quick and painless test that serves as the first step in detecting hearing loss in babies. It should be performed on all newborns because hearing loss is the most common sensory disorder and can be present at birth. Although congenital hearing loss can occur in any newborn, certain factors increase the risk—such as infections during pregnancy, the use of ototoxic medications, birth weight under 1,500 grams, and family history of hearing loss or genetic syndromes.
Early detection allows for timely diagnosis and treatment, which is especially important since hearing loss at this stage can significantly affect language development, cognitive abilities, and social integration. Hearing loss can also lead to educational challenges with long-term effects, and communication difficulties may result in feelings of isolation and loneliness. The primary goal of newborn hearing screening is to detect hearing loss as early as possible to enable timely intervention.
How Is Hearing Loss Detected?
Newborn hearing screening should ideally be done at the hospital before the baby is discharged. If that is not possible, it should be completed before the baby turns one month old. There are two main types of screening tests:
- Otoacoustic Emissions (OAE): Measures whether a part of the ear (the cochlea) responds to sound stimuli.
- Automated Auditory Brainstem Response (AABR): Evaluates how the auditory nerve and brainstem respond to sound.
What to Do Depending on the Test Results
Different protocols apply depending on the type of test, the results—which may be “Pass” or “Refer” in each ear—and the presence of risk factors for hearing loss.
- If the result is “Pass” in both ears and there are no risk factors, it is recommended to monitor the baby’s hearing and language development and consult a doctor if warning signs appear.
- If the result is “Pass” in both ears but risk factors are present, the baby should be referred for follow-up, as there is a possibility of late-onset hearing loss.
- If the result is “Refer” in one or both ears, in some protocols the test is repeated before the baby is one month old. In other cases, the baby is referred for confirmatory diagnostic testing, which should be completed before three months of age.
It is important to clarify that a “Refer” result does not necessarily mean the newborn has hearing loss—it simply indicates the need for further testing to confirm or rule out the diagnosis.
Confirmatory audiological tests include a series of objective exams that determine the type and degree of hearing loss. If hearing loss is confirmed, further medical evaluations—such as imaging, lab tests, and genetic assessments—are conducted to identify the cause.
Diagnosis should ideally be completed before the baby is three months old, with appropriate interventions in place by six months.
Why Is Newborn Hearing Screening Important?
Early identification of hearing conditions enables timely interventions, such as the use of hearing technology (hearing aids, cochlear or bone-anchored implants) and therapy. These interventions are essential to minimize impacts on the child’s language, cognitive, emotional, and social development.
It is also important to note that newborn hearing screening programs are cost-effective for countries. The long-term costs of not addressing hearing loss, such as special education services and medical interventions, can be significantly higher.
Newborn hearing screening and accurate diagnosis are key to preventing disabilities related to hearing loss. By detecting hearing issues early, healthcare professionals can implement interventions that greatly reduce the risk of delayed language development and related challenges.
It is essential to stress the importance of completing screening, diagnosis, and rehabilitation before six months of age, as studies show that children who receive early treatment perform comparably to hearing children in language development by the time they reach school age. This leads to better cognitive and social development—foundations for their future success and well-being.
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