Newborn Hearing Screening

One or two babies in every 1000 are born with a hearing loss that may affect their speech and language development. Newborn hearing screening helps to find those babies and offer help and support from the start.

The Screen

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One or two babies in every 1000 are born with a hearing loss. Most of these babies will be born into families where no-one else has a hearing loss. It is not easy for parents to tell if a young baby has a hearing loss. Finding out early is important for a baby’s development. It also means that support and information can be offered right from the start.

Hearing screening tells us which babies may have a hearing loss. The screening test shows us which babies need more tests to decide if they have a hearing loss.

Screening does not detect all hearing loss or prevent future hearing difficulties.

The automated otoacoustic emissions (AOAE) is the main test used for well babies. However, it is not always possible to see a clear response within the first 24 hours with this test so if a mother is likely to be discharged within 24 hours, her baby's hearing is screened again using a different test, the automated auditory brainstem response (AABR). This is so that a smaller number of babies leave hospital needing follow up. If it is not possible to do an AABR, for example if baby becomes unsettled, then another AOAE screen may be offered in the community.

Babies at high risk are screened using AABR only. High risk babies are babies who have spent more than 48 hours in a Special Care Baby Unit/Neonatal Intensive Care Unit.

A small soft-tipped earpiece is put in the outer part of the baby’s ear. This makes a clicking sound and the equipment shows the screener how the baby’s ears are responding to the sound.

Three small sticky pads are put on the baby’s head and neck. Small headphones are put over the baby’s ears, which will make a clicking sound. The equipment shows the screener how the baby’s ears are responding to the sound.

Both tests are best carried out when the baby is settled or asleep.

Automated Otoacoustic Emissions (AOAE)

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Automated Auditory Brainstem Response (AABR)

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Over 70% of babies will be tested in the first week of life or as soon as possible after that. We aim to screen most babies by 4 weeks of age. This may not be the case if your baby is born early or is unwell and needs Special Care.  In this case  the screener will explain to you the best time to screen your baby.

We try to screen as many babies as possible in the hospital so we hope to offer the test before you go home. If the test is not done in hospital, it will be offered in the community, usually at your local clinic.   It is helpful if you take baby's seat, buggy or pram to this appointment.  Your baby needs to be settled or asleep for the screening test so it helps if baby has just been fed. Written consent for the test is taken by the screener, so if this is your baby’s first screening appointment, someone with parental responsibility needs to bring baby. The Parental Responsibility checklist sent with your appointment letter tells you who has parental responsibility.

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The screening test is done by a trained screener while your baby is settled or asleep. It will not hurt or harm your baby.  The test only takes a few minutes and you can stay with your baby while the test is done.

The screener will tell you the result of the test straightaway, and explain if another test is needed.

Well Babies

If there is a clear response from one or both of your baby’s ears it is unlikely that your baby has a hearing loss that will affect speech and language development. No further hearing screening tests are needed. The screener will give you information on how babies respond to sound as they grow and what to do if you have any worries about your baby’s hearing.

If neither of your baby’s ears shows a clear response, it does not necessarily mean your baby has a hearing loss. Clear responses may also not be seen if:

  • the baby is unsettled;
  • there is fluid in the ear after birth;
  • there is too much noise near the baby when the test is done.

If your baby does not have a clear response in either ear, a further hearing test will be offered either by the screener, or with an audiologist (hearing specialist). If your baby needs a test with the audiologist, the screener will give you a leaflet to explain this.  The webpage "At the Audiology Clinic" also gives you more information.

If only one of your baby’s ears shows a clear response, you may choose to have another hearing test.  Your choices are explained below.

 
A clear response in one ear

About a fifth (20%) of all well babies screened has a clear response in only one ear. Only a very small number of babies are born with a permanent hearing loss in one ear, so it is likely that your baby hears well with both ears. A clear response may also not be seen if the baby is unsettled, if there is fluid in the ear after birth or if there is too much noise near the baby when the test is done.

We will write to your GP and Health Visitor to say that your baby had a clear response on newborn hearing screening and that no further tests are needed. However, you do have the following choices:

  • You may choose to have another hearing screening test within the next few weeks. This test will be  done in a special hospital clinic.
  • You may choose to wait and have a hearing test when your baby is nine months old. This test will be done in a local or hospital clinic.

If you choose to have another hearing test, phone the number below within a week of the screening test to make arrangements: tel:02921843568

Babies who have needed special care for more than two days

If there is a clear response from both of your baby's ears it is unlikely that your baby has a hearing loss that will affect speech and language development.  No further hearing screening tests are needed.  The screener will give you information on how babies respond to sound as they grow and what to do if you have any worries about your baby's hearing.

If neither of your baby's ears shows a clear response, it does not necessarily mean your baby has a hearing loss.  Clear responses may also not be seen if:

  • the baby is unsettled;
  • there is fluid in the ear after birth;
  • there is too much noise near the baby when the test is done.

If your baby does not have a clear response in either one or both ears, a further hearing test will be offered with an audiologist (hearing specialist) and this will be arranged by the screening programme.  The screener will give you a leaflet explaining this.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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About 1 or 2 in every 100 babies will need tests with an audiologist after the screening test.  These tests need to be done when a baby is still likely to sleep a lot during the day and you will be sent an appointment for the test within 4 weeks.  If your baby was born early you will be sent an appointment for the test within 8 weeks. This allows time for your baby's hearing pathway to develop.

For more information on the hearing assessment appointment click here, or you can read our leaflet Your Baby's Visit to the Audiology Clinic.

For every 10 babies who are referred for another hearing test with an audiologist, one will have a permanent hearing loss. A baby who needed special care may be more likely to have a hearing loss.

Babies who have a clear response on the newborn hearing screen will not need to have a further hearing test unless you or a professional has concerns about your child's hearing. In this case your child should be referred by your Health Visitor or GP. An appointment will be offered for a further test in the Audiology Department in your area.

It is important to check your baby’s hearing as he or she grows. The checklist for parents helps you look for and listen to your baby’s responses. The checklist may also be found in your baby’s red book.

Improving the physical and emotional health and wellbeing of expectant mothers, infants, children and young people throughout Aneurin Bevan University Health Board Area.

(N.B: The Family and Therapies team at ABUHB is NOT responsible for the content on the webpage links that we refer to in our resource sections and linked information to external sites. All information was accurate and appropriate at the time the webpage was created.)

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