Jane Auriemmo, Au.D., CCC-A
CHC would like to review and clarify the critical importance of newborn infant hearing screenings (NIHS) in light of an article in The New York Times, A Hearing Test for Babies Has Angered Parents, published December 22, 2021.
Newborns receive several screening tests after birth. The purpose is to identify conditions that must be treated early if they are present. One of the tools utilized is a hearing screening. Hearing loss is the most commonly occurring condition present at birth. Fortunately, due to this early screening and early intervention, infants with all degrees of hearing loss can reach developmental milestones including speech and language skills, and achieve the same social and academic success as infants with normal-hearing.
While hospital protocols may differ slightly, most use a very simple, inexpensive procedure to screen the newborn infant’s hearing called otoacoustic emissions, or OAE. A small rubber tip is inserted in the infant’s ear canal by a technician. A measurement is made in a matter of seconds. The result is either a “pass” or a “refer.”
Of all newborns screened, 98 to 99% pass when first tested. The babies who do not pass are “referred” for a second hearing screening, typically done before the baby is discharged from the hospital. Most babies will pass the second screen; it is not uncommon for newborn infants to have fluid in their ear canals related to the birthing process, and this may result in a false positive “refer” result.
However, if the infant does NOT pass the second screening, it is very important that parents follow up with their pediatrician and have a complete diagnostic hearing test conducted. About 90% of the babies who do not pass the second screen are found to have a hearing loss, either a temporary or permanent one. This makes the OAE approach an excellent and cost-effective screening tool.
Some hospital protocols use an approach that involves the use of more expensive equipment (an ABR) if the infant does not pass the initial OAE test. While this can increase the efficacy further, it is not typically employed in the well-baby nursery due to the extra expense. (It is important to note that it might be important to use this extra test in the neonatal intensive care unit, as these infants are at higher risk for hearing loss). The specific protocol for screening infants’ hearing is up to the individual hospital. When properly employed, the value of performing these screenings is immeasurable since the “cost” of missing an infant with hearing loss is simply too high.
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