Families: Screening

Newborn hearing screening is important to make sure that all babies born with hearing loss are identified and receive access to early intervention services in a timely manner. When hearing loss is identified at birth and children receive access to early intervention services, these children are more likely to achieve language, cognitive, and social developmental skills are par with typically hearing peers.

Why is it important that my baby complete their newborn hearing screen?

Even if your baby is responding to sound at home, there is a chance your baby may have a hearing loss. Newborn hearing screening is important to make sure babies and children with hearing loss are identified so they can receive early access to services.

Research shows that babies and children who are early identified with hearing loss and receive early access to services are more likely to develop language, cognitive, and social skills similar to typically hearing peers. The Colorado Early Hearing Detection & Intervention (CO EHDI) program works to ensure that all babies in the state of Colorado receive a hearing screening and receive access to early diagnosis and intervention services. 

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For Families: What is the difference between a hearing screening, a re-screening, and a diagnostic hearing evaluation?   

Newborn Hearing Screening

A newborn hearing screening is a test to screen if your baby may or may not have a hearing loss. A newborn hearing screening test is typically conducted by a trained professional before you and your baby leave the hospital or birthing center. If your baby was born at home, a newborn hearing screening can be performed in the home by a trained professional like your midwife or at a hospital. Newborn hearing screening is a simple and easy process – your baby is often asleep during the entire screening and the screening takes only a few minutes. 

At the end of the newborn hearing screening, your baby will either receive a pass or refer result for each ear after the screening test. A “pass” result means your baby may not be showing signs of hearing loss in that ear. Most babies who “pass” their newborn hearing screening in both ears have normal hearing, although it is possible your child may develop a hearing loss as they grow older.

A “refer” result means that your baby may be showing signs of hearing loss in one or both ears, but it does not necessarily mean that your baby has hearing loss. Your baby may refer on their hearing screening due to fluid (vernix) in the ear or due to movement because of movement or crying during the test. Re-screening is an important next step to confirm whether your baby may or may not have a hearing loss. 

Re-Screening

If your baby receives a “refer” result on their first newborn hearing screening in either ear, a re-screening may be recommended to confirm whether your baby may or may not have a hearing loss. This re-screening may occur before you and your baby are discharged from the hospital or birthing facility, or you and your baby may be asked to return to the hospital for the re-screening visit.

The trained professional may use the same screening test or a different screening test at the re-screening visit. A “pass” result means your baby may not be showing signs of hearing loss in that ear. Most babies who “pass” their newborn hearing screening in both ears have normal hearing, although it is possible your child may develop a hearing loss as they grow older.

A “refer” result means that your baby may be showing signs of hearing loss in one or both ears. At this point, a diagnostic hearing evaluation is needed to gather more information. 

Diagnostic Hearing Evaluation (Identification)

For babies who receive “refer” results on their newborn hearing screening, they will be referred for a diagnostic hearing evaluation by an audiologist. An audiologist is a trained expert in diagnosing and treating hearing loss.

During this visit, the audiologist will ask questions about your child’s birth history, health history, and family history in order to gather more information. They will also conduct several tests to learn more about your child’s hearing status. This visit is a longer visit than the screening and re-screening visit because several tests are performed. 

Continued Screening & Diagnostic Hearing Evaluation As Your Child Grows

Your baby may pass their newborn hearing screening, but it is possible that your child may develop hearing loss as they grow older. As your child grows, it is important to have your child’s hearing screened again if you, your child’s teacher, or other people in your child’s life develop concerns about your child’s response to sound or if your child is showing signs of a speech or language delay. These observations or concerns are something that you can bring up with your child’s pediatrician at any time. A hearing screening or diagnostic hearing evaluation can be conducted on infants and children at any age. 

What type of tests might be included in the hearing screening or diagnostic hearing evaluation? 

Tests may include, but are not limited to: 

  • Auditory Brainstem Response (ABR) Test. A test that evaluates the brain’s response to sound. Because this test does not rely on a child’s behavioral responses, the test can be conducted while your baby or child is sleeping.
  • Otoacoustic Emissions (OAE). A test evaluates the inner ear’s response to sound. Because this test does not rely on a child’s behavioral responses, the test can be conducted while your baby or child is sleeping.
  • Behavioral Audiometric Evaluation. A test that evaluates overall response to sound by testing the entire hearing pathway, from the outer ear to the brain. Your baby or child must be awake for this type of testing so that they can actively respond to the sound they hear.

How can I ensure that my baby receives a hearing screening if my baby is born at home or at a birthing center with a midwife?

Midwives in Colorado are required to either conduct hearing screenings or to provide information to parents on where they can obtain an infant hearing screening. You should reach out to your midwife or birthing facility to ask for more information about their hearing screening procedures or to obtain a list of places where you can have your baby’s hearing screened.

How can I ensure that my baby receives a hearing screening if I…

  • Recently moved to Colorado from another
  • Recently adopted nationally or internationally 

Whether or not your child may have had their hearing screened may depend on whether your child was adopted in the United States or internationally, whether your child was born at home or in a birthing facility, and the state that you lived in. You can reach out to your child’s primary care physician or pediatrician for more information about how to ensure your child has their hearing screened.

Newborn hearing screening and adoption (Baby’s First Test)

For more information, contact Hannah Glick.