If your baby does not pass the newborn hearing screening, talk with your doctor. The doctor will refer your baby to a pediatric audiologist for follow-up testing. To find where you can go for follow-up testing, visit EHDI Pals.
What Does it Mean if a Baby Does Not Pass the Newborn Hearing Screening?
When a baby does not pass the newborn hearing screening, it does NOT necessarily mean that he or she has a hearing loss.
2-10% of all babies in the U.S. fail their first hearing screening and less than 1% will have permanent hearing loss
Babies with normal hearing can fail the newborn hearing screening due to:
- Vernix (a waxy coating on a newborn's skin) in the ear canal
- Fluid in the middle ear
- Movement and/or crying during the screening
Even though most babies will pass the follow-up hearing testing, it is VERY important to take your baby for follow-up testing by the time he or she is 1 month old. This is the best way to be SURE about your baby's hearing. Follow-up testing can identify whether your baby has normal hearing or a permanent hearing loss. Follow-up diagnostic hearing testing also identifies if your baby can receive early intervention services. The audiologist and other professionals involved will assist you in linking to early intervention programs in your community.
Early intervention services are key to helping your child succeed. Evidence shows the sooner you can give your child the resources they need, the better they will learn language (spoken and/or signed).
Can a Baby Pass the Newborn Hearing Screening and Still Have Hearing Loss?
Sometimes babies can pass a hearing screening and still have hearing loss. Mild hearing loss or hearing loss that affects only some pitches may not be picked up by the hearing screening.
What is an Audiogram? – Understanding Hearing Test Results
Infant Hearing Loss Developing After Birth
Some infants have hearing loss that is not present at birth. These babies are born with normal hearing, but develop a hearing loss later due to accident, use of certain medications, illness or genetics. Regardless of your baby's age, there are safe and accurate tests that can be used to measure how your baby hears.
If your baby has risk factors for a later-occurring hearing loss or if you have concerns about your child's responses to sound or his or her speech development, you should discuss this with your baby's doctor.
https://www.babyhearing.org/what-to-do-if-newborn-fails-hearing-test
https://www.babyhearing.org/non-genetic-hearing-loss
What Factors Put a Child at Risk for Hearing Loss?
Background
The Joint Committee on Infant Hearing (JCIH; www.jcih.org) is a group of experts who provide guidance on best-practices for early identification, intervention, and follow-up with infants and young children who are deaf or hard of hearing and their families. The JCIH also provides a list of factors that place a child at risk for hearing loss. These risk factors help doctors, audiologists, and parents identify children who pass newborn hearing screening with some degree of hearing loss and children who develop hearing loss after the newborn period. Children with risk factors will need to be monitored for the presence of hearing loss and may need follow-up or additional hearing testing after the newborn period. Contact your child's doctor to discuss scheduling a
hearing evaluation with a pediatric audiologist if your child has one or more of the following risk factors, or if you have any concerns about their speech, hearing, or
development.
RISK FACTORS MONITORED BY DOCTORS AND AUDIOLOGISTS (JCIH, 2019)
|
Risk Factor |
Questions to consider |
Family history of permanent childhood hearing loss | Do any of my family members have a history of early, progressive (gets worse over time), or late onset (begins in childhood after newborn period) hearing loss? |
Neonatal intensive care (NICU) visit of more than 5 days
| Was my baby in the NICU? Was it more than 5 days?
|
Received an exchange transfusion
| Did my baby have an exchange transfusion to treat high bilirubin levels?
|
Received certain antibiotics in the NICU for more than 5 days.
| Did my baby receive antibiotic medications as a newborn (ask your doctor what type)? |
| Chemotherapy | Has my child been treated for cancer with chemotherapy? |
Poor oxygen levels leading to brain damage
| Did my baby experience a lack of oxygen to the brain during birth? |
Received ECMO treatment
| Did my baby receive ECMO treatments to support their heart and lungs in the NICU? |
| Exposed to infections in the womb | Was my baby exposed to infections during pregnancy (e.g., toxoplasmosis, cytomegalovirus (CMV), Zika)? |
Infections occurring after birth
| Did my baby or child have a positive test indicating a bacterial or viral infection (herpes, varicella), meningitis, or encephalitis? |
| Birth conditions | - Was my baby born with malformations of the head or face (e.g., cleft lip/palate, ear malformations)?
- Was my baby born with microcephaly (abnormally small head) or hydrocephaly (fluid buildup around the brain)?
- Did radiology reports show any temporal bone malformations?
- Was a syndrome identified? There are many syndromes linked to late-onset and progressive hearing loss (see https://www.babyhearing.org/genetic-hearing-loss).
|
Injury to the head
| Did my child have an injury that caused trauma to the head (e.g., fracture)? |
| Parent/caregiver concerns | Do I have
any concerns for my child's hearing, speech, or development? If so, there should be referral for further evaluation. For developmental milestones in speech and language, visit:
Speech and Language Development Milestones as Your Child Grows (boystownpediatrics.org) and
Developmental-Milestones.pdf (handsandvoices.org)
|
