As a result of Early Hearing Detection and Intervention (EHDI) legislation enacted in 2000, most hospitals today screen for hearing loss before a newborn is discharged from the hospital. The initial exam is referred to as a “screening” because the testing is not as involved as a comprehensive hearing examination and so, the results are not definitive. Follow-up testing that involves a comprehensive hearing evaluation is required to confirm the diagnosis of a hearing loss.
If an initial screening comes back with a fail result in one or both ears, then a second screening and, perhaps, follow-up testing will be recommended to confirm whether a hearing loss is present and, if so, the type and nature of the loss. This should be done by an audiologist (someone with an advanced degree and appropriate licensure/certification in evaluating hearing) with pediatric experience and the ability to conduct a thorough assessment. It is important that parents do not wait to have the recommended follow-up testing done. Every moment counts when it comes to helping a child who, ultimately, is found to be deaf or hard of hearing. Providing improved access to sound is of utmost importance in helping a child hear and develop a foundation for listening. Putting your child into intervention services should assist you in providing your child with improved access to sound (typically, through appropriately-fitted hearing technology) and access to services and supports that result in development of speech, language and literacy.
Once a hearing loss is confirmed, your pediatrician should refer your child to an ear, nose and throat (ENT) specialist, a physician also known as an otolaryngologist, who will evaluate your child to determine if there is an underlying cause to your child’s hearing loss. In addition to making recommendations related to treatment, an ENT physician who specializes in pediatrics may also provide information on various communication approaches for your child.
What is involved in screening?
Hearing screening methods for infants and children are non-invasive and painless.
- ABR (Automated Brain Stem Response): Sounds are presented through earphones while the baby rests quietly or sleeps. Brainstem responses to sound are measured through small electrodes, which are taped on the baby’s head. These responses are processed by a computer.
- OAE (Otoacoustic Emissions): A small probe tip is inserted into the baby’s ear canal. It measures the function of the inner ear, or cochlea. This screening can also be performed on a sleeping infant.
- Behavioral Testing: These types of tests are used when a child is old enough to turn his or her head in response to sound or play a game. These tests measure the quietest sounds the child can hear and the child’s ability to understand words.
- Acoustic Impedance Tests: These tests can be administered to children of all ages and can help identify middle ear problems (e.g., the presence of fluid and the status of eardrum) through quick, non-invasive, computerized technique.