Newborn Hearing Screening

Hearing Screening in the Hospital

If your baby is born in a hospital setting, the hearing screening will be done in either in the Well-Baby Nursery, or in a special care nursery such as a Neonatal Intensive Care Unit (NICU). The type of screening test used in each of the nurseries is slightly different. The hearing screening will be performed in both nurseries by hospital nurses or by specially trained screeners from the community. Screening is quick, simple and safe – it is not painful and will not hurt your baby in any way. It takes only minutes to complete and your baby will probably sleep through the whole experience.

Screening in the Well-Baby Nursery

In the Well-Baby Nursery, the test used is called a Distortion Product Otoacoustic Emission (DPOAE). A soft ear tip is placed in the baby’s ear and faint sounds are played through it. The ear’s response to these sounds is measured and results are given right away. The ears are tested one at a time.

Screening in the Special Care Nursery

In the Neonatal Intensive Care Unit, a test called the Automated Auditory Brainstem Response (AABR) is used. Small tips that produce sounds are placed in the baby’s ears. What is different about this test is that a sticky pad is placed on the baby’s forehead and behind each ear. These pads measure the brain’s response to sounds. A computer analyzes the responses and gives the tester results in just a few minutes.

Hearing Screening in Community Centres

For some babies the hearing screening may not be done or may not be completed before discharge from the hospital. This might happen if there is not enough time to see the baby for the test before discharge, or if the baby is too restless to complete the test. If this happens, the family will be contacted by the local IHP office to set up an appointment for screening at a convenient local screening center. If the family is not contacted within a month of hospital discharge, they should call the local IHP office and arrange an appointment. Click here for local IHP office numbers. At the community screening centers both the DPOAE and AABR screening tests can be done.

Screening Results

Pass

Most babies will receive a pass result from the screening test. This means that the baby's hearing in each ear was fine at the time of the test. For a very small group of infants, a hearing impairment may develop at a later stage in childhood, so it is very important to watch for signs of hearing loss as the baby grows.

Passed but is at risk

Some babies who pass the initial screening are known to be at risk of developing a hearing impairment in childhood.  These babies should have their hearing screened again at a later date. Someone from the baby's family will be contacted by the IHP when it is time for the re-screening. It is very important to keep this appointment because if a hearing loss does develop, it needs to be discovered as soon as possible. Some reasons why the baby may be at risk for developing a hearing loss later in childhood include:

• The baby spent some time in the special care nursery
• A history of hearing loss that began in childhood in one or more close relatives.

Refer

Well baby nursery

If the baby's screening result from the DPOAE is refer, then usually another screening test, the AABR, will be done before hospital discharge. If it is not possible to do the AABR before discharge, it will be done as soon as possible in a community centre. Most babies who receive a refer result have perfectly normal hearing. If the baby has a slight cold, has some fluid or material in the ear canal, is fussy during the test, or if there was too much noise in the room where the baby was tested, a refer result is not unusual. If the screening result from the AABR is refer, the baby will need a second AABR screen after about a month. If this AABR also gives a refer result then it is VERY IMPORTANT that the baby attend a detailed Hearing Assessment.

Special care nursery

Infants in the special care nursery who are at risk for permanent hearing impairment are screened using the AABR, whereas those infants who are not at such risk are screened using the DPOAE. If the result from the AABR screen is refer, then the infant will be booked for a detailed hearing assessment. If the result from the DPOAE screening done in the special care nursery is refer, then the infant would be screened using the AABR. If the result from the AABR is refer, then the infant will need a hearing assessment.

Incomplete

In some cases the screening may not be completed before the infant is discharged from the hospital. The screening may have been attempted but could not be completed because of too much noise in the test area, or the infant was too restless. In other cases, the screener may not have been able to access the infant before discharge. If this happens, the family will be contacted by the local IHP office to set up an appointment for screening at a convenient local screening center. If the family is not contacted within a month of hospital discharge, they should call the local IHP office and arrange an appointment.

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