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From birth, an important way for babies to learn is through listening. Although most babies have good hearing, according to statistics, the current incidence of congenital hearing impairment in mainland China is 1‰-3‰, and there are about 23,000 newborns with hearing impairment every year, which is one of the countries with the largest number of hearing-impaired children in the world.
Studies have found that the best time for newborn hearing screening is 48-72 hours after birth. Hearing screening of newborns facilitates early detection of problems and interventions that can have a positive impact on their communication and language development.
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Why do newborns need hearing screening?
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Hearing screening is an important and important step in helping us understand if your baby may be deaf or hard of hearing. Without newborn hearing screening, it can be difficult to know when your baby's hearing will change during the first months and years of life.
For example, a baby may respond to noise by startling or turning its head to sound. But that doesn't necessarily mean they can hear everything around them and what we're saying. Babies who are deaf or hard of hearing may hear some sounds but still don't hear enough to understand spoken language.
Babies who are deaf or hard of hearing need the right support, care, and early intervention to promote healthy development. If the hearing status is not recognized, it can have a negative impact on your baby's communication and language skills. Missed hearing loss can also affect a child's academic performance and social-emotional development in the long run.
Image source: Visual China
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How is newborn hearing screening performed?
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There are two screening methods that can be used for hearing screening in newborns
1. Automatic Auditory Brainstem Response (AABR)
AABR: tests the auditory nerve and brain response to sound. The clicks or tones are played into the baby's ears through soft headphones. Three electrodes placed on the baby's head measure the response of the auditory nerve and brain.
Image source: Visual China
2. Otoacoustic Emission (OAE)
OAE: Measurement of sound waves produced by the inner ear. A tiny probe has just been placed in the baby's ear canal. When a click or tone is played into the baby's ear, it measures the response (echo) of the baby's ear.
Image source: Visual China
Both screens are fast, about 5-10 minutes, painless, and can be done while your baby is sleeping or lying still.
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What happens if my baby doesn't pass the initial hearing screening?
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If your baby is not screened for hearing at birth, it does not necessarily mean that he is deaf or hard of hearing. When a baby has amniotic fluid or vernix in their ears, or when there is too much noise in the room, it can affect the results. Therefore, it is necessary to re-screen the baby from birth to 42 days. If the re-screening is not successful, you should see your paediatrician for a more detailed medical test before your baby is 3 months old.
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If your baby is diagnosed with deafness or hearing impairment, what treatments and interventions are available?
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Studies have shown that if any changes in your baby's hearing are detected, and support and intervention is initiated at 6 months of age, your baby will have the best chance of developing speaking, as well as his or her normal hearing peers. The sooner the intervention, the better.
Infants who are deaf or hard of hearing should be referred to an early intervention unit for evaluation and services. Audiologists and otolaryngologists can diagnose the type and extent of your baby's hearing changes and how to intervene next. These follow-up treatments may vary depending on the parent's choice and the type and extent of the hearing changes.
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If my baby passes the newborn hearing screening, does it mean that he will not have hearing loss in the future?
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Unfortunately, no. Some babies may experience hearing loss later in childhood. Causes of delayed or progressive hearing loss in children can include genetics, frequent ear infections, other infections such as measles or meningitis, head injuries, exposure to damaging noise levels, and secondhand smoke, among others. Neonates who require extended neonatal intensive care may also be at increased risk of hearing loss later in life.
Even if your baby passes the newborn hearing screening, parents should be aware of the following signs of hearing loss as their child grows:
➤ Doesn't be startled by loud noises at 1 month of age or doesn't turn to sound at 3-4 months of age.
➤ He doesn't notice you until he sees you.
➤ Focus more on vibration noise than other types of sounds.
➤ Doesn't seem to like reading.
➤ Begin to speak slowly, incomprehensibly or not speak single words such as "Daddy" or "Mommy" at 12-15 months of age.
➤ Not always responding when calling him, especially if the person is in another room.
➤ It seems that only some sounds are heard, but not all of them. (Some children have hearing loss that affects only the high pitches; some children have hearing loss in only one ear.) ）
➤ Difficulty keeping your head steady, or sitting or walking slowly without support. (In some children with sensorineural hearing loss, the part of the inner ear that provides information about head balance and movement is also impaired.) ）
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If my baby passes the first hearing test, why do I need more screening?
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Even if babies show no signs of hearing changes, the American Academy of Pediatrics (AAP) recommends that they be screened again at 4, 5, 6, 8, and 10 years of age, and that supplemental screening be done sometime between ages 11-14, 15-17, and 18-21 or whenever there is concern. For children at higher risk of hearing loss, more frequent follow-up screening is recommended. Hearing loss is sometimes gradual and difficult to notice at first. Routine screening can detect hearing changes early, and the earlier the baby's hearing changes are detected, the more likely it is that the intervention will have a positive impact.
Bibliography:
[1] Li Dandan, Ren Haijun, Su Yangna, et al. Study on the optimal time for primary screening of newborn hearing screening[J]. Modern Medicine and Health, 2021,37(14):2444-2446.
[2] Xu Qihua, Su Jun. Research progress on newborn hearing screening[J]. Chinese and Foreign Medical Research, 2021,19(16):188-190.
[3]https://www.healthychildren.org/English/ages-stages/baby/Pages/Purpose-of-Newborn-Hearing-Screening.aspx