Hearing Screening
The initial hearing screening in the hospital for a newborn baby is a very specific and finicky hearing test. The options for these hearing tests are either the automated auditory brainstem response or the otoacoustic emissions test. We have to use these fancy tests because newborns are not very good at raising their hands and letting us know which ear they hear a beep in, as we do with older kids’ hearing screening at well visits and school nurse hearing checks.
The otoacoustic emissions test measures responses coming from the inner ear organ, the cochlea. The baby has special earphones that have both a microphone and an earphone. This way the sounds that are played and the echo responses from those sounds can be measured. If a baby has hearing loss, an absent or reduced echo would be recorded.
The automated auditory brainstem response measures responses coming from the cochlea as well as from the baby’s brainstem as sound travels up to the brain. For this type of screening, stickers with small electrodes in addition to cute baby earphones are placed near the baby’s ear. Then the sounds and their responses are recorded. If there are no responses recorded after a sound is played, then we get concerned about significant hearing loss.
Oftentimes if the baby is not perfectly still or quiet or the room is not quiet, we will get false results. So if baby does not pass the screening in the hospital, not to worry. We will repeat that test at a later date with an audiologist (hearing specialist) for a more in-depth evaluation.
Now for the older kiddos, we test hearing at regular intervals starting when they can understand and interact enough that they can let us know if they hear a beep on some cool headphones and which ear the beep is in. Oftentimes if a kiddo has a cold or recent ear infection, some of the frequencies will be difficult to hear, and we will re-screen the kiddo in 2-4 weeks.
Our friends at Audiology.org have provided us with this nifty hearing milestone checklists that we screen for in clinic:
How a child is progressing with speech, language, and hearing milestones can be a good indicator of whether there should be concerns for hearing. An infant with normal hearing should be able to:
Around two months of age
Startle to loud sound
Quiet to familiar voices
Make vowel sounds such as “ohh”
Around four months of age
Look for sound sources
Start babbling
Make squeals and chuckles
Around six months of age
Turn head toward loud sounds
Begin to imitate speech sound
Babble sounds such as “ba-ba”
Around nine months of age
Imitate speech sounds of others
Understand “no-no” or “bye-bye”
Turn head toward soft sounds
Around 12 months of age
Correctly use “ma-ma” or “da-da”
Give toy when asked
Respond to singing or music