57442285Hearing tests for newborn babies and young children

Hearing tests are offered to all newborn babies and tend to be performed in the first few weeks’ of life. They are usually undertaken by a person who has done specialist training, called a ‘newborn hearing screener’ or by a trained health visitor.


NB. A screening test looks for signs of possible problems.

If you have your baby in hospital, this test is normally performed before you are discharged home; however, if, for any reason, this was not possible, or you gave birth at home (homebirth), your baby will either be checked at home or in a local health clinic. The hearing test appointment will be organised by your local Health Centre who will contact you to arrange a convenient time for when the test can be performed.


Does my baby need this test?

It is very important that any hearing loss is identified as soon as possible as this can have an impact on your child’s speech and development as well as, having a longer term impact on your child’s ability to learn, make friends, and develop vital social skills.

Around 840 babies are born each year with permanent hearing loss in both ears. Ninety per cent of these babies are born into families where there is no history of hearing impairment or deafness. For this reason, it is not easy to predict which of those babies could possibly be affected.


What does it involve?

In the last few years, technology has advanced to such an extent that it is now possible to identify any hearing problems shortly after your baby’s birth by using the Newborn Screening test. Parents remain with their baby whilst the test is being conducted and are given the results of the screening test within a few minutes of its completion.

The test does not hurt your baby and you can stay with your baby whilst it is being performed. It involves placing a small ear piece into your baby’s outer-ear; this can be done whilst your baby is sleeping which means that he or she will generally be unaware that the test is being conducted. The ear piece is connected to a computerised machine by means of a thin wire, which sends out gentle clicking sounds. If the baby’s ears are healthy, the clicking sounds produce an echo. This echo response is measured by the computer and the results indicate if the baby has a healthy/normally functioning middle and inner ear.

If the test does not show a clear response, you will be advised by the health visitor/newborn hearing screener to have it repeated at a later date. Where your baby’s hearing test does not give a clear response, this doesn’t necessarily mean that your baby has hearing loss. The outcome of the hearing test can be affected by various factors, which can give inaccurate results. This can be particularly the case, where your baby is very unsettled or fractious, or if there is fluid or debris from around the time of the birth still inside your baby’s ears.

If the second (repeat) test does not show an echo response, then a different type of test is performed; this looks at the brain’s response to sound signals between your baby’s ears and their brain. The test involves placing three small sensors onto your baby’s head and neck, and placing some headphones over their ears. A set of clicking sounds are then played and the computer measures the brain’s response to these sounds. This test will not hurt your baby either and can also be performed whilst baby is sleeping; it usually takes around 5 -35 minutes to complete.

NB. If your baby needed to be transferred to the neonatal intensive care unit (NICU) after their birth and were nursed there for more than 48 hours, it is likely that they will have received both types of these hearing tests.


Will my baby need more tests?

Sometimes, despite performing both of these tests, your baby’s results will still not give a clear response. Where this is the case, they will be referred to an audiologist (a health care professional specialised in diagnosing and treating hearing disorders).

In some cases, deafness can be a temporary situation which is caused by a condition called ‘glue ear’; this is caused by the inner ear becoming filled with a glue-like fluid instead of air. Although this condition generally resolves on its own, a minor surgical procedure may sometimes be required to help remove the fluid.


What happens if a hearing problem is found?

If a baby is found to have permanent hearing loss, an audiologist will explain the severity and give advice regarding the appropriate follow-up care and management. This might include fitting your child with hearing aids or cochlear implants (a mechanical sound processor placed just above their ear that gives a sense of sound where there is partial or profound deafness).


I’m not sure whether my baby has been tested?

It is very important that your baby receives a hearing test. If you are concerned that your baby may have missed his or her hearing test, do not hesitate to contact your local GP surgery to arrange an appointment or home visit.

Parents are the most likely people to notice any possible hearing loss in their child. If you have any concerns as your baby grows older, it is very important to inform your GP or health visitor to request another hearing test.

BBC News (2006). Hope for better baby hearing test. BBC News. 2 pages.

Declau F, Boudewyns A, van den Ende J et al (2008). Etiologic and audiologic evaluations after universal neonatal hearing screening: analysis of 170 referred neonates. Pediatrics 121(6):1119-1126.

Holster IL, Hoeve LJ, Wieringa MH et al (2009). Evaluation of hearing loss after failed neonatal hearing screening. Journal of Pediatrics 155(5):646-650.

Newborn screening and hearing test (2011). Journal of Midwifery and Women’s Health 56(4):419-420.

Puig T, Municio A, Medà C (2005). Universal neonatal hearing screening versus selective screening as part of the management of childhood deafness (Cochrane Review). (Date of Most Recent Substantive Amendment: 22 February 2005). The Cochrane Database of Systematic Reviews issue 2.

Sirimanna KS (2002). Management of the hearing impaired infant. Seminars in Neonatology 6(6):511-519.

Useful websites