PROFESSIONAL ISSUES

Newborn Hearing Screening

Overview

The scope of this page is hearing screening for children ages 0-6 months of age. Newborn screening is but one part of a comprehensive Early Hearing Detection and Intervention (EHDI) program of service.

Newborn hearing screening is the standard of care in hospitals nationwide. In 2011, 97.9% of babies born in the United States had their hearing screened in the first few weeks of life (Centers for Disease Control and Prevention [CDC], 2011). The primary purpose of newborn hearing screening is to identify newborns who are likely to have hearing loss and who require further evaluation. A secondary objective is to identify newborns with medical conditions that can cause late-onset hearing loss and to establish a plan for ongoing monitoring of their hearing status (Joint Committee on Infant Hearing [JCIH], 2007). Infants who do not pass the newborn hearing screening (and/or rescreening) are referred immediately for a comprehensive audiologic evaluation, with a goal of having hearing loss confirmed by 3 months of age.

Screening programs target permanent childhood hearing loss (PCHL) irrespective of type. However, various protocols are more effective at identifying different types and degrees of hearing loss within different populations (i.e., well-infant nursery [WIN] or neonatal intensive care unit [NICU)].

Passing a screening does not mean that a child has normal hearing across the frequency range. Because minimal and frequency-specific hearing losses are not targeted by newborn hearing screening programs, newborns with these losses may pass a hearing screen. Because these losses have the potential to interfere with the speech and psychoeducational development of children (Yoshinaga-Itano, DeConde Johnson, Carpenter, Stredler Brown, 2008), hearing, speech, and language milestones should receive ongoing surveillance and monitoring throughout childhood.

The content of this Portal page is based on ASHA's Expert Panel Recommendations on Newborn Hearing Screening.

Expert Opinion

  • "All infants should have access to hearing screening using a physiologic measure before 1 month of age" (JCIH, 2007, p. 900).
  • Regardless of previous hearing screening outcomes, all infants are to receive ongoing surveillance of communication development, beginning at 2 months of age (JCIH, 2007).
  • Children should receive systematic hearing screening (through the medical home or as part of a school screening program) through adolescence. "Minimally, these screenings should occur for all children referred for early intervention services, and upon school entry" (ASHA, 2013, p. 6).
  • Because the typical settings of current screening technologies may not detect minimal or mild levels of hearing loss, reports of screening results should reflect this technological limitation (ASHA, 2013).
  • For infants born outside of the hospital, outpatient screening should take place no later than at 1 month of age (JCIH, 2007).

See the Screening: General Findings section of the permanent childhood hearing loss evidence map for pertinent scientific evidence, expert opinion, and client/caregiver perspective.

Key Issues

Resources

References

Content Disclaimer: The Practice Resource Project, ASHA policy documents, and guidelines contain information for use in all settings; however, members must consider all applicable local, state and federal requirements when applying the information in their specific work setting.