From the Guidelines
If a newborn fails their initial hearing screen, the next step is to schedule a follow-up diagnostic hearing test, typically within 1-3 months of birth, to be performed by a pediatric audiologist with expertise in infant hearing assessment. This comprehensive evaluation is crucial for early identification of hearing loss, which allows for timely intervention and significantly improves outcomes for speech, language, and cognitive development 1. The diagnostic testing will likely include auditory brainstem response (ABR) testing, which measures how the hearing nerve responds to sound, and may also include otoacoustic emissions testing to evaluate inner ear function. Many babies who fail the initial screening ultimately pass the follow-up test, as the first screening can be affected by fluid in the ear, movement during testing, or background noise. However, if hearing loss is confirmed, the audiologist will discuss intervention options, which may include hearing aids, cochlear implants for severe cases, or early intervention services.
Some key points to consider in the follow-up diagnostic hearing test include:
- The importance of not delaying the follow-up test, as early identification of hearing loss is crucial for language and communication development 1
- The need for a comprehensive evaluation to be performed by a pediatric audiologist with expertise in infant hearing assessment 1
- The potential for intervention options, including hearing aids, cochlear implants, or early intervention services, if hearing loss is confirmed 1
- The significance of early detection and management of hearing loss in improving outcomes for speech, language, and cognitive development 1
It is essential to prioritize early intervention, as infants with mild-to-profound hearing loss who are identified in the first 6 months of life and provided with immediate and appropriate intervention have significantly better outcomes than later-identified infants and children in vocabulary development, receptive and expressive language, syntax, speech production, and social-emotional development 1. Therefore, referral to an early intervention program should be initiated within 2 days of confirmation of hearing loss, and intervention services should begin as soon as possible after diagnosis but at no later than 6 months of age 1.
From the Research
Next Steps for Newborns who Failed the Hearing Screen Test
- If a newborn fails the hearing screen test, it is essential to conduct further examinations to determine the extent of the hearing loss 2.
- The next step typically involves a more comprehensive audiological evaluation, such as automated auditory brainstem responses (AABR) or otoacoustic emissions (OAEs), to confirm the diagnosis 3, 4.
- Early identification and intervention are critical, as hearing loss can significantly impact speech development and lead to disorders in psychological and mental behaviors if left undetected and untreated 3, 5.
- Infants with confirmed hearing loss should be fitted with hearing aids or other amplification devices within the first few months of life to maximize their development of speech, language, and communication skills 3, 5.
- Ongoing monitoring and follow-up care are necessary to ensure that the infant's hearing loss is adequately addressed and to provide support for the family 2, 6.
- It is also important to note that some newborns may have false-negative results, and therefore, ongoing health care programs should continue to monitor for signs of hearing loss even in infants who passed the initial screening 2.