At what age, in months, should infant hearing screening commence?

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Last updated: April 15, 2025View editorial policy

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From the Guidelines

Infant hearing screening should ideally be performed at no later than 1 month of age. The recommended approach is universal newborn hearing screening, which means screening all infants within the first few days of life, usually 24-48 hours after birth for healthy newborns, as stated by the Joint Committee on Infant Hearing (JCIH) in their 2007 position statement 1. For infants in the NICU, screening should occur when medically stable and prior to discharge. If screening doesn't occur before hospital discharge, it should be completed by 1 month of age. Early identification of hearing loss is critical because normal hearing during the first 6 months of life is essential for proper speech and language development. Delayed identification can lead to permanent impairments in communication, cognition, reading, and social-emotional development, as highlighted in the 2007 position statement on principles and guidelines for early hearing detection and intervention programs 1. The screening typically involves quick, painless tests such as otoacoustic emissions (OAE) and/or automated auditory brainstem response (AABR). If an infant doesn't pass the initial screening, follow-up testing should be completed by 3 months of age, with appropriate intervention beginning by 6 months of age if hearing loss is confirmed, as recommended by the JCIH 1.

Some key points to consider in the hearing screening process include:

  • The importance of early intervention, as infants and children 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 1.
  • The need for a comprehensive audiological evaluation, which should include at least one ABR test for confirmation of permanent hearing loss in children younger than 3 years, as stated in the 2007 position statement 1.
  • The timing and number of hearing reevaluations for children with risk factors should be customized and individualized depending on the relative likelihood of a subsequent delayed-onset hearing loss, with at least one diagnostic audiology assessment by 24 to 30 months of age for infants who pass the neonatal screening but have a risk factor 1.

Overall, early hearing screening and intervention are crucial for maximizing linguistic competence and literacy development in children who are deaf or hard of hearing, and should be prioritized in clinical practice, as emphasized by the JCIH 1.

From the Research

Infant Hearing Screening

  • The ideal age to start infant hearing screening is not explicitly stated in the provided studies, but it can be inferred that screening should start at birth or shortly after, as newborn hearing screening has been widely adopted and has made significant achievements 2.
  • Newborn hearing screening is typically performed using Otoacoustic Emissions (OAE) or Automated Auditory Brainstem Response (AABR) testing, and it is essential to identify hearing loss early to provide appropriate intervention and prevent developmental delays 2, 3.
  • The American Academy of Pediatrics recommends that all newborns be screened for hearing loss before they are one month old, and if a baby does not pass the screening, further testing should be done by three months of age 3.

Importance of Early Screening

  • Early identification of hearing loss is crucial, as it can lead to developmental delays and educational problems if left untreated 3, 4.
  • Hearing loss can also have a significant impact on an individual's quality of life and ability to function independently, making early screening and intervention essential 5, 6.
  • While there is no specific age mentioned in the studies for starting infant hearing screening, it is clear that early screening is vital for identifying hearing loss and providing timely intervention.

Screening Methods and Outcomes

  • Various screening methods are available, including OAE and AABR, which have been shown to be effective in detecting hearing loss in newborns 2.
  • The studies also highlight the importance of follow-up testing and intervention for babies who do not pass the initial screening, as well as the need for awareness and education among healthcare professionals and families about the potential effects of hearing loss 3, 4.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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