Screening the newborn for hearing loss
- Lisa M Adcock, MD
Lisa M Adcock, MD
- Clinical Assistant Professor of Pediatrics
- Texas A&M College of Medicine
- Drifa Freysdottir, MD
Drifa Freysdottir, MD
- Assistant Professor of Pediatrics
- Florida State University
- Section Editors
- Steven A Abrams, MD
Steven A Abrams, MD
- Section Editor — Neonatology
- Professor, Department of Pediatrics
- Dell Medical School at the University of Texas at Austin
- Teresa K Duryea, MD
Teresa K Duryea, MD
- Section Editor — General Pediatrics
- Associate Professor of Pediatrics
- Baylor College of Medicine
Significant hearing loss is the most common disorder at birth and leads to delayed language development, difficulties with behavior and psychosocial interactions, and poor academic achievement. Detection of hearing loss during infancy can initiate intervention resulting in improved language outcomes.
Screening for hearing loss in the newborn will be reviewed here. The etiology, evaluation, and management of hearing impairment in children are discussed separately. (See "Hearing impairment in children: Etiology" and "Hearing impairment in children: Evaluation" and "Hearing impairment in children: Treatment".)
The extent of hearing loss is defined by measuring the hearing threshold in decibels (dB) at various frequencies. Normal hearing has a threshold of 0 to 20 dB. Hearing loss ranges from mild to profound. In individuals with bilateral hearing loss, the severity of loss is based on the better-functioning ear. Severity of hearing loss is defined as follows [1,2]:
●Mild − 20 to 40 dB
●Moderate − 41 to 60 dB
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- RATIONALE FOR SCREENING
- Earlier detection
- Earlier diagnosis improves outcome
- SCREENING TESTS FOR HEARING
- Auditory brainstem response
- - Technique
- Otoacoustic emissions
- - Technique
- Comparison of ABR and OAE
- RISK FACTORS FOR HEARING LOSS
- NICU admissions
- SELECTIVE SCREENING
- UNIVERSAL SCREENING
- Program attributes
- - Single stage
- - Two stage
- Birth hospitalization screening
- - Well-baby nursery
- - NICU
- - Infants who fail screening
- - Infants who pass initial screening
- Term infants who failed OAE but passed ABR
- NICU graduates
- At-risk patients who passed initial screening
- - Test choices
- LOST TO FOLLOW-UP
- SCREENING IN THE UNITED STATES
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS