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Early Hearing Detection and Intervention

Newborn Hearing Screening

Newborn hearing screening is done soon after birth to check your baby’s hearing. When hearing loss is found early, your baby can get the help they need for their speech, language, learning, social and emotional development.

Why should my baby’s hearing be checked (screened)?

About 1 in 500 babies is born without normal hearing. This is called permanent congenital hearing loss (PCHL).

Without screening, it can be hard to tell if a baby has hearing loss. Even though your baby may respond to sounds, they may not hear well enough to develop speech and language. More than half of all babies with PCHL are healthy and have no family history of hearing loss.

The earlier hearing loss is found, the sooner your baby will have support to help prevent delays in their development. If hearing loss isn’t found early, children have a high risk of having problems with speech, language, memory, learning, and social development.

When should I have my baby screened for hearing loss?

It’s best to have your baby screened before they are 1 month old.

Hearing screening can be done quickly while your baby sleeps or is quiet. Younger babies spend a lot of time sleeping, so it’s easiest to screen hearing in babies who are very young.

How is hearing screening done?

There are 2 tests to screen for hearing loss in newborns. Learn about them by watching Early Hearing Detection and Intervention (video).

With both tests, a healthcare professional who is trained to screen hearing uses a small, soft ear probe to play quiet sounds into your baby’s ears. A computer measures how your baby’s ears respond to the sound.

  • Automated Otoacoustic Emission (AOAE) checks to see how well the cochlea (a part of the ear that detects and responds to sound) is working. The cochlea’s response to sound is called an otoacoustic emission. AOAE screening only takes a few minutes.
  • Automated Auditory Brainstem Response (AABR) checks how well the nerve for hearing is working. AABR uses 3 small sensors that are placed on your baby’s head and neck. When the ear hears sound, the sensors record the response of the nerve. This response is called an auditory brainstem response. AABR screening takes about 20 minutes.

Does hearing screening hurt?

Hearing screening is safe and doesn’t hurt. The sounds are quiet and the ear probes are soft.

Do I have to have my baby’s hearing screened?

No, you don’t have to have your baby’s hearing screened. But it’s important to talk your healthcare provider if you don’t want your baby’s hearing checked. They may give you information to help with your decision or offer resources to check your baby’s hearing.

When will I get the results of the hearing screening?

You will get the results as soon as the screening is done. The result of the test is a pass or refer.

  • A refer result means your baby did not pass the hearing screening. The test does not tell us why your baby did not pass. To find out why your baby did not pass and to rule out hearing loss, they will be referred for a more specialized hearing test.

Why do some babies get a refer result on their hearing screening?

Your baby may get a refer result on their hearing screening because they have a permanent hearing loss or there may be temporary problems, like:

  • the ear canal is blocked with debris
  • fluid in the ear canal
  • fluid in the middle ear space

The best way to find out why your baby did not pass the hearing screening is to take them to the more specialized hearing test called a diagnostic Auditory Brainstem Response (ABR) test.

My baby got a refer result – what happens next?

Your baby will be referred for a more specialized hearing test called a diagnostic ABR test. This test is done by a pediatric audiologist (a healthcare provider who specializes in children’s hearing) at an audiology service centre closest to you. If this appointment has not been scheduled by the time your baby is 8 weeks old, talk to your baby's healthcare provider.

Why is it important to take my baby for a diagnostic ABR?

The diagnostic ABR test is the best way to find out if your baby has hearing loss. The test is safe and won’t hurt your baby.

If your baby has hearing loss, you will get information about services to help your baby with their speech, language, learning, social and emotional development.

What happens at the diagnostic ABR test?

The diagnostic ABR test is done while your baby sleeps. The test is scheduled for up to 3 hours to allow time for your baby to fall asleep and to do the test. You can sit and hold your baby during the test.

Two sensors are placed on your baby’s forehead and 1 sensor is placed behind each ear. A small, soft probe will be put into each of your baby’s ears to play quiet sounds. The sensors record your baby's response to sound.

When should my baby have a diagnostic ABR test?

It’s important that your baby has the diagnostic ABR test when they are between 4 and 8 weeks old. The test is easiest to do in babies of this age because they sleep a lot so the test is often shorter and can be done in 1 appointment. Older babies are more alert so the test can take longer or may need to be done over several appointments.

The earlier hearing loss is found, the sooner your baby will get the services they need to support their speech, language, learning, social and emotional development.

Why can’t a diagnostic ABR test be done right after hearing screening?

Waiting is hard, but the diagnostic test is more accurate when your baby is at least 4 weeks old. Also, if your baby had any vernix (the white substance that covers a baby at birth) or fluid in their ears at the time of the screening, waiting gives the ears a chance to clear.

What can I do to help prepare my baby for a diagnostic ABR test?

Try to bring your baby to the appointment awake but sleepy. We know it’s not easy, but your baby must be sleeping during the test. The test is scheduled for up to 3 hours to allow time for your baby to fall asleep and to do the test.

To help get your baby ready to sleep during the test:

  • Keep your baby awake for at least 1 hour before the test.
  • Try not to feed your baby for about 1½ hours before the appointment. You can feed your baby when the test begins to help them fall asleep.
  • Bring any special blankets or items that may help your baby fall sleep.
  • If you are driving to the appointment, have another adult in the car to play with your baby to keep them awake.

What will happen after the diagnostic ABR test?

The pediatric audiologist will talk with you about the results of the test and what they mean. Most of the time, you will get the test results on the same day as the test. If the test finds that your baby has permanent hearing loss, they may need another ABR test to better understand how your baby is hearing different sounds. You will also be referred to other specialists to help support you and your baby.​

Current as of: September 23, 2021

Author: Early Hearing Detection and Intervention (EHDI) Program, Alberta Health Services