Hearing Screening E-Learning Course
Hearing Screening Programs
Newborn Hearing Screening
Congenital hearing loss is the one of the most common detectable disabilities in newborns. This invisible disability is 20 times more common in newborns than the metabolic blood disorder phenylketonuria (PKU), a disorder for which screening is routinely performed (ASHA, 2010). Refer to the Universal Newborn Hearing Screening, Diagnosis, and Intervention Guidelines for Pediatric Medical Home Provider.
Risk factors for congenital hearing loss include neonatal intensive care unit admission for 48 hours, family history of permanent childhood sensorineural hearing loss, craniofacial anomalies and in utero infections associated with deafness (JCIH, 2007). Because 50% of children born with hearing loss have no risk factors, many children with hearing loss could be missed without Universal Newborn Hearing Screening (USPSTF, 2008).
Early identification of children with hearing loss is an important preventive health care service, as the critical time for acquiring language and stimulating auditory pathways is 0 to 6 months.
Newborns are typically screened within 24 hours of birth with Otoacoustic Emission (OAE) equipment and/or Automated Auditory Brainstem Response (AABR) (JCIH, 2007). Minnesota State Law requires screening all newborns for hearing loss prior to hospital discharge (Minnesota Statute 144.966). The Minnesota Department of Health, Early Hearing Detection and Intervention (EHDI) program tracks the hearing screening and works to ensure children requiring follow-up hearing screenings, evaluations, and diagnosis receive them in a timely manner. Prior to the implementation of universal newborn hearing screening in 2007, only about half of newborns were screened for hearing loss (CDC, 2003) and the average age of identification of children/ infants with hearing loss was 2.5 years. The MN EHDI goal it to diagnose infants with hearing loss by 3 months of age, in 2014 58% of infants diagnosed with hearing loss were identified by 3 months of age (MDH,2014).
Of the 68,112 infants born in Minnesota in 2014, 99 percent were screened for hearing loss. Of the 585 newborns that did not pass the screening, 40 percent did not receive follow-up screening and 43 percent had typical hearing. Of the 156 diagnosed with hearing loss, only 100 newborns enrolled in an early intervention program (Minnesota Early Hearing Detection and Intervention [EHDI], 2013).
A critical role of the primary care provider is to facilitate appropriate referrals. Providers should support families in following up on hospital referrals from newborn hearing screening (NHS) in a timely manner. Up to one fifth of infants referred for further testing after properly administered NHS has a hearing loss (CDC, 2013).
The Early Hearing Detection and Intervention (EHDI) program goals are 1-3-6:
- Screen babies for hearing loss by 1 month of age
- Identify hearing loss by 3 months of age
- Offer early intervention services to deaf and hard-of-hearing infants and families by 6 months of age
For additional information about newborn hearing screening, refer to MDH Universal Newborn Hearing Screening (UNHS) Program website.