Audiological screening of newborns

One of the most important senses in a child’s development, particularly in the early years, is hearing. A baby’s ability to hear influences all aspects of their development, including their ability to communicate and recognize their parents’ voices and learn to speak.

This is the reason it’s crucial to screen newborns for hearing problems. This quick test can assist in identifying any hearing problems early on, enabling prompt implementation of any required interventions. Early identification can have a big impact on how well a child learns language and social skills.

Although this screening may not be well known to many parents, it is a common practice in many settings for the care of newborns. It’s possible to allay worries and guarantee that your child has the best start possible by being aware of what it entails and why it’s crucial.

Audiological screening in newborns is a simple yet essential step in ensuring their healthy development. Early detection of hearing issues can make a significant difference in a child"s ability to learn, communicate, and thrive. If any concerns arise from the screening, it’s important to follow up with additional tests and treatments as recommended. Addressing potential problems early can lead to better outcomes and support for your child’s growth. Ultimately, this screening gives parents peace of mind, knowing that their baby"s hearing is being carefully monitored right from the start. Aspect Details What it is A hearing test to check if a newborn can hear well. When it"s done Usually within the first few days after birth, often before leaving the hospital. How it"s done A soft sound is played in the baby’s ear, and the response is measured. Why it"s important Early detection of hearing issues helps with early treatment and support. What happens if a baby doesn’t pass Further tests will be done to confirm if there is a hearing problem. Next steps If a problem is found, specialists will guide the parents on the best options.

Why is it?

A baby’s response to sounds may give you hints about hearing issues. A newborn will typically reflexively rock, squeeze their eyelids shut, or spread their arms to the sides in response to loud noises. The baby starts to focus on the sounds he hears in the second week of life, and by the end of the first month, he exhibits the fading signs of an orienting response to sound. The baby learns to listen and respond to sounds in the second month of life, at which point they start to coo.

At the specified developmental stages, there will be an obvious hearing impairment. On the other hand, the mother might not be aware that her infant has hearing loss if the condition is minor or if there is unilateral pathology.

When an audiological examination is done as early as possible, it can help detect even mild disorders and treat them, preventing future speech and socialization issues in the child. The exam’s name is derived from the Latin word "audio," which means "hearing."

According to medical professionals, babies up to six months of age can guarantee normal hearing development at the level of healthy children by wearing prosthetics with hearing aids. For these children, the development of the native language, passive and active vocabulary, comprehension of grammatical constructions, and other aspects of speech development happen at a typical rate; this is not the case for toddlers diagnosed at 6 months or later. To identify hearing loss at the earliest stage and facilitate prompt rehabilitation, medical professionals carry out a research project known as "neonatal audiological screening."

According to order 108, which has been in effect since 1996, such screening is used in Russia to diagnose hearing issues in children from risk groups; however, as of 2008, the examination has been performed on all newborns.

Types of examinations

The process of audiological screening involves two phases. In order to send the young patient for a second stage of diagnostics—which is already known as a more thorough examination—they first evaluate the state of the baby’s inner ear receptor apparatus. The tests are secure and non-invasive. They are reasonably priced, incredibly sensitive, quick to use, and require little effort. An approach denoted by the acronym OAE has been developed for precise objective diagnostics during the initial screening phase. The acronym for "otoacoustic emission" is these letters.

Experts calculate that this method has a 90% sensitivity and a 93%–95% specificity. OAE screening may not reveal auditory neuropathy in children; auditory potential recording is a more sensitive and accurate way to detect auditory neuropathy.

It can still identify the majority of hearing issues, though.

Every newborn is treated using the OAE method. This kind of screening is typically done in the maternity hospital between the third and fourth day of the baby’s life. Either a neonatologist or a skilled nurse performs it. If, for whatever reason, the maternity hospital was not the site of the examination, the infant should have had it done at the children’s clinic that the newborn is connected to. In this instance, a pediatrician, ENT physician, or nurse performs the screening.

How the examination is performed?

An audiometer is used to record otoacoustic emission; it is a specialized handheld device with a highly sensitive microphone on its probe. The probe is made to resemble a standard earphone by placing an earmold on it prior to use. Next, the baby’s external auditory canal is sealed off with the probe. Once one ear has been examined, the procedure is carried out again on the other.

The inner ear’s hair cells are impacted by the apparatus. These cells are designed to record and amplify sound waves. They can also use their own vibrations to "respond" to sound waves. Otoacoustic emission refers to the appearance of these vibrations, which are produced by hair cells.

The gadget projects a sound impulse into the inner ear, and in an instant, the hair cells produce a response signal that the device receives. Information regarding the outcome is then shown on the screen.

When the outcome is positive, many devices show the word pass, signifying that the child has passed the test and that the impulse has been received. The word refer will show on the screen if the outcome is dubious or unfavorable. This indicates that the test needs to be clarified; in other words, it’s too soon to become alarmed, and the test needs to be done again to rule out hearing loss. Using the OAE method alone, it is impossible to diagnose a child right away.

If the screening was done in a maternity hospital, the results are entered into the newborn’s discharge paperwork; if it was done in a children’s clinic, they are entered into the medical record. The entry is typically shown as a plus sign with a designated ear for each. The letter D is used to indicate the right one, and the letter S is used to indicate the left. The outcome could appear as D (+); S (+). Another common way to write it is as follows: D = S (+). In the event that the inner ear cells do not respond to the stimulation, the plus sign is replaced with a (-).

Features of the procedure

It is crucial to take into account the following crucial details in order to guarantee accuracy and accurate results:

  • the test should be carried out in complete silence; the procedure lasts 5-15 minutes;
  • it is recommended to check hearing between feedings; the newborn should be calm, preferably sleeping;
  • the baby should not be allowed to suck on a pacifier during the test, even if it calms him down; sucking can distort the results.

What"s next?

The determination of OAE is no longer done for the newborn during the first year if the test is passed. In the event that the test yields negative results, it is repeated in a children’s clinic during the fourth week of life, or slightly later, but no later than three months, with all the conditions that were in place for the initial screening. The child is sent to the audiology office or center to undergo the second round of screening if the results of the second test are also negative.

In order to make an accurate diagnosis, it entails examining the eardrum and outer ear, asking parents questions, and performing a number of additional tests. At this point, tests include tonal audiometry, acoustic reflexometry, auditory evoked potential recording, and impedancemetry.

Babies from risk groups receive special attention, such as when a hereditary pathology is suspected and the newborn exhibits hearing loss despite the parents’ impairment.

The risks are also higher in cases where the expectant mother smoked or drank alcohol, or if the woman had a bacterial or viral illness while she was pregnant. Furthermore, certain medications taken by the pregnant woman during both the early and late stages of her pregnancy may cause hearing loss in the infant. Among the harmful medications, "Gentamicin," "Kanamycin," "Amikacin," and "Furadonin" stand out in particular because they frequently cause deafness.

The doctor determines the kind and extent of hearing impairment after doing a thorough examination. After that, advice on choosing a hearing aid is provided, and the viability of implanting a cochlear implant is evaluated. Furthermore, experts create a thorough plan outlining how the child’s speech and hearing will be improved during the first few years of life. Parent consultations, including psychological ones, are required.

Aspect Details
What it is A hearing test to check if a newborn can hear well.
When it"s done Usually within the first few days after birth, often before leaving the hospital.
How it"s done A soft sound is played in the baby’s ear, and the response is measured.
Why it"s important Early detection of hearing issues helps with early treatment and support.
What happens if a baby doesn’t pass Further tests will be done to confirm if there is a hearing problem.
Next steps If a problem is found, specialists will guide the parents on the best options.

Newborns should undergo a straightforward but crucial aural examination to ensure a healthy development. A child’s capacity to learn, communicate, and develop can be significantly impacted by the early detection of hearing problems.

It’s crucial to proceed with additional testing and treatments as advised if the screening results raise any concerns. Early intervention can help prevent future issues and promote your child’s development.

In the end, this screening provides parents with comfort, knowing that their infant’s hearing is being closely observed from the beginning.

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Maria Smirnova

Teacher with 15 years of experience, author of educational programs for preschoolers. Goal - to share effective methods for developing children's intelligence and creativity. It is important to help parents better understand how to teach children through play and exciting tasks.

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