Newborn Hearing Assessments

Screening Results

If the baby does not pass the newborn hearing screening, it does not necessarily mean that the baby has a hearing loss. About 20 to 100 babies out of 1000 do not pass the screening test, however, only 1 to 3 out of 1000 have a permanent hearing loss (cited on babyhearing.org).

A hearing assessment is a follow-up to the screening test, and it is more detailed. It is very important to attend this appointment, as this is the test that will confirm if the baby has a hearing impairment. An Audiologist, who is a specialist in hearing assessments, will do the testing and is specially trained by the Infant Hearing Program (IHP).

Several tests will be done during the assessment and together they will give more information about the baby’s hearing. The assessment can take up to two hours, and a second visit may be necessary so that all the testing can be completed. The tests are painless and will not harm the baby in any way.

It is very important that some simple guidelines are followed to prepare the baby for the hearing assessment. Since the baby must sleep for most of the tests, it is important to keep the baby awake for a few hours prior to the test so that he/she will arrive tired and ready to sleep. If travelling by car, it is helpful to have a companion that can keep the baby awake.

It is also recommended that the baby arrive to the hearing assessment hungry. The baby can be fed just before the test starts and this will help him/her fall asleep more easily.

If the baby is not prepared for the test and does not sleep, it will be necessary to return on another day so that testing can be completed. This will cause further delay in determining the baby’s hearing ability, so it is very important to do everything possible to make sure the baby is well prepared on test day.

If your baby has a hearing impairment

Once the baby has had a complete hearing assessment by an IHP Audiologist, the results are discussed with the family. If the baby is found to have a hearing impairment, the Audiologist will explain the details of the hearing impairment to you. This might include the type of hearing loss the baby has, what sounds the baby is able to hear, what sounds the baby might not hear, and how the hearing impairment may affect the development of language.

The audiologist will also discuss some of the supports and services that are available to the family. At this point, the Audiologist may suggest that you meet with the Family Support Worker for your region. It is important to keep in mind that although the news of a hearing loss may be troubling, when it is found early there is more time to take advantage of all the services that are available. In addition, most deaf and hard of hearing children whose hearing impairment is identified early, and who receive the support and services they need, will develop language.

 

Hearing Tests: Summary Table

Otoacoustic Emissions (OAE)	For children of all ages A probe is placed in the ear canal and a computer records the cochlea’s response to sound A response can be demonstrated at a number of frequencies or pitches to evaluate the health of the outer hair cells in the cochlea
Auditory Brainstem Response (ABR)	For children of all ages Small electrodes are placed on the child’s forehead and behind their ears Sounds are presented through earphones placed in your child’s ears The hearing system and the brainstem responses are measured by the electrodes and recorded by a computer The electrodes will also record muscle movement, therefore the child must be sleeping to enhance the detection of the brain’s response to the sounds The test helps to identify the type and degree of hearing loss and health of auditory system
Tympanometry	For children of all ages A probe is placed in the ear canal to record movement of the eardrum It can detect problems such as fluid in the middle ear or a hole in the eardrum

Acoustic Reflexes	For children of all ages A probe is place in the ear canal to record movement of the eardrum when a muscle in the middle ear contracts to loud noise Provides the audiologist with information on the health of the hearing nerves
Visual Reinforcement Audiometry (VRA)	For children ages 6 months to 2.5 years The audiologist may ask you questions regarding your baby’s hearing health, their communication skills, and their responses to sounds and speech Your child will be trained to turn his/her head when they hear a sound Each time your child reacts to the sound, a toy will be lit up and move as a reward The audiologist can determine your child’s minimal response to sounds
Conditioned Play Audiometry	For children 2.5 years to 5 years The audiologist may ask you questions regarding your baby’s hearing health, their communication skills, and their responses to sounds and speech Your child will be tested in a play-like manner, for example to place a block in a bucket when a sound is heard The audiologist can determine your child’s thresholds (the lowest level of the sound that they can hear) using this method

 

Reference:
Sisson, M., (2008). Workbook for parents of children who are newly identified as hard of hearing. Mississauga, Ontario: Oticon Pediatrics.