Newborn Hearing Screening

Your baby cannot tell you if he or she can hear…your voice, a lullaby, or a nursery rhyme. Babies who do not hear may have problems learning to talk. Finding problems early can help.  It is important to have your baby’s hearing tested before leaving the hospital or before one month of age. Hearing problems need to be identified as early as possible to make sure your baby has the best chance to develop normally.

Why test newborns for hearing problems?

Every year 1 to 3 in every 1,000 children are born with a hearing loss. When a child’s hearing loss is identified soon after birth, families and professionals can make sure the child gets intervention services at an early age.

Significant hearing loss is one of the most common major abnormalities present at birth, and, if undetected, will cause problems with speech, language, and cognitive development.  If hearing impaired children are not identified early, it is difficult, if not impossible, for many of them to acquire the basic language, social, and cognitive skills that provide the foundation for later schooling and success in life.  When hearing loss is found early, steps can be taken to help your child.

When should they be tested?

Screening: All infants should be screened before leaving the hospital or before one month of age. Ask your medical home (primary care) provider or call the number below for hearing testing locations.

Evaluation: All infants who do not pass the hearing screening should have a diagnostic audiological (hearing) evaluation before 3 months of age, or as soon as they can. Infant should also have a complete medical evaluation by their medical home (primary care) provider.

Intervention: All infants with hearing loss should receive early intervention services before 6 months of age (medical, audiologic, vision, speech, developmental, educational and family support). Health care professionals will give families information about the full range of communication and intervention options so they can make the best choice for their child and family.

How is it done?

There are two types of hearing tests that may be used with your baby. Auditory brainstem response (ABR) testing measures the brain’s response to a "click" through miniature earphones. Sensors measure your baby’s entire hearing pathway to determine if the sounds are heard normally.  Otoacoustic emissions (OAE) measure the response of outer hair cells within the cochlea by placing a small probe in your baby’s ear to determine your baby’s hearing status.  Both tests are very safe, do not hurt, and take only minutes to complete. Most babies sleep through the test.

What do the results mean?

If your baby does not pass the screening, he/she will be "referred" for further evaluation. This does not mean that your baby has a hearing loss. There are a few reasons why your baby may not "pass" the first hearing test and require a second evaluation. Perhaps your baby was too active, had fluid in his/her ears, or you were discharged before the procedure was completed.

If your baby is referred, the hospital will tell you whom to contact for repeat testing. If a hearing loss is suspected at that time, then your baby will be scheduled to see your physician and/or a hearing specialist, who will determine the degree of hearing loss, and with the family’s help, decide on the best method to improve your baby’s hearing.

In some cases, even if your baby passes the screening, follow-up may still be needed. Certain risk factors increase the likelihood of a hearing loss developing later. Talk with your primary care physician about possible risk factors for your baby.

Many babies and young children develop otitis media (ear infection) which can affect hearing. Hearing loss as a result of an infection is generally temporary, but can cause permanent damage if left untreated.

It is important for parents/caregivers and health care providers to understand that a "pass" on the newborn hearing test does not rule out later development of a hearing problem in infancy or early childhood. Continuously monitor your child's speech and language development. Infants who are at risk for progressive hearing damage should be checked twice a year.

Normal Speech, Language, and Hearing Development

Insure that your baby is achieving these milestones:

Around Two Months of Age

  • Startles to loud noise
  • Quiets to familiar voices
  • Makes vowel sounds like "ohh" and "ahh"

Around Four Months of Age

  • Looks for sounds with eyes
  • Starts babbling
  • Uses a variety of voice sounds, such as squeals, whimpers, chuckles

Around Six Months of Age

  • Turns head toward sound
  • Begins to imitate speech sounds
  • Babbles ("ba-ba" and "ga-ga")

Around Nine Months of Age

  • Imitates speech sounds of others
  • Understands "no-no" and "bye-bye"
  • Turns head toward soft sounds

Around Twelve Months of Age

  • Correctly uses "ma-ma" or "da-da"
  • Gives toy when asked for
  • Responds to singing or music
  • Locates sound in all directions

Are resources available for parents?

If your newborn has been diagnosed with a confirmed hearing loss, then he/she may be eligible for services from the State of Tennessee.

Early Intervention Services: Tennessee’s Early Intervention System (TEIS) is a voluntary education program for families with children birth through two years of age with disabilities or developmental delays.  This program is Part C of the Individuals with Disabilities Education Act (IDEA). For further information, please see http://www.TN.Gov/education/teis or call 1-800-852-7157. 

Medical Services: Your baby may qualify for the Tennessee Department of Health's Children's Special Services program. This program may provide or assist your family to obtain services available to your child. For more information, call 615-741-8530.

Parent and Family Support: Three Newborn Hearing Parent Consultants are available to assist, inform and support families who have a child with hearing loss. Each of these consultants is the parent of a child with hearing loss and can offer families support from a family perspective. Parent Consultants work in concert with Family Voices of Tennessee to build and strengthen family networks and resources for children who may be deaf or hard of hearing as well as other chronic disabilities. For more information, call 615-383-9442; TTY: 615-292-7790.

For more information about newborn hearing screening, contact:  Tennessee Newborn Hearing Screening, 630 Hart Lane, Nashville, TN 37216. Phone: 615-262-6160 Fax: 615-262-6159 - Women’s Health/Genetics Newborn Screening.