Hearing Screenings 101

By Guest Blogger Meagan P. Lewis, AuD, clinical manager of audiology at Wake Forest Baptist Health

If you have a child under the age of 5, you’re probably pretty familiar with hearing screenings. However, most parents still have questions. Here are some of the most frequent questions I get – along with my answers:

When should my child get screened?
Since the year 2000, all babies are screened in the hospital shortly after they’re born. Depending on the results of the newborn screening, your baby may require a follow-up screening. Hearing screenings are required again before your child enters kindergarten.

If my baby’s screening was normal, why would he or she need further screenings?
Hearing loss can have a number of causes, including environmental factors, certain medication reactions or unknown (idiopathic) causes. Because of this, a child may develop hearing loss over time.

It’s also important to note that newborn screenings only test for congenital hearing impairment, which is a high-frequency hearing loss. Some babies may pass that test but later go on to be diagnosed with a lower-frequency hearing loss.

What are the signs my child needs a hearing screening?
Beyond scheduled screenings, additional tests may be recommended if your child has had previous abnormal screening results or has been exhibiting hearing problems. Parents are usually the first to notice hearing problems. However, depending on your child’s age, it may not be noticeable right away. Typically, the following behaviors are cause for concern:

– Turning up TV, radio or video games
– Not responding to their name being called
– Not picking up on environmental sounds
– Improper speech development (By age 1, a baby should be saying single words. By age 2, the child should have a 200-250 word vocabulary and be able to string short phrases together.)

How are hearing screenings conducted?
Screenings differ based on your child’s age. Newborns undergo a screening known as automated auditory brainstem response (AABR). During this test, electrodes are placed on your baby’s forehead and behind his or her ear so that the audiologist can record the brainstem’s response to different frequencies. Your baby needs to be asleep for the test to be conducted accurately.

If your child is between 6 months and 2 ½ years, a test known as visual reinforcement audiometry is usually conducted. During this screening, your child is sitting on your lap and is wearing earphones. Your child is then taught to look in a certain direction when he or she hears a sound from the earphones. The audiologist achieves this by using toys that light up or dance.

For children between the ages of 2 ½ and 5, audiologists use conditioned play audiometry. This method helps your child make a game out of sound response. For example, your child will be taught to put a block on a stick or in a bucket when he or she hears a sound.

Another type of hearing screening is known as otoacoustic emissions. This method, which is often used for children under age 3, involves putting a probe with a soft flexible tip into your child’s ear. This probe generates two different sounds. When the inner ear is working correctly, an echo is created.

Over age 5, children undergoing a hearing screening are generally asked to raise their hands when they hear tones through a headphone.

What do abnormal screening results mean?
Abnormal hearing screenings aren’t always cause for concern. Sometimes something as innocent as a child’s shyness can be the problem. If your child is too timid, he or she may be afraid to raise his or her hand during a hearing test. Other times, a buildup of earwax or fluid from an infection can lead to poor hearing responses. In newborns, vernix (the waxy coating on newborns’ skin) can block the ears.

What’s next?
If your child’s screening results are abnormal, your next steps depend on the cause of the abnormality. If it’s determined that wax buildup is the problem, have the wax removed and then schedule a retake of the test. If the problem is related to middle ear fluid, your pediatrician will likely refer you to an ear, nose and throat doctor (otolaryngologist).

If the audiologist conducting the screening believes your child’s hearing loss is sensorineural (damage at the level of the inner ear or auditory nerve), he or she will discuss a medical evaluation of the hearing loss, as well as amplification options (hearing aids), if appropriate.

It’s important that you don’t delay this process. If there’s damage to your child’s hearing, it can affect how he or she learns social skills, speech and language. And, as you know, language is the basis for learning everything else. Interventions that address hearing loss as early as possible will help keep your child on track.

If you’d like to schedule a hearing test for your child, you can contact us by calling 716-3103. You may visit the website here.

* Sponsored by Wake Forest Baptist Health