Hearing Blog

What is the Universal Newborn Hearing Screening, and Why is it Important?

What is the Universal Newborn Hearing Screening, and Why is it Important?

As a part of Indiana’s newborn screen, all babies receive the Universal Newborn Hearing Screening (UNHS) before leaving the hospital or before one month of age. Approximately 2-3 out of every 1,000 infants are born with a permanent hearing impairment every year in the United States. By screening hearing at birth, it is Indiana’s goal to identify a hearing loss by three months of age and obtain early intervention services by six months of age. Studies show that the younger a child receives intervention, the better the chances of developing normal language skills.

Newborns can have their hearing screened through two types of testing in the hospital: otoacoustic emissions or auditory brainstem response. If a baby does not pass the initial screen in one or both ears, a second screen is completed. When a baby does not pass the second screen in one or both ears, then the baby will be referred for follow-up diagnostic testing.

Diagnostic testing will be completed by a licensed audiologist and will include tympanometry (to assess eardrum mobility), otoacoustic emissions (to assess the permanent hearing structures of the inner ear) and Auditory Brainstem Response, or ABR (to assess the function of the auditory nerve and establish hearing thresholds). These infants will be tracked by the Indiana State Department of Health and the Early Hearing Detection and Intervention (EHDI) program. The audiologist will diagnose or rule-out a hearing loss and will report testing results and recommendations to the state.

Even when a child passes the UNHS in the hospital or passes follow-up diagnostic testing, some children will have risk factors for delayed onset hearing loss; if there are risk factors then a referral will be made to First Steps and the primary care physician for continued monitoring. Late onset or progressive hearing loss may be due to one or more risk factors: family history of permanent childhood hearing loss, exposure to infection in-utero, hyperbilirubinemia that required an exchange transfusion, and ear/craniofacial anomalies. Other risk factors that require monitoring include: spending more than five days in the Neonatal Intensive Care Unit (NICU), having a genetic syndrome/condition known to be associated with hearing loss, bacterial meningitis, or if a parent or caregiver has concerns for the development of hearing and language.

Without the UNHS, the average age of diagnosis is over two years of age. Hearing loss may be invisible, but the effects can lead to lack of exposure to language and cause lifelong cognitive, educational, and vocational challenges. It is vital that children diagnosed with hearing loss receive intervention as early as possible. Children who receive services by six months of age can develop language (spoken or signed) comparable to their normal hearing peers.