This document provides information about newborn hearing screening. It discusses why screening is important, as untreated hearing loss can cause delays in speech, language, and learning. The screening can detect hearing loss at birth but not losses that develop later. It outlines best practices for screening programs, including educating parents, using objective physiological tests, and having follow-up for babies who do not pass. Screening should be done before hospital discharge using auditory brainstem response or otoacoustic emission tests in a quiet room. Protocols vary but include screening both ears and rescreening any ear that does not pass initially.

1. Newborn
Hearing
Screening
Eatedal

2. Before leaving the hospital, your newborn baby’s
hearing will be checked using a quick, simple test.
Hospital hearing screens are important for
detecnding hearing loss early. If you are not sure
about the results of this screening, ask your doctor.

3. Why is newborn hearing
screening important?
– Hearing loss is invisible.
– 2–3 per 1,000 babies will have hearing loss at birth.
– Untreated hearing loss can cause speech and language
delays.
– Early access to sound through hearing aids and other
technology will help prevent speech and language
delays.

4. Children with hearing loss that
is not treated:
• have difficulty learning to listen and speak;
• have trouble learning to read;
• have difficulty in school.
Newborn hearing screening can only tell you if your baby’s hearing is okay at
birth. Some babies develop hearing loss later. Pay attention to how well
your child reacts to sounds. Also keep track of his or her speech and
language development. Ask your doctor to order a diagnostic hearing test if
you have any concerns.

5. General Considerations
Universal newborn hearing screening (UNHS) programs typically
include:
– parent/caregiver written education materials,
– hearing screening protocols using objective physiological test(s),
– a process for communicating screening results,
– a follow-up system for infants who do not pass the hearing
screening
– documentation and data systems to track screening and follow
up,(New York State Department of Health, Early Intervention Program, 2007; JCIH, 2007).

6. Screening techniques:
– Objective measures.
– Questionnaire.
– OAES.
– ABR.

7. Types of newborn hearing
screening
1.Universal:
- all live births
2. Targeted:
- high risk population

8. High risk for hearing loss
– The list of risk factors or indicators for HL in neonates has
evolved over the years.
– They include indicators for neonates from:
1. Birth to 28 days of age .
2.Then rescreen from 29 days to 2 years.
3. For auditory neuropathy

9. High risk for HL Joint Committee(2000)
from birth to 28 days of age
1. Neonatal condition require NICU for ≥ 48h.
2. + ve family history for SNHL in childhood.
3. Infection during pregnancy ( e.g. rubella, herpes, toxoplasmosis).
4. Congenital disorder associated HL.
5. Craniofacial anomalies including ear canal & pinna anomalies.

10. Standard Universal Precautions:
– All procedures must ensure the safety of the patient and
clinician Decontamination, cleaning, disinfection, and
sterilization of multiple-use equipment before reuse.

11. Timing of Screening
Newborns cared for in the WIN are screened as close to
hospital discharge as possible and at least prior to 1 month
of age. NICU newborns are screened when they are ready
for discharge and/or when they are medically stable.

12. Testing Environment
Screening can be done in a quiet room with the infant
resting quietly or sleeping.
A sound booth is not needed. The preferred method for
testing is to have the newborn resting quietly in his/her
bassinette, although, if needed, the newborn can be held.

13. Protocols
– Screening protocols can be broadly classified into four different
categories:
– ABR only,
– OAEs only,
– OAEs with ABR rescreen only if OAE is failed,
– ABR and OAEs.
The choice of protocol for a newborn hearing screening program is based
on the specific needs and requirements of the hospital and the population
being screened

14. Technology
– Auditory brainstem response (ABR) and otoacoustic emissions (OAEs) are
appropriate physiologic measures for screening the newborn population. Both
are noninvasive and available in automated versions that are easily utilized by
trained hospital staff.
– Both ABR and OAE technologies will miss delayed-onset hearing loss, mild
hearing loss, or hearing loss that is only present at isolated frequencies; and
both ABR and OAE responses are affected by outer or middle ear dysfunction.
That is, when a transient middle ear condition is present, both will likely result
in a "failed" screen. Both OAE and ABR screening reflect physiologic processes
within the auditory system and identify hearing loss most accurately from 2k to
4kHz.

15. Pass/Fail Indications
– A newborn must pass screening in both ears during one session to
be considered a "pass." If the newborn fails one ear, both ears
must be rescreened. If the newborn passes the screening or the
rescreening and has no risk factors for late-onset or progressive
hearing loss, then the screening is complete. If the newborn
passes the screen and has risk factors for late-onset or progressive
hearing loss, then the newborn's hearing should be followed
during early childhood (Harlor & Bower, 2009; JCIH, 2007).

16. Thanks for your attention
Done by:
Eatedal Alqahtani