Infant & Childhood Hearing Screening, Monitoring, & Treatment

Hearing loss in babies

About 1 in 300 babies will be born with permanent hearing loss. Hearing loss is invisible, and young children cannot tell us when there is a problem. Many babies born with hearing loss have parents with normal hearing. 

The Michigan Early Hearing Loss Detection & Intervention (MI EHDI) program requires that all birthing hospitals in Michigan screen babies for hearing loss. This is generally performed while your baby is still at the hospital shortly after birth. If your child doesn’t pass a hearing screen, your child will be seen for testing again once they are discharged from the hospital. 

It is important to identify hearing loss as soon as possible. Children learn to speak by overhearing language around them, and every moment counts. Hearing loss can cause delays or problems with learning spoken language. Early treatment including hearing aids, cochlear implants, speech therapy, and other medical treatment or accommodations as needed are the keys to success for children with hearing loss. 

Screening

Hearing screening is a safe, painless procedure that identifies babies in need of additional testing. Your child may have one or two types of hearing screening. An auditory brainstem response (ABR) and/or an otoacoustic emissions (OAE) test is done. You will get the results as soon as the screening is completed.

Sounds are played through tiny earphones placed in the baby’s ears.  The baby’s responses to the sounds are measured using electrodes placed on different parts of the baby’s head (ABR) and “echoes” that come back from the baby’s ear (OAE).

The baby does not feel any pain during either of these tests. Testing is quickest and easiest if the baby is sleeping. Do not allow your baby to nap or eat right before the appointment. It is best to schedule the test at feeding time so the baby can eat after arriving for the test. A pacifier, extra diapers, formula or breastmilk, or anything that will help your child sleep are helpful for you and your baby’s comfort during the test.

If your child passes the hearing screen, you should monitor your child’s hearing and speech development along with your child’s pediatrician. If you have any concerns with your child’s hearing at any age, please contact one of our offices for immediate assistance. 

If your baby did not pass the hearing screen, he or she should have another test as soon as possible after discharge from the hospital to re-check for hearing loss. Testing is safe and painless. Hearing loss is something that cannot be seen but may cause delays in developing language and other skills. The earlier the hearing loss is identified, the sooner it can be treated. It is important that you follow up to complete this additional testing. 

Monitoring Hearing

Some babies that are born premature or receive intensive care at the time of birth are at risk for developing hearing loss later in life. Once your baby is discharged, our Infant Hearing team will check for any of these risk factors. You will be advised if your child has a risk factor, and you will be contacted when it is time for you next appointment to monitor for hearing loss. 

If your family has a history of permanent childhood hearing loss, you should let your pediatrician and hearing health care team know. Children with a family history should have hearing tests throughout early childhood to monitor hearing status. 

The following are some of the common risk factors for childhood hearing loss taken from the Joint Committee on Infant Hearing’s 2019 Position Statement:

• A family history of childhood hearing loss
• Certain medical conditions, illnesses, and medications
• More than 5 days of intensive care at the time of birth
• Babies with jaundice that require a blood transfusion 

What if my child has hearing loss?

Test results will measure the amount of hearing loss and the type of hearing loss your child has. Depending on your child’s specific hearing loss, you be evaluated by your hearing health care team and treatment options will be determined. The team may include:

• An audiologist 
  • This is likely the person that will identify your child’s hearing loss. The audiologist specializes is diagnosis of hearing loss and treatment using hearing aids or other hearing technology. You will see the audiologist for follow ups over time to monitor your child’s hearing and make sure the hearing technology your child uses is working correctly. 
• A pediatric Ear, Nose, & Throat (ENT) doctor
  • The ENT will look for causes of the hearing loss and may order testing such as a genetic evaluation, imaging of your child’s inner ear (X-rays, CT scans, MRI scans), or other tests. If there is a medical procedure needed to help your child’s hearing, the ENT will discuss it with you. 
• Pediatrician
  • Your child’s pediatrician will monitor your child’s overall development. This person can help coordinate specialty care, educational services, family support, and community services that are important to the overall well-being of you and your child. 
• Early Intervention (Early On)
  • The Michigan Early Intervention Program is called Early On. This program provides services for children from birth to age 3 with developmental delay(s) and/or disabilities. Research tells us that treating delays early on results in the best outcomes for children, even into adulthood.
    • Learn More about Early On
• Speech Language Pathologist (SLP)
  • The SLP will monitor your child to determine if the hearing loss is causing issues with your child’s speech and language development. Your child may receive speech therapy as he or she learns speech and language.

Speech and hearing milestones

Children will develop hearing and speech skills over time in early infancy and childhood. Please note these milestones are for babies born full term. If your baby was born early, your child should still reach the same milestones but may be delayed.

• Birth to 3 months of age:
  • Blink or startle when there is a sudden, loud noise
  • Quiet or smile when hearing your voice
  • Make cooing sounds like ‘ooh’ and ‘aah’
• 3 to 6 months of age:
  • Look for sounds with eyes
  • Start babbling
  • Enjoy sounds with rattles
• 6 to 10 months of age:
  • Turn head toward louder sounds
  • Begin to imitate things your say
  • Babble more frequently using phrases like ‘ba-ba,’ ‘ma-ma,’ and ‘ga-ga’
• 9 to 12 months of age:
  • Respond to own name
  • Understand ‘no-no’ and ‘bye-bye’
  • Turn head toward soft sounds
• 12-15 months of age:
  • Correctly use ‘ma-ma’ and ‘da-da’
  • Point to a favorite toy or object when asked
  • Respond to singing and music