Treatments & Therapies

Newborn hearing screening – treatment, effects and risks

Newborn Hearing Screening

In every 1,000 births , on average, two children are born with a hearing impairment . Hearing problems can severely affect a child’s development. Newborn hearing screening was introduced in Germany in order to be able to assess hearing abilities at an early stage .

What is newborn hearing screening?

Newborn hearing screening is an early detection examination to diagnose hearing disorders in newborns as early as possible. Hearing disorders can massively impede the development of children. Only a child who hears normally has the chance to learn to speak normally. 

Emotional development, the ability to communicate, willingness to learn and learning success depend on the ability to hear properly. Hearing deficits in babies and toddlers can have negative consequences for private and professional development throughout life.

From day one, hearing enables children to differentiate between their surroundings. Hearing is the basis for all language development and thus for the later ability to read and write. Hearing disorders are congenital in rare cases. However, they can also be triggered by diseases. 

If a hearing disorder is uncovered by the newborn hearing screening, it can be compensated for even in small children using modern hearing aid technology. The screening ensures that children affected by hearing deficits have an easier start in life.

Function, effect & goals

Newborn hearing screening is carried out in the maternity clinic in the first few days of the child’s life. The examination is not associated with any impairment or pain for the child. The test can be performed even on a sleeping child. The newborn does not have to react actively to any stimuli.

Today there are two measurement methods that can be used to determine hearing deficits. One method is based on the measurement of otoacoustic emissions (OAE). This measurement method uses the ability of the human ear not only to receive noises but also to emit sound.

For newborn hearing screening, a tiny probe is placed in the outer auditory canals of the ears, which emits soft clicking sounds. The vibrations of the clicking noises are transmitted to the structures of the inner ear . The sound stimulates the sensory cells in the inner ear. 

The test for newborns makes use of the fact that the sensory cells send back an echo of the received sound waves. These vibrations are registered by the probe in the outer auditory canal, which also has a small microphone installed to record the sound waves from the inner ear.

The strength of the vibrations is measured. If there are no sound waves from the inner ear or if only very weak signals are registered, this can indicate an existing hearing impairment.

If the measurement results indicate disturbances in the transmission of sound to the sensory cells, this does not necessarily mean that there is a disease. The measurement should be repeated some time later. Background noise, fluid in the middle ear due to inflammation or if the child is very restless during the measurement can falsify the test results. Another approved method of newborn hearing screening that does not require any activity from the child is called brainstem audiometry . 

This is a special form of an EEG. In this method, the activity of the auditory nerve is tested when acoustic stimuli are transmitted. Every nerve function in our organism causes a measurable electrical activity. In the test, small measuring electrodes are attached to the newborn’s head.

With this procedure, too, clicking sounds are emitted via the external auditory canal with a probe. The electrodes can be used to measure the electrical activity during the transmission of the sound waves of the auditory nerve from the inner ear to the auditory center in the brain . If the measured values ​​are outside the normal range, this can be interpreted as an indication of a possible hearing loss. With this method of measuring hearing ability, too, the child should sleep as much as possible. 

The more restless and active a person is, the more electrical signals the brain, central and peripheral nervous systems produce. In the sleeping state, it is easier to match the signals to the activity of the auditory pathway from the ear to the brain.

Risks, side effects & dangers

If hearing impairment is detected by the newborn hearing screening, both measurement methods can be used to identify the area of ​​the hearing system that is responsible for the deficit. While OAE shows damage to the sensory cells in the inner ear, brainstem audiometry reveals problems in the auditory pathway and thus in the auditory nerve.

This distinction is important for prescribing the appropriate hearing aid. However, negative test results should not be overestimated if they were found in the first few days after birth.

A hearing impairment does not necessarily have to be concluded from these measured values ​​outside the norm. On the other hand, even inconspicuous measurement results are no guarantee for an unrestricted hearing ability of the child. Experience with newborn hearing screening has shown that a whole range of children are conspicuous with abnormal measurement results.

Only a very small percentage of children tested with negative readings actually have a hearing impairment. Nevertheless, the screening should be an indication to pay more attention to the hearing ability of the newcomer. In the event of the first abnormal findings that the test has produced, both measurement methods, OAE and brainstem audiometry, should be carried out. The measurements should be checked after some time with the repetition of the tests,

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.