Normal hearing is critical for normal speech development. Screening enables early detection of hearing loss and timely hearing support.
Timing and screening methods
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For neonates of at least 34 weeks of gestation, hearing screening is performed at discharge or after 24 hours.
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For neonates born before 34 weeks, screening is performed once they complete 34 weeks of gestation.
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Normal neonates may be screened with either otoacoustic emissions (OAE) or automated auditory brainstem responses (AABR). High-risk neonates should receive both tests.
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In OAE screening, one probe emits sound and receives the response. In AABR screening, an ear probe emits sound and scalp electrodes record the response.
Failed screening and intervention
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If the first screening is failed, repeat screening after 48–72 hours reduces false positivity through a two-step approach.
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A diagnostic auditory brainstem response (ABR)* is performed to confirm hearing loss.
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Neonates with confirmed hearing loss need a hearing aid or cochlear implant by 6 months of age, along with speech rehabilitation.
Repeat screening after an initially normal result
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Re-screen a neonate who develops an illness that can impair hearing, such as meningitis.
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Parental concern about hearing or a red flag in speech development also warrants re-screening.