On this page...
How is hearing tested in babies?
Oto-acoustic emissions (OAE) screenings are done by sending sound into the baby’s ear canal as a small microphone measures the response of the cochlea inside the ear. Some hospitals use another test, the automated auditory brainstem response test (AABR), which involves providing sound to the baby with earphones. Electrodes are placed on the baby’s skin to measure brainstem activity in response to the sound.
In Iowa, newborn hearing screening for hearing loss is usually done in the hospital shortly after birth. For babies born outside of the hospital, a family can take their baby to any local Area Education Agency, private audiologist or local hospital. You can learn from an audiologist about how newborn hearing screening is performed here. Contact Iowa Family Support Network (888-425-4371) for the locations nearest you. A hearing screen takes just a few minutes. It is safe and painless.
EHDI - Screening
Please contact Iowa Family Support Network for the locations nearest you or call the EHDI program at (833) 436-8040. You may be able to return to the birth hospital, see an educational audiologist at your local Area Education Agency or visit a private practice audiologist.
This means the baby did not pass the newborn hearing screen. It does not necessarily mean your baby has hearing difference. Your baby must return for a follow-up hearing screen which is similar to the newborn screen. Some audiologists may complete a diagnostic test at the time of the re-screen.
Options for re-screening include returning to the birth hospital, seeing an educational audiologist at your local Area Education Agency or seeing a private practice audiologist.
It is possible. Some babies are born with medical conditions that are associated with hearing differences. These may include infections, such as CMV, herpes, rubella, syphilis or toxoplasmosis. Children with some syndromes or differences in the shape of the head/face can have hearing differences. Newborns that have stays longer than five days in an intensive care unit or require transfusions for jaundice may also be at risk for hearing differences. Certain chemotherapy treatments or medications typically used to treat severe infections are known to be toxic to the hearing system. Additionally, a family history of childhood hearing differences may indicate a genetic disposition towards hearing differences.
Much of a child’s ability to communicate relies on hearing. It is important to find hearing differences as early as possible because babies start learning how to use sound as soon as they are born. Listening in the first months of life prepares babies to speak. Babies start by babbling and using many of the sounds they hear spoken around them. By their first birthday, babies are already learning what words mean. These early steps are building blocks for communication. The first step to identifying hearing differences and avoiding the disruption of development is screening.
You and your primary care doctor will receive a letter outlining suggested follow up for children with risk factors for late onset hearing differences. If you have questions about whether your child is at risk for hearing differences, ask your primary care provider or audiologist.
Don’t know what to ask at your child’s appointment? Here's potential questions to ask your child’s:
EHDI - Diagnosis
If your newborn undergoes screening and does not pass the hearing screens, it is recommended he or she receives a diagnostic assessment before three months of age. A diagnostic assessment is a test to give you more information about the hearing abilities of your newborn. You can learn from an audiologist about how a diagnostic assessment is performed. Not all audiology providers are able to provide this test for young infants. Find an appropriate diagnostic audiology center near you by contacting the Iowa EHDI staff at (833) 496-8040.
If your newborn has already received a diagnosis of a permanent hearing differences, you will receive the written results from your provider. There is a spectrum along which diagnosis could occur, from completely deaf to slightly hard-of-hearing to at-risk for hearing differences. Your understanding of your baby’s hearing differences and the services available to your baby and family will play an essential role in helping your child to succeed. We are here to help your family learn about hearing differences and where to go for support services.
After your child has received a diagnosis of a permanent hearing difference, our program will send your family a family guide. The family guide is available in English and Spanish (Guia para Familia en Español). This family guide is meant to get you started in knowing what are some next steps and resources available to your child and your family related to the newly diagnosed hearing difference. The family guide is not a comprehensive list, however, it was designed by families and professionals with families like yours in mind.
Need help understanding the medical and audiology terms and vocabulary used to describe your child’s hearing differences, communication methods, assistive hearing devices, etc.? Use this glossary to improve communication with the health professionals caring for your child.
EHDI - Intervention
After diagnostic testing shows that your baby has a hearing difference or is at-risk for hearing difference, it is important that conversations begin about intervention options. By intervening early, speech delays can be avoided. Early intervention is a system of services that helps babies and toddlers with developmental delays or disabilities. Early intervention focuses on helping eligible babies and toddlers learn skills that typically develop during the first three years of life.
Iowa's early intervention system is called Early ACCESS. Early ACCESS works with families to identify child and family needs and coordinate services to meet those needs. Early intervention can make a difference. If you are interested in early intervention, refer to the Iowa Family Support Network's website below. Together, with the help of other parents of children with hearing differences, professionals and your family, you will work towards incorporating your child’s hearing differences into your everyday life.
Learn even more about early intervention:
If diagnostic testing shows that your baby has a hearing difference, a number of professionals will work together to help your baby and family. Professionals may include the following:
- Pediatric Audiologist - A professional who specializes in testing the hearing of infants and children and recommends hearing aids and other forms of treatment or interventions.
- Pediatrician or Family Practitioner - A doctor who provides health care for infants and children.
- Ear, Nose and Throat Physician - A doctor who specializes in problems of the ear, nose and throat.
- Early ACCESS Service Coordinator – A mediator that works with early intervention programs. They work closely with families to identify their needs and ensure that providers work together to meet those needs.
- Early Intervention Specialist – An educator that specializes in working with infants who have hearing differences.
- Genetics Team - A group of professionals that help counsel on the potential genetic component of hearing differences.
- Speech Pathologist - A trained professional that works with individuals who have speech and language difficulties.
All of these professionals will provide support to your family and work together to assist in your baby’s development.
Myths vs. Clinical Facts
Making decisions throughout the hearing screening process requires accurate information. Explore the common misconceptions surrounding hearing differences below.
Fact: Children identified with hearing differences after 6 months of age are more likely to have speech, language, and cognitive delays than children identified before 6 months. Children identified early can avoid these delays through evidence-based early intervention programs.
Fact: Hearing difference affects about 1 to 3 children per 1,000 births, and is considered to be one of the most common birth defects.
Fact: Before newborn hearing screening, most children were not found to have a hearing difference until 2-3 years of age. Children with milder hearing difference weren't found until 4 years of age.
Fact: As many as 50% of infants born with hearing differences have no known risk factors.
Fact: Babies younger than 3 months can typically be tested without need for sedation.
Fact: Children as young as 1 month of age can now be fit with and benefit from hearing aids.
Fact: 95% of babies born with hearing differences are born to parents with normal hearing.