Is it safe if my child passes the newborn hearing screening?

Author: Xiao Dingliang Hunan Children's Hospital

Reviewer: Cai Zili, deputy chief physician, Hunan Children's Hospital

When mothers bring their babies for physical examinations, they often ask, "My child passed the hearing screening when he was born, does he need to undergo a hearing screening again during the physical examination?"

With the widespread implementation of newborn hearing screening across the country, the age of diagnosis of congenital hearing loss has been advanced to within 6 months after birth. The initial screening of normal newborns is usually completed 48 to 72 hours after birth. Screening otoacoustic emissions (OAE) or automatic auditory brainstem response (AABR) can be used as the initial screening tool. If the initial screening fails, a rescreening is required within 42 days after birth. If the rescreening still fails, it is necessary to be promptly referred to an institution with hearing impairment diagnosis and treatment qualifications within 3 months after birth for diagnosis and follow-up. Newborns and infants admitted to the neonatal intensive care unit need to be screened with AABR before being discharged from the hospital when their condition stabilizes. If they fail, they need to be referred in time.

If your baby passes the newborn hearing screening, does he need to have a hearing test in the future? The answer is yes, he needs to.

Some children pass the newborn hearing screening, but are found to have hearing loss during their subsequent growth and development due to delayed speech development. Some children are found to have hearing loss when they seek medical treatment in the preschool or school age period due to learning or communication difficulties, or when they feel their hearing has decreased.

Then why do people with normal hearing at birth develop hearing impairment later in life?

Delayed hearing loss in children is a hearing loss that is discovered after the newborn's hearing is passed, accounting for 11% to 31% of permanent hearing loss in children. Its causes are complex and can be classified into the following categories: ① Genetic factors: the most important cause of permanent hearing loss, and multiple gene mutations can lead to delayed hearing loss; ② Perinatal factors: intrauterine infection such as congenital cytomegalovirus, severe respiratory failure of newborns, extracorporeal membrane oxygenation, etc.; ③ Inner ear malformations: enlargement of the vestibular aqueduct is the most common; ④ Auditory neuropathy. Some other causes are still unknown.

Which children may be more likely to develop delayed hearing loss?

The incidence of delayed hearing loss is higher in children with high-risk factors for hearing loss. Therefore, children with high-risk factors such as intrauterine infection, hyperbilirubinemia that meets the requirements for exchange transfusion, birth weight <1500g, birth asphyxia, meningitis, hospitalization in the neonatal intensive care unit for more than 5 days, craniofacial malformation, and family history of permanent hearing impairment in childhood should be more vigilant about the occurrence of delayed hearing loss. These high-risk infants and young children should have hearing follow-up every 6 months for at least 3 years of age, and audiological evaluation should be performed in a timely manner if there is suspected hearing loss.

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How can we detect delayed-onset hearing loss in children early?

Hearing screening for children is an important supplement to hearing screening for newborns. It needs to be carried out at the following age stages: Infants and young children aged 0 to 3 years: In accordance with my country's "Technical Specifications for Children's Ear and Hearing Care", 6, 12, 24 and 36 months are the key ages for hearing screening. At this stage, it is recommended to use otoacoustic emissions combined with tympanometry for screening, and referral should be made in time if a positive result is found. 3 to 6 years old: Children in this age group can use pure tone audiometry and pediatric behavioral audiometry for hearing screening of speech frequencies, combined with tympanometry testing, and referral should be made in time if a positive result is found. 6 to 18 years old: Children in this age group can use pure tone audiometry combined with tympanometry for hearing screening, and areas with conditions can add high-frequency hearing tests to detect high-frequency hearing loss related to noise.

By conducting regular hearing screening on children, we can detect late-onset or acquired hearing loss early and intervene in time, which can greatly reduce its adverse effects on children's speech development and learning.