Earlier is Better to Catch Hearing Loss

By McIver, Steve 
March 21, 2017

Earlier is Better to Catch Hearing Loss

When should your child's hearing be tested? Sooner than you think.

All states have laws or voluntary compliance programs requiring hearing tests in newborns, usually before they leave the hospital. Every year, about 2% to 3% of babies are born with hearing problems in the U.S.

For years, routine hearing tests took place only when children entered school. But hearing loss can cause serious problems much earlier. And, hearing problems affect the development of language and speech.

During the first 6 months, babies begin to recognize the spoken sounds that are critical for developing language. Poor hearing can slow down that progress for both speaking and reading.

Risk factors

Consider having your child tested for hearing loss, especially if he or she has any of the following risk factors:

  • Premature birth

  • More than 5 days in neonatal intensive care

  • History of severe jaundice requiring blood transfusion

  • Maternal/neonatal infections

  • Meningitis or history of brain injury that required hospitalization

  • Family history of childhood hearing loss

  • Family history of certain hereditary or congenital syndromes like neurofibromatosis, Down syndrome, osteopetrosis, and Usher syndrome

Even without risk factors, parents should remain alert to hearing problems. You may notice the following signs of hearing loss in your baby:

  • Does not notice loud noises

  • After 6 months, does not turn toward sounds

  • By 12 months, does not say single words

  • Does not turn head when called by name

In your young child, you may notice delayed speech development or unclear speech.

Recurrent ear infections, which are common in young children, can also delay language development. A newborn can pass a hearing test and still develop hearing problems later in childhood.

Hearing tests in infants

Your baby is likely to undergo one of these painless, quick, and sensitive tests:

  • Auditory brainstem responses. Sound is introduced to the baby's ears through tiny earphones while the baby is sleeping. Using sensors attached to the baby's head, the test records electrical activity produced by the auditory nerve and brainstem when it's stimulated by this sound.

  • Otoacoustic emissions (OAE). The normal ear makes faint acoustic signals, sometimes called inner-ear echoes. Although people can't hear their own sounds from their inner ear, tiny, sensitive microphones placed in the ear canal during the screening can measure the sounds. Infants who can't hear create no emissions.

Hearing tests in children

Your child's healthcare provider may check your child's hearing with a simple device called a tuning fork. Or your child may have tests from an audiologist or hearing specialist. Tests include the two discussed above and:

  • Pure tone audiometry. This test checks hearing at different decibels or sound levels.

  • Tympanometry. This test is often used to check hearing in children with ear infections.

Other hearing evaluation tests may include:

  • Speech audiometry. This test checks the spoken word.

  • Behavioral testing. This is done for children who are unable to be tested with other methods.


March 21, 2017


Early Hearing Detection and Intervention (EHDI). American Speech-Language-Hearing Association., Up To Date. Hearing Impairment in Children: Etiology, Up To Date. Hearing Impairment in Children: Evaluation

Reviewed By:  

Adler, Liora C., MD,Holloway, Beth Greenblatt, RN, M.Ed.