Newborn hearing screening programme

The Newborn Hearing Screening Programme

The Newborn Hearing Screening Programme (NHSP) aims to identify moderate, severe and profound deafness in newborn babies. The programme automatically offers all parents, in England, the opportunity to have their baby's hearing tested shortly after birth. Early identification, via the programme, gives babies a better ‘life chance' of developing speech and language skills and of making the most of social and emotional interaction from an early age.

Why screen my baby's hearing?

Your baby will be offered a series of routine health checks in the first few weeks of life. This will include a hearing screening test. One to two babies in every 1000 are born with a hearing loss in one or both ears. It is not easy to identify that a young baby has a hearing loss. The hearing screening test will allow those babies who do have a hearing loss to be identified early. Early identification is known to be important for the development of the child. It also means that support and information can be provided to parents at an early stage. It is important to screen all babies, even if no-one in your family has a hearing loss. Most babies born with a hearing loss are born into families with no history of hearing loss.

What does the newborn hearing screening test involve?

Your baby will be offered the hearing screening test within the first few weeks of life. The hearing screening test is usually carried out at home by a Health Visitor during the new birth visit at home 10-16 days after the birth of your baby. Babies who require care in a neonatal intensive care unit or special care baby unit will usually have their hearing screening tests carried out by a hearing screener, staff nurse or nursery nurse before they leave hospital.The screening test involves placing a small soft tipped earpiece in the outer part of your baby's ear which sends clicking sounds down the ear. When an ear receives sound, the inner part, known as the cochlea, usually produces an echo. The screening equipment can pick up a response. This type of test is called an Automated Otoacoustic Emission (AOAE) screening test. The AOAE screening test is safe, only takes a few minutes and does not hurt your baby. The hearing screening test will usually be done while your baby is asleep or settled.  You can stay with your baby while the screening test is done.

How can I help prepare my baby for the hearing screening test?

The screening test is easier to carry out if your baby is asleep. Don't worry if your baby will not settle. Your hearing screener will understand that it is difficult to get a young baby to sleep. The following may help your baby to settle during the test:

• If possible, feed your baby shortly before the hearing screening test.

• Ensure you have the things you may need to make your baby comfortable and happy.

When will I get the results of the hearing screening test and what do they mean?

The results will be given to you at the time of the screening test. If you have any concerns or questions about your baby's results speak to your health visitor or the hearing screener. 

If the screening test shows a clear response from both of your baby's ears this means that your baby is unlikely to have a hearing loss. The NHS Newborn Hearing Screening Programme is a very reliable way of detecting hearing loss early.

Children can develop or acquire a hearing loss later on so it is important to check your child's hearing as they grow up. Even if your baby gets a clear response from their hearing screening test, you can use two checklists to help you assess the development of their hearing; ‘Reactions to sounds checklist’ and ‘Making sounds checklist’. These can be found in the leaflets ‘Screening tests for you and your baby’ and ‘Screening tests for your baby’ and in your ‘My personal child health record’ book.

If you have any concerns about your child's hearing you can discuss them with your health visitor or family doctor. Your child's hearing can be tested at any age.

Why does my baby need a second hearing screening test and what does it involve?

If the AOAE screening test does not show a clear response from one or both ears, your baby will need a second hearing screening test. A lot of babies need to have a second screening test and this doesn't necessarily mean that your baby has a hearing loss.  Some common reasons, other than hearing loss, for having a second hearing screening test are:

• Your baby may have been unsettled at the time of screening.

• There may have been background noise when the screening test was carried out.

• Your baby may have fluid or a temporary blockage in their ear after the birth. This is very common and will pass with time.

Most babies are found to have no hearing loss after the second screening test but it is still important that your baby has the second screen. This is because babies who have a hearing loss will usually react to some sounds. If your baby does have a hearing loss it is important to find out as soon as possible.

The second screening test may be the same as the first screening test, the Automated Otoacoustic Emission (AOAE) screening test. Your baby may also have another type of screening test. This is known as the Automated Auditory Brainstem Response (AABR) screening test. This involves three small sensors being placed on your baby's head and neck. Soft headphones, specially made for babies, are placed over your baby's ear and a series of clicking sounds are played. The hearing screening equipment tells us how well your baby's ears respond to sound. The AOAE screening test takes a few minutes, whereas the AABR screening test can take between 5 and 30 minutes. You can stay with your baby while the screening test is done.

Babies who are screened in neonatal intensive care and special care baby units automatically have the AABR screening test as well as the AOAE test. This is because babies born prematurely, those requiring special or intensive care and those with some medical conditions can be at a higher risk of having a hearing loss.

Why has my baby been referred for an appointment at the local audiology clinic?

If the second screening test does not show a clear response from one or both of your baby’s ears you will be referred to your local audiology department. They will carry out special tests to measure your baby’s hearing. Again, this often happens and does not necessarily mean your baby has a hearing loss.

There may be a number of other reasons why the second screen could not get a clear response from one or both of your baby’s ears. Further tests by an audiologist will give you better information about your baby’s hearing.

I have been told my baby has a hearing loss. What does this mean and where can I get further information and support?

Parents and families may have many questions when they find out their baby has a hearing loss. Each baby's hearing loss will be different and your audiologist will be able explain the sounds your baby can hear and which sounds it may be difficult for them to hear.

You may be told that your baby has a mild hearing loss. This means that your baby's hearing is slightly below the level considered normal. Your baby has a good degree of useful hearing but may have difficulty hearing quieter sounds.

If you are told that your baby has a unilateral hearing loss, it means that your baby has a hearing loss in one ear.

Alternatively you may be told that your baby has a bilateral hearing loss, which means that your baby has a hearing loss in both ears.

Parents react in many different ways when they first find out that their baby has a hearing loss and can experience a wide range of emotions. Whatever your feelings it is important that you acknowledge and share them. There are a variety of organisations that can provide support for you and your baby. You can ask your audiology department for further information about support in your local area or alternatively you can contact the National Deaf Children's Society Free phone Helpline on 0808 800 8880 (10am to 5pm Mon-Fri) or send an e-mail to helpline@ndcs.org.uk or visit the website www.ndcs.org.uk. Their experienced advisors can help answer any questions you may have and put you in touch with other parents with deaf children through a network of local support groups.

Key Facts

• About 1,700 babies are now screened every day as part of the NHS Newborn Hearing Screening Programme.
• It is estimated that in England some 4,700* children with confirmed deafness in one or both ears have been identified by the newborn hearing screen.
• Before the introduction of the NHS Newborn Hearing Screening Programme, half of children with a permanent deafness were not identified until they were 18 months old and a quarter not identified by three and a half years of age.

*NHSP statistics October 2009

For further information please contact:

NHS Newborn Hearing Screening Programme
Royal Free Hampstead NHS Trust
344-354 Gray's Inn Road
London WC1X 8BP
Phone: +44 (0) 207 164 2100 (switchboard)

www.hearing.screening.nhs.uk

Jenny Langlands
Newborn Hearing Screening Programme Team Leader Somerset
Taunton and Somerset Foundation Trust
Musgrove Park Hospital
Taunton TA1 5DA

Tel 01823 342048
Email jenny.langlands@tst.nhs.uk

Melanie Couch
Newborn Hearing Screening Programme Local Manager Somerset
East Reach House
East Reach
Taunton TA1 3EN

Tel 01823 287836
Email melanie.hitchcock@somcomhealth.nhs.uk