Newborn hearing screening: how it works and what the result means

The NHS describes newborn hearing screening as a test to find babies who have hearing loss. NHS England’s programme overview says it aims to identify permanent moderate, severe and profound deafness and hearing impairment in newborn babies, and that finding out early can give these babies a better chance of developing language, speech and communication skills.

The NHS says hearing loss is not very common in babies, but identifying it as early as possible means you and your baby can get the support you may need with language and speech. A trust leaflet notes that most babies born with hearing loss are born into families with no history of hearing loss, which is why every baby is offered the test.

The programme overview says screening is offered to all babies in England, ideally within the first 4 to 5 weeks after they are born, and can be done up to the age of 3 months. The NHS says it will be offered in hospital or at home, or sometimes you may be invited to a clinic.

If you are not offered a test, the NHS says to ask your health visitor or GP to arrange an appointment, or contact your local hearing screening service. It is your choice whether your baby is screened, and if you decide against it you will be given checklists to help you check your baby’s hearing as they grow.

The first test is the automated otoacoustic emission (AOAE) test. The NHS says a small soft earpiece is placed in the baby’s ear and gentle clicking sounds are played to check how the baby responds. The programme overview says the response is picked up by the screening equipment and the test takes just a few minutes. A trust leaflet explains that when an ear receives sound, the inner part, the cochlea, usually produces an echo that the equipment can detect.

If this does not give a clear result, the test is repeated or a second, different test is offered. That second test is the automated auditory brainstem response (AABR). The overview says 3 small sensors are placed on the baby’s forehead, the nape of the neck and shoulder, soft headphones are placed over the ears and gentle clicking sounds are played, and it takes between 5 and 15 minutes. One trust says it can take between 5 and 30 minutes.

You can stay with your baby throughout. The test is done when the baby is settled or asleep.

You are given the result as soon as the test is done. The NHS says a clear result in both ears means it is unlikely that your baby has hearing loss, but that the test does not pick up all types of hearing loss and children can also develop hearing loss later on.

The checklist in your baby’s personal child health record, known as the red book, tells you how to check hearing as your child grows older, and the NHS advises talking to your health visitor or GP if you have any concerns, even after a clear result.

A trust leaflet is reassuring on this. It says a lot of babies need a second test, most are found to have no hearing loss after the second test, and it is still important that they have it. It lists a restless baby, background noise and fluid or a temporary blockage in the ear after birth, which it says is very common and passes with time, as reasons other than hearing loss.

If the second test does not show a clear response in one or both ears, the NHS says an appointment will be made at an audiology clinic within 4 weeks, which usually takes about 1 to 2 hours including time to settle your baby. A hearing specialist places 3 sensors on the forehead, back of the neck and shoulder, and soft headphones play gentle clicking sounds to see if the hearing nerve responds. The test can take up to 15 minutes, and the specialist can usually give you the results at the end and explain whether more tests are needed.

The NHS signposts the National Deaf Children’s Society (NDCS) for support and information for families with children and young people with hearing loss. The programme overview notes that more information about the tests is available in the GOV.UK leaflet “Screening tests for you and your baby”.

Newborn hearing screening is one of the national population screening programmes available in England. Arrangements in Scotland, Wales and Northern Ireland are run by the devolved health services and may differ in detail.