Hearing tests for newborns are becoming more common, but not all states require them, even though the U.S. Preventive Services Task Force, the government's panel of independent health experts, recommended universal screening in 2008. But skipping newborn hearing tests does increase the risk that children with hearing loss will suffer developmental delays by age 5, according to new research published today in the Journal of the American Medical Association.
Newborns can't let anyone know if they are hearing or not, so newborn tests detect otoacoustic emissions—basically, sound that bounces off the cochlea in the baby's inner ear and is picked up by a small microphone. Another test, the auditory brainstem response test, picks up signals from the auditory nerve through electrodes attached to the baby's scalp. The tests are painless, but cost and time are an issue, as they are for all universal medical tests. An older method, called distraction testing, can't be done until a child is at least 6 months old. With that method, testers watch a child while making a noise to see if the child turns in the direction of the noise.
In the JAMA study, researchers in the Netherlands studied children as universal newborn hearing tests were phased in between 2002 and 2006. They analyzed the development of 150 children with permanent hearing loss, 80 of whom had undergone hearing tests as newborns, and 70 of whom were tested with distraction testing. The children with hearing loss that had been identified in newborn testing did better on motor skills and social development than the children tested later on. They used sign language less, and spoken words more. The researchers felt the children also had a better overall quality of life.
Earlier hearing tests do help children born with hearing loss. But the universal testing programs are run by the states, and state health programs are under huge budget pressures. So don't expect a big push for universal newborn hearing screening anytime soon.
The American Speech-Language Hearing Association tracks state laws on newborn hearing testing; it's a good place to start if you'd like to know about the status of hearing tests in your state. Ask your pediatrician if they're routine, and what the options are for getting your newborn tested if they're not.