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Follow-Ups Are Critical For Hearing Problems

Most U.S. babies, as many as 97% of them, will have their hearing screened in the hospital's newborn nursery. But follow-up testing is crucial and 46% of those who failed the newborn screening test back in 2007 also failed to get repeat testing or undergo treatment said Marcus Gaffney. Gaffney is a health scientist at the Centers for Disease Control and Prevention's Early Hearing Detection and Intervention program. "Screening a child doesn’t do a lot of good," says, "if you don’t take the appropriate follow-up."

Not Standard

Prior to the late 1990's, the average age at which a child might receive a diagnosis for hearing loss was at 2 1/2 years. The testing was not standard and was performed only when a child was slow to speak. Children with mild hearing issues, or hearing loss in just one ear, often took a lot longer to receive a diagnosis.

"Hearing loss has often been thought of as the silent disability," said Dr. Judith E. C. Lieu, "It may look like not paying attention; they talk while the teacher is talking." Lieu, a pediatric ear, nose and throat specialist at St. Louis' Washington University authored a study linking the loss of hearing in one ear to poor language skills and adds that hearing loss can be difficult to identify in older children.

Yet hearing loss happens to be one of the commonest congenital disabilities that exist today. Hearing loss affects 2-4 out of every 1,000 babies. The loss can be genetic or may develop as a result of a prenatal infection. The infections that can damage a developing fetus have earned their own mnemonic device: TORCH, which stands for toxoplasmosis, rubella, cytomegalovirus, herpes, and "other." Many of these diseases can cause hearing damage.

Two Technologies

There are two different technologies in use for testing a newborn's hearing. One method employs otoacoustic emissions and involves the insertion of a tiny microphone into the ear of a sleeping newborn to measure the echoes that bounce from the cochlea when stimulated by sounds. In automated auditory brainstem response testing, a few electrodes are placed on a baby's head (the electrodes have stickers attached to them), and these help to measure brain responses to soft sounds.

One of these two technologies is used as a first step in what is termed the 1-3-6 plan. Babies are screened by the age of one month. Those who fail that first test need to have a diagnostic evaluation by 3 months, and those babies need to be in treatment by the age of 6 months.

Christine Yoshinaga-Itano, an audiology professor from the University of Colorado, published a study during the 1990's showing that children who were given treatment for hearing loss by the age of 6 months developed better speech and language skills than did those whose hearing loss was discovered at a later age.