Hearing Screening
Hearing screening is an important part of keeping your child healthy and learning, developing and growing normally.Hearing loss often does not have symptoms until speech and language are already delayed. Since children’s language centers in the brain are developing during infant and toddler years, hearing problems during critical periods can lead to lifelong speech and language problems. Hearing problems starting later in childhood can cause learning, social, and emotional difficulties. Young children often cannot tell that they have a hearing problem; it sounds normal to them.
Hearing is another excellent example of the importance of well-child visits; undetected hearing loss can cause lifelong disability if not treated at the right time. Once the critical period of development is past, treatment is far less effective.
There are now several hearing screenings that children receive throughout their childhood.
Newborn hearing screening
For many years, we tested the hearing of newborns who were at higher risk of having hearing loss. Starting in the late 1980’s, the US began developing statewide programs to screen all newborns; these programs went into effect in the early 2000’s, and now every state coordinates a program for screening all babies born in that state, following-up and repeating abnormal screenings, and getting children who have hearing loss into treatment by 3-6 months of age. This test is performed in the hospital before discharge. Babies born at home or other locations need to have testing done in the first few weeks of life.
Children who are considered to be at higher risk are screened again around 24-30 months of age.
Newborns are screened with either a device that can actually hear the hair cells in the inner ear moving in response to a click, or with a device that measures brain waves in response to a sound.
Toddlers can also be screened in special rooms where response to sounds from specific locations is tested.
Childhood hearing screens
Children are screened with headphones which produce sound of different pitches and sound levels. Currently, they are screened every year from 4-6 years old, every 2-3 years after that, and every 3 years during the teenage years. We make sure that they can hear the range of sounds from high to low that is the normal range of human speech. They should be able to hear these sounds as soft as 20 dB. Recently, screening higher pitches was added to teen screening to detect hearing loss due to earbud/headphone use.
Tips on protecting your child’s hearing
- If your child uses headphones, be sure that your child knows the maximum setting he is allowed to use.
- Protect your child’s ears when using outdoor power equipment, indoor or outdoor tools. Provide ear plugs or other hearing protection.
- Teach your child that if she has to raise her voice to be heard, the sound in the room is too loud and she needs to leave.
- Teach your child to leave places where the noise level hurts her ears or causes ringing in the ears afterwards.
- Watch out for loud toys: some can reach 90 dB.
- Prolonged exposure to sounds above 85 dB can damage the hearing. Here are some common sound levels:
- Garbage disposal: 85 dB
- Maximum volume on portable music player: 110 dB (100x greater than 85 dB)
- Noisy restaurant or crowd: 85 dB
- Siren: 120 dB
References
Hagan JF, Shaw JS, Duncan PM, eds. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 4th ed. Elk Grove Village, IL: American Academy of Pediatrics, 2017.