Universal Infant Hearing Screening is done hours after birth, detects hearing loss early

Here are the signs parents should watch for if their child has hearing difficulties

Within a few hours of your newborn’s birth, your care team will do an evaluation for an early determination of your baby’s health. One such test is Universal Infant Hearing Screening, which is a strategy for early detection of hearing loss.

At the Telfair BirthPlace, infants have their hearing screened as part of their routine evaluation. The screening is performed shortly after birth without discomfort to the baby.

Shea Stromberg
Shea Stromberg, Au.D., CCC-A, clinical audiologist with the St. Joseph’s/Candler Center for Oto-Neurology

Every day, 33 babies are born in the United States with permanent hearing loss. In Georgia, 1 in 1,000 babies are born deaf, according to the latest findings from the Georgia Hearing Screening and Intervention program. Hearing loss is the most frequent health condition in newborns, including 20 times more prevalent than sickle cell disease.

A baby may be born with hearing loss or develop hearing loss after birth into childhood due to certain maternal illnesses during pregnancy, if the mother was exposed to certain medications or chemicals during pregnancy, complications during the pregnancy or delivery or due to genetics, says Shea Stromberg, Au.D., CCC-A, clinical audiologist with the St. Joseph’s/Candler Center for Oto-Neurology.

An audiologist is a master’s or doctorate level healthcare professional who evaluates, diagnoses, treats and manages hearing loss and balance disorders in adults and children.

There are two methods of hearing screens used for newborns and infants: otoacoustic emissions (OAE) and auditory brainstem response (ABR), describes Stromberg, who holds a doctorate in audiology. An OAE measures a very soft sound coming back from the hearing organ, called the cochlea, in response to sounds introduced to the ear.  An ABR measures the response of the hearing nerve to soft sounds that travel through the entire ear. Both tests are performed while the infant is sleeping. All infants born at Telfair BirthPlace at Candler Hospital receive an ABR hearing screen.

If the baby passes the hearing screen, there is 99 percent confidence that hearing is adequate for speech and language development. If the baby does not pass the hearing screening, further diagnostic testing is required.

“A complete hearing evaluation is recommended if the infant/child does not pass a hearing screen in either ear,” Stromberg adds. “With today’s technology, no child is too young to have an accurate hearing test.”

The Universal Hearing Screening program was instituted in Georgia in 1998 with the goal of screening all babies by 1 month of age and performing diagnostic testing by 3-months-old so that intervention can begin by 6-months-old. If a child can be fitted with amplification by 6 months, even children with mild to severe hearing losses can develop normal or near-normal speech and language skills provided cognition is normal, Stromberg says.

Watching for the signs of hearing loss

Because hearing loss can occur after birth, watching for the signs of hearing loss and periodic screening is recommended. An infant with more significant hearing loss will often show signs of hearing loss much earlier than an infant with a hearing loss of lesser degree, Stromberg says.

An infant with severe hearing loss may not wake or startle to sounds that are loud or very loud and may not calm to a parent’s voice, says Stromberg. An infant with slight or moderate hearing loss will react to everyday sounds but would not show signs of hearing loss until 12 to 18 months when a child should begin saying first words, Stromberg says.

“In general, a parent should be concerned about hearing loss if the child does not consistently respond to speech, react to every day environmental sounds and/or demonstrates delayed speech,” Stromberg says. “Fortunately with the technology we have today and the Universal Infant Hearing Screening program, babies can be tested for hearing loss as early as their first day of life or any point afterwards.”

If a parent is concerned with their child’s hearing, Stromberg recommends talking to your pediatrician and requesting a hearing screen. At the Center for Oto-Neurology, the audiologists perform several tests to assess each part of the hearing pathway to determine how soft a child can hear sounds necessary to learn speech and language and recommend the appropriate follow-up.

When an infant is identified with hearing loss, the child is referred to an otolaryngologist for a medical evaluation to determine possible reason, medical treatment options and to obtain medical clearance for hearing aids, if needed, Stromberg says. The infant also will be referred to a pediatric habilitation audiologist who will determine and fit the appropriate type of amplification. Additionally, a referral to city and state support services would be completed.

“Hearing loss is an unexpected obstacle but not impossible to overcome,” Stromberg says. “When hearing loss is identified at a very early age, the child has every opportunity to be successful with consistent use of hearing aids and good educational and social support.”

To learn more about Universal Infant Hearing Screening and the audiologists at the Center for Oto-Neurology, visit our website

  • St. Joseph's Hospital Campus: 11705 Mercy Blvd., Savannah, GA 31419, (p) 912-819-4100
  • Candler Hospital Campus: 5353 Reynolds St., Savannah, GA 31405, (p) 912-819-6000
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St.Joseph's Hospital Campus: 912-819-4100

Candler Hospital Campus: 912-819-6000