Newborn Hearing Screening: When and How Is It Performed?

Created: 10.07.2024 · Last Updated: 17.08.2026 · Category: Audiology · Prepared by the Academic Hospital Web and Editorial Board.

Hearing plays an essential role in the development of speech, language, learning and social communication. Because hearing loss in newborn babies may not be obvious from observation alone, systematic hearing screening is important.

What Is Newborn Hearing Screening?

Newborn hearing screening is a quick and painless assessment performed shortly after birth to determine whether the baby's auditory system responds appropriately to sound.

The purpose of screening is not to make a definitive diagnosis of hearing loss. It identifies babies who may require repeat screening or a comprehensive diagnostic audiological evaluation.

Screening is not the same as diagnosis. A baby who does not pass the screening does not automatically have permanent hearing loss.

Why Is Newborn Hearing Screening Important?

Babies begin listening to speech and environmental sounds long before they learn to speak.

Undetected hearing loss during infancy can affect:

  • Speech and language development
  • Communication skills
  • Learning
  • Social and emotional development

Earlier identification and appropriate intervention can help support a child's communication and language development.

When Should Hearing Screening Be Performed?

Newborn hearing screening is ideally completed before the baby leaves the birth hospital.

International Early Hearing Detection and Intervention programmes recommend that all babies complete hearing screening before 1 month of age.

If screening cannot be completed before discharge, it should be arranged as soon as possible rather than being postponed for several months.

How Is Newborn Hearing Screening Performed?

Newborn hearing screening is painless and does not require the baby to actively respond to sounds.

It is generally easiest to perform while the baby is asleep or calm.

Depending on the screening method, a small probe or earphone is placed in or around the ear. With AABR screening, small electrodes are also placed on the baby's head to record electrical responses to sound.

The test usually takes only a short time. Movement, environmental noise or temporary fluid in the ear may occasionally make repeat testing necessary.

What Are AABR and OAE?

Automated Auditory Brainstem Response – AABR

AABR measures electrical responses generated by the auditory nerve and brainstem following sound stimulation.

Small electrodes placed on the baby's head record these responses automatically.

Otoacoustic Emissions – OAE

OAE measures sounds generated by the outer hair cells of the inner ear in response to auditory stimulation.

It is a quick and painless test. However, because it mainly assesses cochlear function, OAE alone may not identify certain neural hearing disorders such as auditory neuropathy.

What Does It Mean If a Baby Does Not Pass Hearing Screening?

Not passing the first screening does not necessarily mean that the baby has permanent hearing loss.

Possible explanations include:

  • Temporary fluid or debris in the ear canal
  • Middle-ear fluid
  • Movement during testing
  • Environmental noise
  • Permanent or temporary hearing loss

The baby should therefore complete the recommended repeat screening or diagnostic evaluation without unnecessary delay.

A failed screening should not simply be postponed until the child is older. Follow-up testing should be completed within the recommended early-hearing-detection timeline.

How Is Hearing Loss Diagnosed?

Babies who do not pass screening require a more detailed audiological assessment to determine whether hearing loss is present and, if so, its type and degree.

Testing may include:

  • Diagnostic ABR
  • Otoacoustic emissions
  • Tympanometry and other acoustic immittance measures
  • Ear, Nose and Throat examination
  • Age-appropriate behavioural hearing tests

Additional medical, genetic or imaging investigations may be appropriate in selected children to investigate the cause of confirmed hearing loss.

What Is the 1-3-6 Benchmark?

Age Goal
Before 1 month Complete newborn hearing screening
Before 3 months Complete diagnostic audiological evaluation when screening is not passed
Before 6 months Begin appropriate early intervention when permanent hearing loss is confirmed

Programmes capable of meeting the 1-3-6 benchmarks are encouraged to move toward even earlier 1-2-3 targets where possible.

What Happens If Hearing Loss Is Confirmed?

When permanent hearing loss is confirmed, management is individualised according to the type and degree of hearing loss and the baby's developmental needs.

Options can include:

  • Hearing aids
  • Early auditory and communication intervention
  • Speech and language monitoring
  • Audiology and ENT follow-up
  • Cochlear implant assessment in appropriate children
  • Family-centred communication and early-intervention programmes

Not every child with hearing loss requires the same device or treatment. Management is based on the individual hearing profile and family-centred goals.

Which Babies Have a Higher Risk of Hearing Loss?

Hearing loss can occur even when no known risk factor is present, which is why universal newborn screening is important.

Factors that may require closer audiological follow-up include:

  • Family history of permanent childhood hearing loss
  • Prolonged neonatal intensive-care admission
  • Certain congenital infections
  • Some craniofacial abnormalities
  • Genetic syndromes associated with hearing loss
  • Certain serious infections such as meningitis
  • Head trauma
  • Exposure to selected ototoxic medicines

Can Hearing Loss Develop After a Baby Passes Newborn Screening?

Yes.

Newborn screening reflects hearing status around the time the test is performed. Some types of hearing loss can develop or progress later in childhood.

Further hearing assessment is appropriate if a child:

  • Does not respond consistently to sounds
  • Does not turn when their name is called at an appropriate developmental age
  • Has delayed speech or language development
  • Appears to lose previously observed responses to sound
Passing newborn screening does not rule out hearing loss developing later. Hearing and communication development should continue to be monitored throughout childhood.

What Is the Purpose of Newborn Hearing Screening?

The main purpose is to identify infants with permanent hearing loss as early as possible and minimise delays between screening, diagnosis and intervention.

Early identification can support timely planning of audiological management, communication development, rehabilitation and family education.

Assess Your Baby's Hearing Early

Babies who do not pass newborn hearing screening or who have concerns regarding hearing development should receive timely audiological assessment.

Frequently Asked Questions

What is newborn hearing screening?
Newborn hearing screening is a quick and painless assessment that checks whether a baby's auditory system responds appropriately to sound. It is intended to identify babies who may require further testing rather than make a definitive diagnosis.
When should newborn hearing screening be performed?
Screening is ideally completed before the baby leaves the birth hospital. International Early Hearing Detection and Intervention programmes recommend completing screening before 1 month of age.
Does newborn hearing screening hurt the baby?
No. Newborn hearing screening is painless and is usually performed while the baby is sleeping naturally or resting quietly.
Does not passing the screening mean my baby definitely has hearing loss?
No. Temporary ear fluid, movement or testing conditions can also affect the result. However, follow-up screening or diagnostic audiological evaluation should be completed promptly.
What is the 1-3-6 benchmark?
The 1-3-6 benchmark means completing hearing screening before 1 month, diagnostic audiological evaluation before 3 months when screening is not passed, and beginning appropriate early intervention before 6 months when permanent hearing loss is confirmed.
What is AABR?
AABR is an automated hearing-screening method that records electrical responses from the auditory nerve and brainstem after sounds are presented to the baby's ears.
Does every baby with hearing loss need a hearing aid?
No. Management depends on the type and degree of hearing loss and the child's individual needs. Options may include hearing aids, early rehabilitation, audiology and ENT follow-up or cochlear implant assessment in appropriate children.
Can hearing loss develop after a baby passes newborn screening?
Yes. Some hearing losses develop or progress later. A child should have another hearing assessment if there are concerns about responses to sound or speech and language development, even if newborn screening was passed.
Academic Hospital note: Not passing newborn hearing screening does not itself confirm permanent hearing loss, but follow-up should not be delayed. Early screening, timely diagnosis and appropriate early intervention are important for supporting communication and language development. You can book an appointment.

References

  1. Academic Hospital. Newborn Hearing Screening Tests
  2. Republic of Türkiye Ministry of Health. Clinical Guideline for Hearing Loss in Children, 2026
  3. Centers for Disease Control and Prevention. Screening for Hearing Loss
  4. Centers for Disease Control and Prevention. Newborn Hearing Screening
  5. Joint Committee on Infant Hearing. Position Statements and Early Hearing Detection and Intervention Guidance