Universal Newborn Hearing Screening (UNHS)

The primary aim of universal newborn hearing screening (UNHS) program is to identify babies who might have hearing loss and who require further evaluation. A secondary objective is to identify newborns with high risk factors or medical conditions that can cause late-onset of hearing loss and to create a protocol for continued monitoring of their hearing thresholds until they reach 4-5 years of age (critical age period or neural plasticity period). Most UNHS guidelines follow the 1-3-6 rule, which includes hearing screening completion by 1 month of age, diagnosis of any hearing loss by 3 months of age, hearing aid selection and fitting within 6 months of confirmation of hearing loss.

Passing a newborn hearing screening does not mean that the baby has normal hearing sensitivity across the frequency range. Because minimal to mild and frequency-specific hearing losses are not assessed by newborn hearing screening programs, babies with these type of hearing losses may pass a hearing screening but may still require monitoring of their hearing sensitivity and speech and language developmental milestones because early identification of hearing loss can minimize speech and language delays, dysfluent speech and deaf-mutism in children.

The newborn hearing screening test helps identify babies who have permanent hearing loss as early as possible. This means parents can get the support and advice they need right from the start.

Hearing loss in babies

1 to 2 babies in every 1,000 are born with permanent hearing loss in 1 or both ears. This increases to about 1 in every 100 babies who have spent more than 48 hours in intensive care (NICU). Most of these babies are born into families with no history of permanent hearing loss. Permanent hearing loss can significantly affect babies’ development. Finding out early can give these babies a better chance of developing normal language, speech, and communication skills. It will also help them make the most of relationships with their family or carers from an early age.

When is the newborn hearing test done?

Babies as young as 1 or 2 days old can be tested for hearing loss. If you give birth in a hospital, you may be offered a newborn hearing test for your baby before you’re discharged. Otherwise it will be done by your audiologist. Please visit your nearest audiology clinic and consult your audiologist for more details on the newborn hearing screening test. Ideally, the test is done in the first 4 to 5 weeks, but it can be done at up to 3 months of age and if required right through the growing ages (from 3 months to 5 years) until the end of critical age and neural plasticity period.

How is the newborn hearing test done?

The newborn hearing test is called the automated otoacoustic emission (AOAE) test. It takes just a few minutes. A small soft-tipped earpiece is placed in your baby’s ear and gentle clicking sounds are played. It’s not always possible to get clear responses from the 1st test. This happens with lots of babies, and does not always mean your baby has permanent hearing loss.

If the baby does not pass the 1st newborn hearing screening test. It could mean:

  • Your baby was unsettled when the test was done.
  • There was background noise.
  • Your baby has fluid or a temporary blockage in their ear, In these cases, your baby will be offered a 2nd test. This may be the same as the 1st test, or another type called the automated auditory brainstem response (AABR) test.

The AABR test involves placing 3 small sensors (electrodes) on your baby’s head and neck. Soft headphones are placed over your baby’s ears and gentle clicking sounds are played. This test takes between 5 and 15 minutes. Most importantly, these tests will not harm your baby in any way.

If you have any questions or concerns please consult your audiologist at the earliest.