Identifying Infants at Risk for Hearing Loss
Lenore Holte, Supervisor, Speech Pathology and Audiology Services
University Hospital School, University of Iowa Hospitals and Clinics
Recent research has demonstrated that early
identification and treatment of hearing loss
in infants is crucial. As a result, Iowa and
several other states have implemented programs
of universal hearing screening for newborns.
But even infants who pass the newborn hearing
screen can be at risk for progressive hearing
loss. The indicators below can tell you whether
an infant in your care needs to be referred to
an audiologist for further hearing evaluation.
Most children with hearing loss can develop language skills that are not substantially different from those of other children IF:
- Hearing loss is identified before the child is 6 months old
- Professional intervention begins immediately
- The child uses appropriate hearing aids
For newborns from birth to 28 days old, the indicators below are associated with
sensorineural or conductive hearing loss:
In utero infection, such as cytomegalovirus (CMV), rubella, syphilis, herpes,
- An illness or condition requiring admission of 48 hours or longer to an NICU, including
hyperbilirubinemia at a serum level requiring exchange transfusion, persistent pulmonary hypertension,
and conditions requiring the use of extracorporeal membrane oxygenation (ECMO).
- Other findings associated with a syndrome known to include hearing loss
- Craniofacial anomalies
- Family history of permanent childhood hearing loss
When any of these indicators exist, the primary care provider should refer the child to an audiologist for hearing evaluation.
Later-onset risk indicators are usually identified in the medical home during early well-baby visits. The hearing of infants with any of the following indicators should also be monitored every six months:
Parental or caregiver concern about hearing, language use, or
- Infections associated with sensorineural hearing loss, including bacterial meningitis.
- Presence of syndromes or conditions associated with progressive hearing loss, such as neurofibromatosis,
osteopetrosis, Usher syndrome, Hunter syndrome, Friedreich's ataxia, or Charcot-Marie-Tooth syndrome.
- Head trauma.
- Recurrent or persistent otitis media with effusion for at least 3 months.
Again, when any of these indicators exist, the primary care provider should refer the child to
an audiologist for hearing evaluation.
The hearing of a newborn with any of the early- or late- onset indicators listed above should be closely monitored at least every six months until the child is three years old.