May 1, 2020

A parent’s guide to…..

The Universal Newborn Hearing Screening (UNHS)
What is the Universal Newborn Hearing Screening?
There are a series of tests done at the hospital/birthing center after your baby is born. These
tests are done to make sure that your baby is healthy. One of them is a Newborn Hearing
Screening. This test is done to ensure that your baby has normal hearing at birth.

Why is it important for babies to have a hearing screening at birth?

About 4 out of every 1000 babies born in India have some degree of hearing loss at birth. This
number is higher with in the NICU (Neonatal Intensive Care Unit). If hearing loss is not detect-
ed and treated early, it can have a significant impact on speech, language and cognitive de-
velopment. Over time, such a delay can present severe learning difficulties and negatively im-
pact the child’s academic performance.

How is the hearing of a newborn baby tested?

There are two tests that are use to screen the hearing of an infant. These tests may be used in
combination or independently depending on the birthing facility and the birth history of your
child.

- Automated Auditory Brainstem Response (AABR)— Electrodes are placed on the baby’s
head to measures how the hearing nerve and brain respond to sounds. These sounds are a
series of tones that are played through earphones into the baby's ears.

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- Otoacoustic Emissions (OAE)—Clicks/tones are played in the baby’s ear canal and the re-
sponse is measured by a tiny probe. This probe measures the sound waved produced in the
baby’s ear canal.

Both these tests are painless and only take a few minutes to test.

What if your child does not pass the UNHS?

The criteria for testing during Newborn Hearing Screening is a “Pass” or a “Refer”. Refer does
not automatically mean that your child has a hearing loss. Some times the presence of vernix
(waxy white substance found coating the skin of newborn human babies) in the ear canal, flu-
id in the middle ear, excessive baby movement, or crying can get in the way of testing. If
however the baby does not pass on a repeat test then he/she will need further diagnostic
evaluations to determine the degree of hearing loss in that ear.

If you are an expecting mother what should you do?

A lot of hospitals in India are now providing UNHS but that is certainly is not the case every-
where. It is best to enquire with your birthing facility to make sure they will screen your baby's
hearing. If they don’t provide this service you can get your baby’s hearing tested by seeing an
audiologist or an otolaryngologist (Ear Nose and Throat physician) who can provide this test.
Major hospitals may provide this service in their outpatient audiology or otolaryngology de-
partment. You can also reach out to your baby’s pediatrician and they may be able to help
you connect with a hearing professional.

Make sure to look into this ahead of time so that when your baby arrives all you have to do is
to take your baby to the appointment before he/she turns a month old.

What if your baby has been discharged form the hospital/birthing center
without getting a UNHS?
If your baby wasn’t screened for hearing before being discharged from the birthing facility it is
important to get this test done before the baby turns a month old. This can be done by reach-
ing out to an audiologist or an otolaryngologist (Ear Nose and Throat physician) who can pro-
vide hearing screening for babies.

Is UNHS being done in other countries?

All babies born in the United States receive Newborn Hearing Screening. Most of the time the
hearing screening is done within a day or two after the baby is born before he/she is dis-
charged from the hospital. The Joint Committee Of Infant Hearing (JCIH) recommends a 1-3-6
guideline whereby the baby is screened for hearing before 1month of age, diagnosed for any
existing hearing loss by 3 months of age, and provided with Early Intervention or treatment by
6 months of age.

But what if your baby turns to sounds? Doesn’t that mean that he/she is al-
ready hearing?
Babies may respond to loud noises by startling or turning their heads toward the sound but
this does not mean that the baby can hear every sound, especially soft sounds. Even a mild
hearing loss in one ear can affect the normal development of speech and language. Hence
the UNHS is the gold standard for identifying hearing loss in infants.

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UNHS during CoVID 19 or other calamity.

If your baby has already been discharged from the birthing facility without getting a newborn
hearing screening PLEASE do not panic. Also due to the lockdown it may not be possible for
you to take your baby to a professional at this time. In this situation, it is best to wait until it
is safe to go out. Please know that you and your baby's health is of utmost importance.
Once things get better and it is safe to go out make it a priority to get your baby's hearing
tested but until then it is best to stay home and stay safe.

Newborn Hearing Screening a key role in the life of a child with hearing loss.
An undiagnosed hearing loss can create developmental delays. If a child with
hearing loss is not diagnosed early on, slow development of speech and lan-
guage can occur. This can create difficulties in family communication as well as
academic and social problems. The child is deprived of appropriate opportuni-
ties to learn language and as a result, he/she will fall behind the hearing peers
in language, cognition and social-emotional development. Such delays may re-
sult in lower education and negatively impact employment levels in adulthood.

By Jennie Kapadia, Au.D.

Pediatric Audiologist