Hearing loss in newborns can be detected with Pennsylvania’s Hearing Screening and Intervention Program

Two to three out of every 1,000 children are born with permanent childhood hearing loss. Early detection is crucial. Most health systems test newborns within their first day or two after birth, explains Jill McClelland, AuD, CCCA, manager of audiology at Penn State Health. In Pennsylvania, newborns’ hearing is screened through the Pennsylvania Hearing Screening and Intervention program—a program that reportedly tests babies within their first 30 days of life.

Jill S. McClelland, AuD, CCCA, Penn State Health

“Sometimes, the hearing loss is genetic, and it can be hard to predict just by observing your family. Hearing loss is a recessive trait carried on the connexin 26 gene,” explains McClelland. “So your family may not even realize it’s there until along comes your first child with a difference.”

Experts say that non-genetic illnesses in the mother can also cause hearing loss. “A human ear canal generally forms in a fetus between week 20 and 25, so infections in that time span can be worrisome,” McClelland said. Reportedly in years past, rubella was a frequent culprit, but vaccines mostly tamped it down. These days, cytomegalovirus, or CMV, is often a problem. “We’ve seen an uptick,” McClelland said. It often has no symptoms in an adult, but in a baby, CMV can destroy a child’s ability to hear.”

Other causes are more benign, experts say. McClelland explains that doctors sometimes discover amniotic fluid in a baby’s ear canal, like they’ve had a dip in the pool and some of the water became stuck. Once it’s removed, the hearing returns to normal.

But not every post-birth discovery is as simple. For example, a rare, genetic disorder called Usher Syndrome can cause hearing and vision loss over a period of years.

Some children lose their hearing the same way many adults lose theirs―through external, environmental factors. Loud noises, for example. “I personally have seen children where the cause has been video games and headphones,” McClelland said.

The National Institutes of Health recommends two tests for a newborn’s hearing. The otoacoustic emissions tests involve inserting an earphone into the newborn’s ear canal that plays sounds and tests for echo responses. The auditory brainstem response tests include affixing electrodes to the child’s head and inserting earphones into the ears, and a machine measures the brainstem’s response.

However, testing doesn’t guarantee the other key ingredient of the screening program’s success—follow up visits. If the screening test suggests hearing loss, McClellan advises that parents must make follow-up visits with an audiologist to determine why.

“In the plain community, additional factors, such as transportation or cultural and religious beliefs, may make it hard to convince parents to follow up,” McClelland shares. “That’s particularly worrisome in a community where some studies have shown a possible genetic predilection for hearing loss.”

Some parents may ask “What if testing doesn’t catch [hearing loss]?”

“Follow your gut,” McClelland advises. “A hearing screening is just a screening. Watch for possibilities that a child might be struggling to hear. If you can’t sneak up on and startle a child easily, it might be because something is wrong.”

“Usually, hearing lost, is gone forever―but that doesn’t mean there’s no hope,” adds McClellan. “Medical science has made strides in its ability to supplement hearing. Children as young as nine months old can receive a cochlear implant, for example, which, using surgically implanted microphones, speech processors and transmitters, can improve the understanding of language and help with a child’s development.”

As of December 2019, approximately 118,000 cochlear devices have been implanted in the US, and 65,000 of the recipients were children.

Source: Penn State Health

Images: Penn State Health; Photo 41857983 © Rafael Ben Ari | Dreamstime.com