Most children hear and listen to sounds from birth. They 

learn to talk by imitating the sounds around them and 

the voices of their parents and caregivers. But that’s not 

true for all children. In fact, about two or three out of 

every 1,000 children in the United States are born deaf 

or hard-of-hearing. More lose their hearing later during 

childhood. Many of these children may need to learn 

speech and language differently, so it’s important to 

detect deafness or hearing loss as early as possible. 

For this reason, universal newborn hearing screening 

programs currently operate in all U.S. states and most of 

the territories. With help from the federal government, 

every state has established an Early Hearing Detection 

and Intervention program as part of its public health 

system. As a result, more than 95 percent of babies 

have their hearing screened soon after they are born. 

When will my baby’s hearing be 

screened?

Your baby’s hearing should be screened before he or 

she leaves the hospital or birthing center. If you and 

your baby are already home and you haven’t been told 

the results of the hearing screening, ask your doctor. 

If the results indicate your baby may have hearing 

loss, it’s important to work with your doctor to make 

an appointment with a hearing expert, called an 

audiologist (aw-dee-AH-luh-jist), to perform a more 

thorough hearing test before your baby is 3 months old.

How will my baby’s hearing be 

screened?

Two different tests are used to screen for hearing loss 

in babies. In both tests, no activity is required from 

your child other than lying still.

• The otoacoustic emissions (OAE) test shows 

whether parts of the ear respond properly to sound. 

During this test, a soft sponge earphone is inserted 

into your baby’s ear canal and emits a series of 

sounds to measure an “echo” response that occurs 

in normal hearing ears. If there is no echo, it could 

indicate hearing loss.

• The auditory brain stem response (ABR) test 

checks how the auditory brain stem (the part of the 

nerve that carries sound from the ear to the brain) 

and the brain respond to sound by measuring their 

electrical activity as your child listens. During this 

test, your baby wears small earphones in the ears 

and electrodes on the head. Your baby might be 

given a mild sedative to keep him or her calm and 

quiet during the test. 

If your child doesn’t respond consistently to the sounds 

presented during either of these tests, your doctor 

will suggest a follow-up hearing screening and a 

referral to an audiologist for a more comprehensive 

hearing evaluation. If hearing loss is confirmed, it’s 

important to consider the use of hearing devices and 

other communication options before your baby is 6 

months old.

NIDCD Fact Sheet

It’s Important to Have

Your Baby’s Hearing Screened

u.s. department of health & human services ∙ national institutes of health ∙ National Institute on Deafness and Other Communication Disorders hearing balance

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If my child has hearing loss, can hearing 

be improved?

A variety of assistive devices and strategies are helpful 

for children who are hard-of-hearing. Some examples 

of these devices are listed here. An audiologist can 

help you determine whether these or other devices will 

help your child.

• Hearing aids are devices that make sounds louder. 

They are worn in or behind the ear and come in 

several different shapes and sizes. Hearing aids can 

be used for varying degrees of hearing loss from 

mild to severe. An audiologist will fit a hearing aid 

that will work best for your child’s degree of loss. 

Hearing aids can be expensive, so you’ll want to find 

out whether they have a warranty or trial period. 

You’ll also want to talk with your insurance provider 

to understand what, and how much, it will pay for. 

To learn more about different types of hearing aids, 

read the NIDCD fact sheet Hearing Aids.

• Cochlear implants are small electronic devices that 

help provide a sense of sound to people who are 

profoundly deaf or hard-of-hearing. They consist 

of a microphone worn just behind the ear, which 

picks up sound from the environment; a speech 

processor, which selects and arranges the sounds; 

a transmitter and receiver/stimulator, which receive 

signals from the speech processor and convert 

them into electric impulses; and an implanted 

electrode array, which collects the impulses from the 

stimulator and sends them to the auditory nerve.

Not all children who have hearing loss should get 

cochlear implants. Doctors and hearing experts 

think they’re best for children who have such severe 

hearing loss that they can’t benefit from hearing 

aids. Some doctors now recommend the use of two 

cochlear implants, one for each ear, to help children 

identify the directions of sounds. To learn more, 

read the NIDCD fact sheet Cochlear Implants.

Why is it important to have my baby’s 

hearing screened early?

The most important time for a child to learn language 

is in the first 3 years of life. In fact, children begin 

learning speech and language in the first 6 months of 

life. Research suggests that children with hearing loss 

who get help early develop better language skills than 

those who don’t. The earlier you know about a child’s 

hearing loss, the sooner you can make sure your child 

benefits from strategies that will help him or her learn 

to successfully communicate.

How can I recognize if my child 

develops hearing loss later in 

childhood?

Even though the screening tests are designed to detect 

hearing loss as early as possible, some children may 

not develop hearing loss until later in childhood. In 

those instances, parents, caregivers, or grandparents 

are often the first to notice. This means that, even 

if your baby has passed the hearing screening, you 

should still continue to look for signs that your baby is 

hearing well.

For example, during the first year, notice whether 

your baby reacts to loud noises, imitates sounds, and 

begins to respond to his or her name. When your 

child is age 2, ask yourself whether he or she makes 

playful sounds with his or her voice, imitates simple 

words, and enjoys games like peek-a-boo and pat-acake. Is he or she using two-word sentences to talk 

about and ask for things? When your child is age 3, 

notice whether he or she begins to understand “not 

now” and “no more” and follows simple directions. 

The NIDCD fact sheet Your Baby’s Hearing and 

Communicative Development Checklist is a handy 

reference for children from birth to 5 years of age. If 

for any reason you think your child is not hearing well, 

talk to your doctor. 

NIDCD Fact Sheet

It’s Important to Have

Your Baby’s Hearing Screened

hearingbalance

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As children get older, many other devices are 

available to help their hearing. Some devices help 

children hear better in a classroom. Others make 

talking on the phone or watching television easier. 

For example, induction loop systems and FM 

systems can help eliminate or reduce distracting 

noises and make it easier to hear individual voices 

in a crowded room or group setting. Others, such 

as personal amplifiers, are better for one-on-one 

conversations.

How can I help my child communicate? 

There are a variety of ways to help children with 

hearing loss express themselves and interact with 

others. The main options are listed below. The option 

you choose will depend on what you think is best 

for your child. Find out as much as you can about all 

of the choices, and ask your doctor to refer you to 

experts if you want to know more.

• Auditory-oral and auditory-verbal options 

combine natural hearing ability and hearing devices 

such as hearing aids and cochlear implants with 

other strategies to help children develop speech and 

English-language skills. Auditory-oral options use 

visual cues such as lipreading and sign language, 

while auditory-verbal options work to strengthen 

listening skills.

• American Sign Language (ASL) is a language 

used by some children who are deaf and their 

families. ASL consists of hand signs, body 

movements, and facial expressions. ASL has its 

own grammar and syntax, which are different from 

English, but it has no written form. 

• Cued speech is a system that uses handshapes 

along with natural mouth movements to represent 

speech sounds. Watching the mouth movements 

and the handshapes can help some children learn to 

speech-read English; this is especially important in 

discriminating between sounds that look the same 

on the lips. 

• Signed English is a system that uses signs to 

represent words or phrases in English. Signed 

English is designed to enhance the use of both 

spoken and written English. 

• Combined options use portions of the various 

methods listed above. For example, some deaf 

children who use auditory-oral options also learn 

sign language. Children who use ASL also learn to 

read and write in English. Combined options can 

expose children who are deaf or hard-of-hearing to 

many different ways to communicate with others. 

Will my child have a tough time in 

school?

Just like other children, children who are deaf or 

hard-of-hearing can develop strong academic, social, 

and emotional skills and succeed in school. You can 

do a lot to make sure this happens. Find out how 

your school system helps children with hearing loss. 

With your input, your child’s school will develop an 

Individualized Education Program for your child. 

Explore programs outside of school that may help 

you and your child, and talk with other parents who 

have already dealt with these issues. Remember, the 

Individuals with Disabilities Education Act ensures that 

children with hearing loss receive free, appropriate, 

early intervention services from birth throughout 

the school years. Consult the U.S. Department of 

Education, along with other resources below.

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NIDCD supports and conducts research and research training on the 

normal and disordered processes of hearing, balance, smell, taste, 

voice, speech, and language and provides health information, based 

upon scientific discovery, to the public.

hearing, balancesmell, tastevoice, speech, language

NIDCD Fact Sheet: It’s Important to Have Your Baby’s 

Hearing Screened

NIH Publication No. 11-4968

May 2011

For more information, contact:

NIDCD Information Clearinghouse

1 Communication Avenue

Bethesda, MD 20892-3456

Toll-free Voice: (800) 241-1044

Toll-free TTY: (800) 241-1055

Fax: (301) 770-8977

E-mail: nidcdinfo@nidcd.nih.gov

Internet: http://www.nidcd.nih.gov

The NIDCD Information Clearinghouse is a service of the 

National Institute on Deafness and Other Communication 

Disorders, National Institutes of Health, U.S. Department 

of Health and Human Services.

Where can I get more information?

The NIDCD maintains a directory of organizations 

that provide information on the normal and 

disordered processes of hearing, balance, smell, taste, 

voice, speech, and language. Please see the list of 

organizations at http://www.nidcd.nih.gov/directory.

Use the following keywords to help you search for 

organizations that can answer questions and provide 

printed or electronic information on infant hearing 

screening:

• Newborn hearing screening 

• Early identification of hearing loss in children 

• Hereditary hearing loss

For more information, additional addresses and phone 

numbers, or a printed list of organizations, contact:

NIDCD Information Clearinghouse

1 Communication Avenue

Bethesda, MD 20892-3456

Toll-free Voice: (800) 241-1044

Toll-free TTY: (800) 241-1055

Fax: (301) 770-8977

E-mail: nidcdinfo@nidcd.nih.gov

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