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Giving Your Baby a Sound Beginning

A short introduction for parents about why the hospital is doing newborn hearing screening.

National Center for Hearing Assessment & Management (NCHAM) - 6 minutes

Types of Hospital or Outpatient Screenings

Otoacoustic Emissions (OAE) - otoacoustic emissions can be tested using TOAEs - transient otoacoustic emissions - or DPOAEs - distortion product otoacoustic emissions. This test is often used as a screening measure to see if the child is hearing through the level of the cochlea, the small snail-shaped part of the ear. A small probe tip is placed in the baby's ear canal. The probe sends a signal to the cochlea. If the cochlea is working the way it should a echo is measured by the probe. If the child has debris in the ear canal, fluid in the middle ear or a hearing loss an echo will not be measured.

Automated Auditory Brainstem Response Evaluation (AABR) - a screening tool used for infant who have reached at least 34 weeks conceptional age until the child turns 6 months of age. The screening is completed similarly to the ABR however only one pitch at one loudness is presented in each of the child's ears. Then the child's response is compared to a template of children with normal hearing. If the responses match the child passes the screening if the response does not match the child is referred for further testing.

Can a Baby Pass the Test and Still Have Hearing Loss?

Although it is rare, a baby can pass a hearing screening and still have hearing loss. Some mild hearing losses or losses that affect only some pitches may not be picked up by the screening test.


Hearing Development Checklist

A checklist to monitor your baby's hearing health. If you ever have a concern talk to your baby's doctor. 

Speech Sound Development


Speech sound development occurs at different ages.  This speech Sound development chart gives you an idea of what sounds are mastered at what age.  It is important to understand that if your child is deaf/hard of hearing that does not mean we do not expect "typical" speech sounds.  This may take therapies and time but if your family has chosen a communication mode that includes spoken language, make sure that the professionals working with your child are aiming for "typical" development.   Be sure to work with your child's team to determine how they are doing toward these sounds.

speech sound acquisition chart "contains average ages children learn to pronounce consonants (English Speakers).  2-3 years - p, b, m, n, d, t, k, g, w, ng, f, y  4 years - l, j, ch, s, v, sh, z 5 years - r, zh, th voiceless  age 6 th (voiced)

 Risk Factors for Loss of Sensorineural Hearing Over Time

Some babies may have hearing within normal limits at birth but develop a loss of sensorineural hearing over time. 

   This condition may be the result of:

  • spending 48 hours or more in the Neonatal Intensive Care Unit (NICU)

  • having a condition (neurological disorder) that is associated with hearing loss (check with your health care provider)

  • exposure to infection before birth

  • head, face, or ears may be shaped or formed in a different way than usual

  • infection around the brain and spinal cord caused by bacteria (bacterial meningitis)

  • bad jaundice (hyperbilirubinemia) in babies that needed a special procedure (exchange transfusion)

  • bad injury to the head (that needed medical care)

  • ear infections with fluid that last a long time

If your infant has risk factors for a progressive loss of sensorineural hearing of if you have concerns about your child’s responses to sound or speech development, you should contact your baby's doctor and an audiologist.


One of the earliest auditory skills to see in your baby is localization, the ability to find the source of a sound. We hear through two ears (binaurally), therefore we can localize sounds with extreme accuracy.

During the first year, your baby will refine listening skills and should alert to and look for the sources of common sounds around the home, such as a ringing doorbell or telephone, slamming door, children playing, a musical toy and speech.


Signs of Hearing Loss

These signs do not necessarily mean that your child has a hearing problem. If your child exhibits one or more of the following consult your doctor:

  • Your child's speech is not progressing

  • Your child has difficulty identifying where sounds come from.

  • Your child does not startle to loud sounds.

  • Your child's ability to produce and understand spoken language is delayed for their age.

  • Your child appears to not pay attention.

  • Your child has frequent ear infections.


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