About this factsheet

This factsheet is part of our healthcare range. You should read this factsheet if you are a parent or a carer of a newborn baby. We use the term ‘deaf’ throughout to refer to all kinds of hearing loss.

Read this factsheet to find out:

Why should babies be screened for deafness?

Every year in the UK, one or two babies in every thousand is born with a level of deafness in one or both ears that affects their understanding and development of spoken language. About half of these will be severely or profoundly deaf. It’s important to know that your baby is deaf as soon as possible so that you can give them the best possible chance to develop language and communication skills at the same rate as hearing children.

If your child’s deafness goes undetected, it may slow down their social and educational development and is likely to go on to affect many areas of their progress.

What is the newborn hearing screening programme (NHSP)?

The newborn hearing screening programme (NHSP) is a way of screening newborn babies for deafness within the first few hours, or days, of life. It’s now available in England, Scotland, Wales and Northern Ireland. Visit the the NHSP (external link, opens new browser window) website for further information on the programme in England and links to the programmes in other UK countries.

What information can I expect to receive?

You will receive information about the newborn hearing screening procedure before and after your baby is born. You can also get a video about screening that has subtitles and is sign language interpreted. The video is available to view on the NHSP (external link, opens new browser window) website.

If you give birth in a hospital, and your area runs a hospital-based screening service, specially trained staff will probably test your baby as part of your maternity care before you go back home after the birth.

In some places, newborn hearing screening is done as part of a community screening service. This will happen when your baby is a few days old. It’s usually done by your health visitor and may take place either in your own home or at a local clinic.

If your baby is born at home, or didn’t have the test at birth, testing may be carried out at home, your local GP’s surgery or health clinic.

A hearing screening test cannot be done without your permission.

What happened before newborn screening was introduced?

Before newborn screening, babies had the infant distraction test, but not until they were seven or eight months old. The test was done by a health visitor, often at the baby clinic.

During the test, your baby sat on your lap while the health visitor stood behind you and made a series of noises and sounds using their voice and specialist equipment. Another member of staff monitored whether or not your child turned towards the sounds, showing that they had heard them. The test couldn’t be done sooner because your baby needed to be able to sit up and turn their head to look at something interesting (to show that they had heard the test sounds).

What is the role of screening?

Screening tests are only done to identify those babies who may be deaf and should have further tests. Screening does not confirm whether your baby is deaf, nor does it give information about the level or cause of deafness. Further tests will give a clearer picture of your baby’s hearing.

Whatever the results of tests done early in life, it’s important that any signs of deafness that your baby shows later on are followed up and checked straight away. It’s also important that any concerns you have about your child’s hearing are taken seriously and investigated properly. Occasionally, babies who are born with normal hearing can become deaf later. If you have any concerns about your child’s hearing, you should tell your GP or health visitor.

Why was newborn hearing screening introduced?

Because research shows that children identified before six months of age, and whose parents or families receive high-quality information and support, are happier and do better than children whose deafness is identified later. Newborn hearing screening checks all children within the first few days of life and is also more reliable than the infant distraction test.

As a result of screening, the average age when children are identified as being deaf has fallen from 20 months to three months.

Why is it important to screen so early?

Of the 800-900 deaf children born each year in the UK, the infant distraction test used in the past failed to identify about 400 by the time they were 18 months old. Two hundred of these children had still not been identified by the time they were three-and-a-half years old. This meant that their deafness was not detected before the critical early stages of their development.

Eight months is just too late to start testing for deafness. A more reliable test than the infant distraction test – and one that can be done earlier in a baby’s life – had been needed for some time. If your child’s deafness is undetected, they will not get the information they need to develop communication and language skills, and knowledge of the world, at a critical stage in their development.

As soon as you know that your child is deaf, you can take positive action to improve the range and quality of information they receive. It’s now possible to make a very early start. Hearing aids can be fitted from two or three months old and families who want to can start using sign language earlier. You’re also given more time to think about your options.

Parents of deaf babies say it’s helpful to know that their child is deaf as early as possible – even when this knowledge brings challenges and difficult choices. Ninety per cent of deaf babies are born in families with no history of deafness, so early support is important. These families often have no experience of deafness and therefore need access to reliable information and support.

What will happen when my child is screened?

Newborn hearing screening won’t hurt your child. It can even be done as they sleep. The test measures the function of the cochlea (sense organ) in the inner ear. The person carrying out the test inserts a tiny probe just inside your baby’s ear. The probe makes a small sound. If your baby’s inner ear responds normally, the ear produces an ‘echo’ in response to the sound, and the probe picks this up. The test is very quick and gives results immediately. Both ears are checked.

If your baby’s ear does not produce an echo, it does not mean that your baby is deaf. It just means that more tests are needed to confirm whether or not your baby’s ear is responding normally. These further tests are equally simple and painless, but give more detailed information about your baby’s hearing.  Sometimes the echo can’t be recorded due to a temporary blockage in the middle or outer ear, so the test may need to be repeated at a later date or a different type of test may be used.

If the echo can’t be recorded, or your baby has been in the special care baby unit, a second test will be done – the automated auditory brainstem response (AABR). This test involves recording the brain activity in response to sounds that your baby hears through special headphones. There are small discs attached to your baby’s head. Your baby will need to be asleep for this test, which usually takes about half an hour. It’s safe, painless and the results will be available immediately.

What kind of support can I get if my baby is deaf?

You have a range of options and services as a family. These options partly depend on the level of your baby’s deafness. The way you think about the different choices, and which seem best for your child, may change over time. Whatever you decide, remember you’ll be able to get support from a range of agencies from the time that your child is identified as deaf:

What is RNID’s view of newborn hearing screening?

RNID welcomes the introduction of newborn hearing screening throughout the UK. As deaf babies are identified earlier – in the first few months of life – it’s important that family-friendly services for families with very young deaf children are developed. As soon as a family learns that their baby may be deaf, they need ready access to audiology, information and support services that respond quickly and give them the answers and help they need.

References

"A critical review of the role of neonatal hearing screening in the detection of congenital hearing impairment", A Davis, J Bamford et al, Health Technology Assessment, Vol 1, No.10 (1997).

"Language of early-and-later identified children with hearing loss", C Yoshinaga-Itano et al, Paediatrics, 5: 161-1171 (1998).

Where can I get further information?

The National Deaf Children’s Society

NDCS supports all deaf children, young deaf people and their families in overcoming the challenges of childhood deafness.

NDCS, 15 Dufferin Street, London EC1Y 8UR
Information Line: 0808 800 8880
Textphone: 0808 800 8880
Fax: 0207 251 5020
Email: helpline@ndcs.org.uk
Website: The National Deaf Children’s Society website (external link, opens new browser window)

Useful websites

The Newborn Hearing Screening programme website (external link, opens new browser window) gives information on the newborn hearing screening programme in England.

The Early Support (external link, opens new browser window) website gives information about government programmes to improve services for families with disabled children under three, including families with deaf children.

The Deafness at Birth (external link, opens new browser window) website has information for professionals who work with deaf babies and their families. Families with a deaf child may find some information on this website useful, including links to family friendly websites.

Further information from RNID

The RNID Information Line offers a wide range of information on many aspects of deafness and hearing loss.

RNID Information Line, 19-23 Featherstone Street, London EC1Y 8SL
Telephone: 0808 808 0123
Textphone: 0808 808 9000
Fax: 020 7296 8199
SMS 0780 0000 360 (supported by Lloyds TSB)
Email: informationline@rnid.org.uk