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The Newborn Hearing Screening Programme ( NHSP) aims to identify any hearing impairment in newborn babies. NHSP offers all parents in England the opportunity to have their baby’s hearing tested shortly after birth.

On average one to two in a thousand babies are born with a hearing loss in one or both ears. The hearing screen will identify those babies with a hearing loss at a very early stage. This is known to be important for the development of the child. It is important to screen all babies even if no one in your family has a hearing loss. Most babies born with a loss are from families with no history of hearing loss.

If your baby has not had to spend time on the special care baby unit, a neonatal hearing screener will carry out the hearing screen on the post-natal ward.  It is a quick and pain free test called an OAE-Oto-Acoustic Emission.

What takes place during the screening?

It involves a clicking sound being played into the ear via a soft tip.

If a clear response is seen in both ears, then your baby has passed the screen and you will be given a checklist of sounds that a baby should make and respond to as they develop.

If there is no clear response in one or both ears, it does not automatically mean that there is a hearing loss. It could just mean that the testing conditions were not adequate, such as your baby not settling or excessive background noise.

The hearing screener will arrange a time for the test to be repeated. If no response is obtained the second time a different type of test called an AABR is required. Leads will be gently attached to your babies head and shoulders and a clicking sound will be delivered to the ears via small earphones. If a clear response is still not obtained, this again does not mean that baby necessarily has a hearing loss, but an appointment will be made within the next 4 weeks to have a more in depth assessment in the audiology department.

The majority of referrals do turn out to have normal hearing but it is vital that this appointment is attended.

What next?

If your baby has had to spend more than 48 hours on the special care baby unit, the hearing screener will carry out both an OAE and AABR screen.

If a clear response is obtained on AABR in both ears then you will be given the checklist to ensure that baby is responding appropriately to sound as they develop. Babies with a risk factor of late onset hearing problems such as craniofacial abnormalities, a syndrome relating to hearing loss etc. will be given an appointment for a follow up test at 8 months of age.

If no clear response is seen on AABR in one or both ears then an appointment within 4 weeks will be arranged for a more in depth assessment in the audiology department.

Further testing

Many babies need to be referred to their local audiology department for further testing because the screen did not show a strong enough response. Being sent for further tests does not always mean that your baby has a hearing loss, although there is the possibility. Therefore it is important to attend your baby’s appointment, even if you think they are responding to sound. Finding out if there is a problem early on in life, will mean that your baby receives specialised care from the start. This is important for your baby’s development.

Testing will take place in a sound proof room. The appointment may take a while, and we recommend that you allow about 2 hours for the appointment, though it may be quicker than this. Responses can only be obtained if your baby is sound asleep, which is why the test may take a long time, so try not to let your baby sleep before the test. Sometimes feeding and changing your baby just before the test will also help them to settle better. Try not to bring any other children to the appointment, as this might provide unwanted distractions. 

Three small sensors will be placed around your baby’s head. A small insert, which produces a frequency specific sound is placed into the baby’s ear and a computer measures the responses.

After the test, the audiologist will be able to give you the results if possible, or re-book your baby for further testing if not enough information has been obtained at the first appointment.