Window to a world of sound For newborns with hearing loss, early screening can lead to quick intervention
Four-year-old Betty Schottler starts each morning with the same six sounds: (m), (ah), (oo), (ee), (sh) and (s).
Her mom makes the sounds first, then Betty repeats them to check that her cochlear implant is working.
Betty was born profoundly deaf and got her first set of glittery rainbow hearing aids at 6 weeks old. Then, before her 1st birthday, she had surgery to place a cochlear implant in the bone behind her ear. The device sends signals to the brain, and the brain recognizes those signals as sound.
For Betty and thousands of
| children born in the U.S. with a hearing impairment, newborn screening is the first step toward introducing them to the world of sound.
Most babies in the U.S. get screened in the first few days after birth; in 2016, up to 98% of newborns were tested, according to the Centers for Disease Control and Prevention.
Typically, a hearing screener comes to the mother’s bedside and tests the baby in the bassinet. It works best when the child and the environment are quiet.
“A lot of times we swaddle the baby so that the baby is comfortable and can sleep, put the probe in the ear and that test doesn’t take more than five to seven minutes per ear,” said Irene Sideris, a pediatric audiologist with Children’s National Hospital, which is based in Washington, D.C.
The tiny probe looks like an earbud or infant thermometer. It emits a low clicking noise, which stimulates tiny hairs in the baby’s inner ear and makes them vibrate. The test measures the echoes from those vibrations, or otoacoustic emissions.
Most babies pass, and that’s the end of their testing.
Others newborns get “referred,” meaning the doctor recommends they be screened again as soon as possible, usually within days or weeks.
Newborn Betty Schottler didn’t pass.
“They told us that she ‘referred.’ They say referred instead of fail,” said her mom, Jen Schottler.
Sideris said a baby might not pass the initial hearing screening for many reasons, including residual fluid or debris in the ears.
The CDC estimates 1.7% of babies were referred for additional screening in 2016. Hearing loss is the most common congenital condition in the U.S.
Three in 1,000 infants are born with it, according to the American Academy of Pediatrics.
When the hearing screener came to test Betty, Jen Schottler said the whole thing happened quickly.
“Newborns get screenings for a million things, and it’s one of them,” Schottler said. “I just remember receiving the piece of paper with the results and the list of audiologists to reach out to.”
Follow-up tests showed that Betty has profound hearing loss and was, therefore, a candidate for the cochlear implant. Trained as a speech pathologist, Schottler knew that if she wanted Betty to start hearing and learning spoken language, the clock was ticking.
Other parents choose to have their child learn sign language or other ways of communicating.
“Every family’s different,” Schottler said.
In 2000, the federal government set a goal to have all children screened in the first month of life and to have kids with hearing loss identified and diagnosed by their third month. The government’s goal is to get kids enrolled in early intervention programs by the time they’re 6 months old.
Before screenings were so