Warning signs of infant hearing loss

Two types of newborn hearing screening tests are used: automated auditory brainstem response (AABR) and otoacoustic emissions (OAE). Each takes only five or ten minutes and is perfectly painless. Many babies sleep through the screening.

To do the AABR test, a nurse places sensors, connected to a computer, on your baby's scalp. These sensors measure your baby's brainwave activity in response to little clicking sounds that are transmitted through small earphones.

The OAE test measures sound waves in the inner ear. The screener places a little device in your baby's ear that makes soft clicking sounds, and a computer connected to the device records the ear's response to the sounds.

Some hospitals use both tests, while others screen first with OAE and follow up with AABR if the baby doesn't test well.

Your baby's ability to hear is in large part the foundation of his ability to learn. Hearing screening is the most important early way to tell if a baby's hearing is impaired, but parents and other caregivers also need to be alert for warning signs.

Warning signs: Newborn to 3 months

• doesn't startle in response to a sudden loud sound
• doesn't respond to sounds, music, or voices
• isn't soothed by soft sounds
• doesn't move or wake up at the sound of voices or nearby noises when sleeping in a quiet room
• by 2 months, doesn't make vowel sounds like "ohh"
• by 2 months, doesn't become quiet at the sound of familiar voices
  

Warning signs: 4 to 8 months

• doesn't turn his head or eyes toward a sound he can't see
• doesn't change expressions at the sound of a voice or a loud noise when he's in a quiet setting
• doesn't seem to enjoy shaking a rattle, ringing bells, or squeezing noisemakers
• by 6 months, doesn't try to imitate sounds
• hasn't begun to babble to himself or back at others who speak to him
• doesn't respond to "no" and changes in tone of voice
• seems to hear some sounds but not others
• seems to pay attention to vibrating noises (those that can be felt) but not those that are only heard

Warning signs: 9 to 12 months

• doesn't turn quickly or directly toward a soft noisemaker or "shush"
• doesn't respond to his name
• doesn't vary his pitch when babbling
• doesn't make several different consonant sounds when babbling (m, p, b, g, etc.)
• doesn't respond to music by listening, bouncing, or singing along
• at 1 year, doesn't say single words, like "da-da" and ma-ma"
• at 1 year, doesn't pronounce many different consonant sounds at the beginning of words
• doesn't understand words for common items (like "shoe"), expressions (like "bye-bye"), or commands (like "come here")