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Updated: May 27, 2026
Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
Published on: January 23, 2017
Early detection of hearing loss
1Univ. HNO-Klinik Bonn, Deutschland.
Insights
Universal newborn hearing screening (UNHS) is expanding in Germany, emphasizing timely diagnosis and hearing aid fitting within six months. Effective tracking of infants with hearing loss is crucial for successful intervention.
Area of Science:
- Audiology
- Pediatrics
- Public Health
Background:
- Universal newborn hearing screening (UNHS) is increasingly adopted in Germany, driven by pediatric audiologists' initiatives.
- Implementation varies across federal states, with challenges in equipment, training, and data protection for follow-up.
- Consensus exists on diagnosing hearing loss within three months and initiating hearing aid fitting by six months.
Purpose of the Study:
- To outline the current status and critical components of universal newborn hearing screening in Germany.
- To highlight the importance of efficient follow-up protocols for infants identified with hearing impairments.
- To emphasize the timeline for diagnosis and intervention to ensure optimal outcomes for affected newborns.
Main Methods:
- Screening involves two steps: TEOAE measurement followed by AABR testing in maternity hospitals.
- Follow-up for abnormal results includes repeat TEOAE/AABR by a specialist (Step 1) or BERA diagnostics at a pediatric audiology center (Step 2).
- Hearing aid fitting is recommended by pediatric acousticians specialized in children.
Main Results:
- Early detection and intervention are critical, with established timelines for diagnosis and hearing aid provision.
- The tracking system for infants with hearing loss requires significant administrative effort and adherence to varying data protection laws.
- Successful UNHS implementation relies on coordinated efforts from healthcare professionals, including audiologists, physicians, and acousticians.
Conclusions:
- Effective implementation of UNHS in Germany requires robust tracking systems and adherence to strict diagnostic and treatment timelines.
- Pediatric audiologists play a key role in driving UNHS adoption and ensuring timely care for newborns with hearing loss.
- Collaboration among specialists is essential for the successful diagnosis and management of hearing impairments in early childhood.
Abstract:
The universal newborn hearing screening (UNHS) is currently spreading in Germany, as well, even though there can be no talk of a comprehensive establishment. The introduction of UNHS in several federal states such as Hamburg, Hessen, and Schleswig-Holstein can be ascribed to the personal commitment of individual pediatric audiologists. Apart from the procurement of the screening equipment and the training of the staff responsible for the examination of the newborns, the tracking, i.e. the follow-up on children with conspicuous test results, is of utmost importance. This involves significant administration effort and work and is subject to data protection laws that can differ substantially between the various federal states. Among audiologists, there is consensus that within the first three months of a child's life, a hearing loss must be diagnosed and that between the age of 3 and 6 months, the supply of a hearing aid must have been initiated. For this purpose, screening steps 1 (usually a TEOAE measurement) and 2 (AABR testing) need to be conducted in the maternity hospital. The follow-up of step 1 then comprises the repetition of the TEOAE- and AABR measurement for conspicuous children by a specialized physician. The follow-up of step 2 comprises the confirmatory diagnostics in a pediatric audiological center. This always implies BERA diagnostics during spontaneous sleep or under sedation. The subsequent early supply of a hearing aid should generally be conducted by a (pediatric) acoustician specialized on children.
