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Updated: Aug 9, 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
Identification of hearing loss in infants and young children
Insights
Early infant hearing loss detection is crucial but often overlooked. Recognizing risk factors and parental concerns is vital for timely diagnosis and intervention in newborns.
Area of Science:
- Pediatrics
- Public Health
- Audiology
Background:
- Infant hearing loss is detectable at any age, yet early identification remains a challenge.
- The medical community's awareness and conviction regarding the importance of early hearing loss detection are insufficient.
- Existing public health strategies include high-risk registers and behavioral screening, each with pros and cons.
Purpose of the Study:
- To highlight the importance of early detection of hearing loss in infants.
- To discuss current public health strategies for identifying hearing impairment in newborns.
- To emphasize the need for increased awareness and action regarding infant hearing loss.
Main Methods:
- Review of public health strategies for early hearing loss detection: high-risk registers and behavioral screening.
- Discussion of the incidence of handicapping hearing loss in newborns and intensive care nursery admissions.
- Evaluation of the role of automated hearing screening systems like the Crib-o-gram.
Main Results:
- The incidence of significant hearing loss is 1 in 380 newborns and 1 in 61 in NICU admissions, higher than commonly believed.
- Automated screening systems may contribute to improved detection rates.
- Multiple risk factors are often present in infants with hearing loss.
- Parental suspicion is a strong indicator, with a 1 in 4 chance of hearing loss at one year of age.
Conclusions:
- Early detection of infant hearing loss is critical and requires a high index of suspicion.
- Parental concerns about hearing should be taken seriously and prompt immediate referral.
- Improved awareness and utilization of screening methods are necessary to address the prevalence of infant hearing loss.
Abstract:
An infant's hearing loss is detectable at any age. In spite of the importance of identifying deafness early, we do a poor job largely because the medical community is neither aware nor convinced that finding hearing loss is worth the trouble. There are two public health strategies for early detection, the high risk register (family history, hyperbilirubinemia, prematurity, rubella, and maxillofacial anomalies) and behavioral screening. The advantages and disadvantages are discussed. The incidence of handicapping hearing loss in newborns is 1 per 380 births and 1 per 61 in babies admitted to an intensive care nursery. This is higher than generally believed and may be one favorable result of using a new automated hearing screening system--the Crib-o-gram. In most deaf babies there is more than one risk factor present. Evaluating a hearing suspect baby demands a high index of suspicion, and taking the parent's suspicions seriously. The chances that a hearing loss exists at one year of age is about 1 in 4 on parental suspicion alone, regardless of what the physician's opinion might be. Immediate referral upon suspicion needs to occur more often than it does.
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