Newborn hearing screening - The journey from womb to early childhood

Hearing is key to how babies start learning and connecting with the world around them from day one. Detecting hearing loss early can make all the difference in a child’s long-term language, cognitive, and social development.

In the U.S., for example, newborn hearing screening programs have helped to drive early hearing loss detection but with recent program cuts, there’s growing pressure on healthcare professionals to bridge the gap. In this article, we explore:

• how hearing develops,

• how it’s screened for at birth, and

• how digital audiometry improves accessibility and efficiency

How does hearing ability develop?

During the first 20 weeks of gestation, the structural parts of the ear start to develop. The most important time for hearing development is from 25 weeks of gestation to around 5 to 6 months after birth. During this period, the parts of the brain and ear that process sound start learning to recognize different tones and volumes. Unlike vision, hearing needs sounds from the outside world – like speech, music, and everyday noises – to develop properly.

Preterm and term infants can’t properly distinguish sounds with background noise levels greater than 60 dB. Continuous exposure to loud noise can interfere with hearing development, and the ability to distinguish frequencies. This foundation is critical, as early hearing ability plays a crucial role in a child’s later speech, language, and cognitive development.

Why does early hearing screening matter?

According to the World Health Organization (WHO), between 0.5 and 5 out of every 1,000 newborns and infants, across different countries, are born with or develop deafness or severe-to-profound hearing loss early in life.

Today, newborn hearing screening is the standard of care in most hospitals in higher income countries. It’s an efficient, non-invasive way to identify newborns who may have hearing loss, as early as possible, so they can be referred for further testing and intervention. Unfortunately, accessibility remains a barrier in most low-to-middle-income countries (LMICs).

Understanding newborn hearing screening: What happens after birth?

The following screening tests are typically performed:

Otoacoustic Emissions (OAE):

OAE screening measures sound waves generated by outer hair cells of the inner ear (cochlea) in response to soft clicking sounds or tones. If these emissions are absent or reduced, it could indicate a potential hearing issue.

• Why it’s commonly used: In general, OAE devices are portable, fast, and useful for large-scale newborn screening.

• What it tells us: Whether the outer hair cells of the cochlea are functioning properly.

Automated Auditory Brainstem Response (AABR):

For this assessment, electrodes are placed on the baby’s head, and soft sounds are played through earphones to check for a response from the auditory nerve. If the child hears normally, the device detects a response.

• Why it’s commonly used: AABR is an objective test that gives a pass or refer result to help detect hearing loss early. It can also be combined with OAE as part of a more comprehensive hearing assessment.

• What it tells us: It measures responses from the cochlea, cochlear nerve and auditory brainstem as sound travels to the brain.

For a detailed breakdown of hearing assessments conducted by age group, read our blog article on pediatric hearing screening.

What role does digital audiometry play in expanding equitable access to hearing care?

As healthcare systems shift toward more decentralized models – particularly in settings where cost and accessibility remain barriers – digital audiometers that enable accurate, affordable screening and testing capability have never been more vital.

Digital technology like hearOAE enables hearing care professionals to:

• Screen newborns/infants accurately to support early hearing loss detection and intervention,

• Extend their reach of care through portable, cost-effective equipment, and

• Securely store and manage patient data in real-time to support informed care decisions.

A sound start starts with sound

Hearing shapes how a child learns, speaks, and engages with the world. And that journey already starts in the womb. By understanding how the health tech landscape evolves, hearing care professionals can take the first – and arguably most important – step toward supporting early hearing loss detection through accessible care.

In Part 2, we’ll explore how hearing further develops as children grow, the common causes of pediatric hearing loss, and what healthcare providers can do to monitor hearing beyond the newborn stage.