Understanding Newborn Hearing Screening
Around one to two babies in every thousand are born with permanent hearing loss in the UK. Newborn screening catches most of them within weeks.
The NHS Newborn Hearing Screening Programme (NHSP) has been running across England since 2006. It offers a hearing test to all babies within the first few weeks of life, usually before they leave hospital or during the first home visit. It's quick, painless, and one of the most effective screening programmes in the NHS.
Yet despite being routine, the screening can be a source of confusion and anxiety for parents — especially when the result isn't a straightforward pass. If your baby has been referred for further testing, or you're simply curious about how the screening works, this article explains the process step by step.
What Happens During the Screening
The screening is usually done while your baby is sleeping or lying quietly. A health professional places a small, soft-tipped earpiece in your baby's ear and plays gentle clicking sounds. A sensor picks up the response from the inner ear (cochlea). This is called an Otoacoustic Emission (OAE) test, and it takes only a few minutes.
In some hospitals, or if the OAE doesn't give a clear result, a second type of test called an Automated Auditory Brainstem Response (AABR) may be used. For this test, small sensors are placed on your baby's head and neck, and soft sounds are played through earphones. The sensors detect electrical activity in the auditory nerve in response to the sound. Again, it's painless.
Understanding the Results
Clear Response
If the screening shows a clear response in both ears, it means the test detected normal hearing function at the time of testing. No further action is needed. Bear in mind, though, that some types of hearing loss develop later in childhood, so stay alert to any concerns about your child's hearing as they grow.
No Clear Response
If the test doesn't show a clear response in one or both ears, it does not necessarily mean your baby is deaf. There are several reasons for an unclear result:
- Your baby was unsettled or there was too much background noise.
- Fluid or debris in the ear canal (common immediately after birth).
- Temporary middle ear congestion.
- The equipment didn't get a strong enough signal.
If the result isn't clear, the test is repeated. If the second test also shows no clear response, your baby is referred to audiology for diagnostic assessment. Around two to three per cent of babies are referred after screening, and most of those turn out to have normal hearing once the diagnostic tests are completed.
The Diagnostic Assessment
If your baby is referred, you'll be seen at the audiology department, usually within four weeks. The diagnostic test is a full Auditory Brainstem Response (ABR), which is more detailed than the screening version. Your baby needs to be asleep for this test, so you'll be advised to bring them tired and ready to sleep. The test measures the hearing nerve's response to sounds at different pitches and volumes, giving the audiologist a detailed picture of your baby's hearing.
This appointment can feel daunting, but the audiologists are experienced at working with tiny babies and at explaining results to anxious parents. You can bring someone with you for support.
If the Diagnosis Confirms Hearing Loss
If the ABR confirms that your baby has permanent hearing loss, things tend to move quickly. You'll be offered:
- Hearing aids, fitted as soon as earmoulds can be made (usually within a few weeks of diagnosis).
- An introduction to your local teacher of the deaf, who will visit you at home.
- A referral to speech and language therapy.
- Information about communication approaches.
- If the hearing loss is severe to profound, a referral for cochlear implant assessment may follow.
It's a lot to absorb. Many parents describe the period between referral and diagnosis as the hardest, because the uncertainty is so difficult to sit with. Our newly diagnosed support service exists specifically for this time. You don't have to wait for a confirmed diagnosis to reach out to us.
Why Early Identification Matters
Research is clear that deaf children who are identified and supported early achieve significantly better language outcomes than those diagnosed later. The brain's capacity for language development is at its peak in the first few years of life, and giving a deaf baby access to language — whether signed, spoken, or both — during this critical period makes a measurable difference.
The UK's newborn hearing screening programme has reduced the average age of diagnosis from around 18 months (before screening was introduced) to around 9 weeks. That difference of a year or more is profoundly important for language development.
What About Late-Onset or Progressive Hearing Loss?
Not all hearing loss is present at birth. Some children develop hearing loss later, due to genetic factors, illness (such as meningitis or cytomegalovirus), or other causes. A normal newborn screening result doesn't guarantee permanent hearing throughout childhood.
If you have any concerns about your child's hearing at any age — they don't respond to sounds they used to react to, their speech development seems slow, they turn the television up unusually loud — speak to your GP or health visitor and ask for a hearing test. Trust your instincts.
Further Information
The NHS newborn hearing screening page provides official information. The NDCS also has a helpful section for families going through the screening and diagnosis process.
If you're based in Croydon and want to talk to someone who's been through this, get in touch and we'll connect you with a parent who understands.