Hearing tests in newborns: Are there advantages?

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Doing tests in all newborns makes it possible to diagnose and treat hearing problems sooner. This can improve language and speech development in children who have hearing problems.

Children who don’t hear well often learn to speak later than other children do. That can affect their overall ability to learn, as well as their general personal and social development. It is hoped that early treatment of hearing problems that are already present at birth (congenital hearing loss), for example using a hearing aid, could prevent consequences like this. In Germany and other countries, hearing tests are routinely carried out in all newborns to try to detect and treat hearing impairments as early as possible. These tests are simple and don’t hurt. They check whether the baby’s inner ear can receive sounds properly, and whether the sound signals are passed on to the brain properly.

Research on the outcomes of hearing screening programs for newborn babies

Together with researchers from England and the German Cochrane Center, researchers at the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) looked into the effects of routine hearing in all newborns. In particular, they wanted to know

  • how many more hearing-impaired babies are diagnosed as a result of routine ,
  • whether earlier treatment of hearing problems in babies is more effective than later treatment in the short or long term, and
  • whether the and any resulting treatments have a direct impact on the child’s personal and educational development, as well as on their quality of life.

Screening would be a good idea if, for instance, it turns out that children benefit from early treatment. If earlier treatment makes no difference, though, or is actually associated with particular risks, then wouldn’t be worthwhile.

Research on screening and early treatment

The researchers looked for relevant studies in this area. The kinds of studies with the most reliable results are studies in which researchers are able to follow the development of two groups of children – one group which has been screened, and one group which has not – over a long period of time. The effects of the tests can then be determined by comparing the groups.

The researchers found two studies in which children had hearing in different geographical areas or at different times. One of the studies was carried out in England, and the other was carried out in the U.S. Four other studies compared the effects of early treatment for hearing problems with the effects of later treatment. But the quality of many of these studies wasn't good enough to reliably determine what can be expected from routine hearing .

The outcomes of screening programs and early treatment

There were only two studies on programs, and neither of them were randomized controlled trials (RCTs). RCTs are studies that provide the most reliable findings about the effectiveness of treatments and diagnostic tests. Four studies compared early treatment with later treatment. Together, these studies suggest that children with congenital (“at birth”) hearing loss could benefit from and an early .

One of the programs was in the U.S. and one was in England. The studies and the programs were very different. But the research showed that hearing problems are usually diagnosed much sooner if newborns are routinely screened. For instance, the study in England found that hearing problems were detected within the first nine months of life

  • in 3 out of 10 hearing-impaired children who didn't have a hearing test immediately after birth, and
  • in 7 out of 10 hearing-impaired babies who had a hearing test immediately after birth.
In other words, the early hearing was able to detect the hearing impairment early in an extra 4 out of 10 affected children.

How important is early diagnosis?

The research showed that children whose hearing impairment was diagnosed through have better early language development than children whose hearing impairment was diagnosed later. This was confirmed by the four studies in which children who were treated early were compared with children who were treated later. Different treatments were looked at, particularly patient education and the use of hearing aids. There hasn’t been enough research on the long-term effects of newborn hearing on other important areas of the child’s life, such as their development at school, psychological wellbeing and quality of life.

The researchers at IQWiG came to the following conclusion: Routine hearing in newborns can improve the chances of congenital hearing loss being diagnosed and treated earlier. This can improve early language and speech development in children who have hearing problems. But we can't know for certain what long-term effects this has on the children because there haven’t been enough good studies on how early and early treatment affect the child's hearing impairment.

Institute for Quality and Efficiency in Healthcare (IQWiG, Germany). Neonatal screening for early detection of hearing impairment: Final report; Commission S05-01. February 28, 2007. (IQWiG reports; Volume 19).

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Updated on April 15, 2021

Next planned update: 2024


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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