Every year in the United States, 12,000 (or one in 300) children are born with some form of hearing loss. Hearing impairment in newborns occurs more often than all other health problems identified at birth - making it the number one birth defect in the United States.

Despite this, national statistics state only 69 percent of babies are screened for hearing impairment at birth. As of 2002, 37 states and the District of Columbia have adopted policies or mandates supporting universal newborn hearing screening (UNHS). You can check out your state's status at www.hearinghealth.net/pages/home/. All babies should be screened at birth.

The two major screening methods for infant hearing loss are Auditory Brainstem Response (ABR) and Evoked Otoacoustic Emissions (OAE). Both techniques, although they rely on different technology, are non-intrusive and can be performed on a sleeping infant.

The automated Auditory Brainstem Response (ABR) test measures the electrical activity of the hearing nerve pathway from the inner ear to the brain. In this test, large muffs placed on the infant's ears produce a clicking sound to stimulate the mechanism of the inner ear. Electrodes positioned on the infant's scalp measure the response of the brainstem. Because the device measures the electrical activity of the nerve pathway, the presence of debris or fluid in the baby's ear canals will not affect the result of the test.

Evoked Otoacoustic Emissions testing is the newer of the two methods. Otoacoustic emissions (OAEs) are by-products of the activity of the outer hair cells in the cochlea and are produced by healthy ears in response to acoustic stimulation.

OAES are measured by presenting a series of very brief acoustic stimuli to the ear through a probe that is inserted in the outer third of the ear canal. The probe contains a loudspeaker that generates clicks and a microphone that measures the resulting OAES that are produced in the cochlea and reflected back through the middle ear. The resulting sound that is picked up by the microphone is digitized and processed to determine whether the cochlea is functioning properly.

The following information comes from the National Campaign for Hearing Health.

Benefits of early detection
Early identification of deafness can have a significant impact on a child's cognitive development, as well as financial consequences in terms of education, employment and productivity.

According to a study published in the November 1998 issue of "Pediatrics," children whose hearing losses are identified by six months of age demonstrate significantly better language scores than children identified after six months of age. The average age for catching a hearing loss in a child not screened at birth is 30 months, well after language and learning disabilities may have developed.

The earlier that a hearing loss is identified, the more likely it is that interventions such as hearing aids and cochlear implants can allow a child to remain in a mainstream educational program, if their parents choose.

In addition to the importance in a child's cognitive development, early identification of hearing loss also has financial consequences for society. According to the National Center for Hearing Assessment and Management, the cost of educating a deaf child through high school is $420,000. The same child, if identified at birth and given a $40,000 cochlear implant or $5,000 hearing aids, can attend mainstream elementary and high school classes.

According to Marion P. Downs, a researcher in the field, the average deaf person earns an income 30 percent lower than the average hearing person. The combined expenses of deaf education and loss of productivity result in average lifetime costs of over $1 million per deaf individual.

When compared with other tests performed on newborns, universal infant hearing screening programs are remarkably inexpensive. For most birthing hospitals, the cost per procedure is between $20 and $60, not including screening equipment. The cost of identifying an infant with hearing loss is less than one-tenth the cost of identifying an infant with PKU, hypothyroidism, or sickle cell anemia, which are screened for in nearly every state.

Furthermore, the incidence of deafness is much higher than other birth defects for which children are screened. PKU affects 1 in 10,000 live births, hypothyroidism 1 in 5,000 live births, and sickle cell anemia 1 in 12,000 live births.

If you know of someone having a baby or if you are having a baby yourself, make sure your hospital or doctor performs newborn hearing screenings. Early detection is key.