Prenatal

With over 400,000 babies born in Texas each year, 3 out of every 1,000 will be born with hearing loss.  A small percentage of these babies will also have additional medical conditions that require immediate attention.  These issues should be brought to the attention of expectant parents in the health provider's environment.  This web page is designed to provide information about newborn hearing screening and the early hearing detection and intervention process as well as guidance to prenatal care providers in presenting this information to families.  Additonal information is provided to raise awareness of the availability of programs and resources related to the birth of a child and well-baby care.  Information available on this web page can be adapted and used in:

• Prenatal/childbirth classes
• OB/GYN office visits/clinics
• Professional organizations such as the Texas Association of Midwives

 

What is the Texas Early Hearing Detection and Intervention Program?

The Texas Early Hearing Detection and Intervention (TEHDI) Program is designed to oversee the newborn hearing screening, diagnostic, and referral to early intervention process.  The program identifies those newborns with hearing loss so that the ability to achieve communication, language and social skills is obtained at the earliest possible age.  Goals of the TEHDI Program include:

• Provide the earliest possible assessment, referral and intervention for newborns with hearing loss
• Screen all newborns for hearing loss before 1 month of age, preferably before hospital discharge
• Provide all infants who screen positive for hearing loss a diagnostic audiologic evaluation before 3 months of age
• Provide all infants who have confirmed hearing loss with appropriate early intervention services before 6 months of age

What is the Role of the Midwife in Newborn Hearing Screening?

Texas law requires hospitals and birthing centers to provide newborn hearing screening.  Midwives who practice in small birthing centers or perform the birth in a home setting should refer clients for this service.  Midwives are required to inform parents of the required screening tests.

How Can a Newborn's Hearing Be Screened?

With advanced technology, a health care provider can screen a baby's hearing shortly after birth.  Children who have problems hearing clearly often have difficulty learning to communicate.  Therefore, it is imperative to screen a newborn's hearing status using one of the two available methods.  The newborn hearing screening is simple and painless, and requires no active participation by the newborn.

Otoacoustic Emissions (OAE) - in this method, a small earphone that emits a series of soft sounds is placed in the baby's ear.  The inner ear responds to the sounds by creating echoes called otoacoustic emissions, which are then analyzed by the screening equipment.

Automated Auditory Brainstem Response (AABR) - in this method, band-aid-like sensors are placed on the baby's head.  As soft sounds are played into the baby's ear, the equipment analyzes the brain's response to those sounds.

Either of these screening methods is completed within a few minutes, and the results are available immediately.

What Do the Hearing Screening Results Mean?

Most babies pass the newborn hearing screening before they leave the hospital.  Some babies are referred to the appropriate health care professional for further screening (outpatient hearing screening), which should occur by or before 1 month of age.  A parent and their baby's pediatrician will be contacted if outpatient hearing screening is needed.  If more diagnostic testing is needed following the results of the outpatient hearing screening, the child will be referred to an audiologist.

Parents who are asked to return with their babies for follow-up screening or diagnostic testing should do so as soon as possible.  It is important for parents to understand that thei infant's hearing ability has a direct impact on the infant's ability to learn to communicate and eventually to acquire spoken language.  Therefore, access to communication for a newborn is extremely crucial.  Parents want to know that their baby can hear their voices and the words they speak. 

What If Parents Have Questions About Newborn Hearing Screening or Early Hearing Detection and Intervention Process?

After a newborn hearing screening is completed, parents should talk with their health care provider about the results.  Health care educators should encourage parents to read about newborn hearing screening and assist with ideas about how to teach their babies to listen and communicate.  It is important to suggest to parents to discuss information and review brochures and booklets from their health care provider.  Parents need information to support their understanding about how a growing baby responds to sounds and how to observe their baby's cues/behavior in response to the sounds around him/her.  Parents also need information to support their baby's ability to communicate.

What Happens When Hearing Loss is Detected?

If a baby has been diagnosed with hearing loss, there are medical, audiological and early intervention services and resources available to parents and their newborns.  There are many considerations parents must address concerning their newborn.  Questions about genetics are an important consideration for many families.  Health educators and providers should be able to relay information on genetic disorder screenings in a direct and culturally sensitive manner.

Can a Baby Have Genetic Deafness?

Studies have shown genetic factors play an important role in early onset deafness as well as in partial, late onset and progressive hearing loss.  It is estimated changed genes are responsible for hearing loss in at least 50% of deaf and hard of hearing children.  This is what is known as non-syndromic deafness, or inherited deafness.  About 1 in 1,000 children in the United States are born with profound deafness and another 2 - 3 per 1,000 are born with partial hearing loss.  More than half of these cases are caused by genetic factors.  Most cases of genetic deafness (70% - 80%) are non-syndromic; the remaining cases are caused by specific genetic syndromes.