Press Release Date: July 3, 2008
All newborn infants should be screened for congenital hearing loss that is present at
birth, according to a new recommendation from the U.S. Preventive Services Task Force.
The recommendation and the accompanying summary of evidence appear in the July 7 issue
Children whose hearing is impaired at birth, during infancy or in early childhood can
have problems with verbal and nonverbal communication and social skills, increased
behavioral problems, and lower academic achievement compared with children with normal hearing.
Infants at high risk for hearing loss include those who have spent more than 2 days in
a neonatal intensive care unit; those diagnosed with certain syndromes, such as
Waardenburg or Usher syndrome; and those with a family history of childhood hearing
loss. Because half of infants with hearing loss have no identifiable risk factors, the
Task Force proposes universal screening, rather than targeted screening. Detecting and
treating infants for hearing loss, rather than detecting it at a later age, provides
better chances for positive outcomes such as stronger language skills.
For every 1,000 infants born in the United States, congenital hearing loss occurs in
between one and three infants. Congenital hearing loss happens more frequently than
other conditions typically screened for as part of a health care evaluation. Infants
should be screened before they are 1 month old; those who do not pass the screening
should receive further hearing and medical evaluation before they are 3 months old.
Thirty-nine U.S. states have enacted legislation related to universal newborn hearing
screening. Laws differ on whether screening is mandated or encouraged, how results are
reported and how screening is funded.
"Screening for hearing loss should be part of every newborn infant's health care
evaluation," said Task Force Chair Ned Calonge, M.D., who is also chief medical
officer for the Colorado Department of Public Health and Environment. "Screening
at birth allows for hearing loss to be detected early and is associated with better
outcomes for infants who test positive."
The Task Force recommends screening using a two-step screening process that includes
otoacoustic emissions followed by auditory brainstem response in those infants who fail
the first test. Otoacoustic emissions check the inner ear response to sound and are
measured by placing a very sensitive microphone in the ear canal to measure the ear's
response. The auditory brainstem response checks the brain's response to sound and is
measured by placing electrodes on the infant's head to record the brain's response to
sound. Good evidence was found that newborn hearing screening testing is highly accurate
and leads to earlier identification and treatment of infants with hearing loss. Good
evidence was also found demonstrating that early detection and treatment improve
The Task Force is the leading independent panel of experts in prevention and primary care.
The Task Force, which is supported by AHRQ, conducts rigorous, impartial assessments of
the scientific evidence for the effectiveness of a broad range of clinical preventive
services, including screening, counseling, and preventive medications. Its recommendations
are considered the gold standard for clinical preventive services. The Task Force based
its conclusions on a report from a research team led by Heidi Nelson, M.D., at AHRQ's
Evidence-based Practice Center at the Oregon Health & Science University in Portland.
The recommendations and materials for clinicians are available on the AHRQ Web site at http://www.ahrq.gov/clinic/uspstf/uspsnbhr.htm. Previous Task Force recommendations, summaries of the evidence, and related materials are available from the AHRQ Publications Clearinghouse by calling (800) 358-9295 or sending an E-mail to email@example.com. Clinical information is also available from AHRQ's National Guideline Clearinghouse™ at http://www.guideline.gov.
For more information, please contact AHRQ Public Affairs: (301) 427-1244 or (301) 427-1246.
Task Force Recommends Screening for Hearing Loss In All Newborns. Press Release, July 3, 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/press/pr2008/newbhrpr.htm