Hearing tests and your baby

• Infections caught in the womb
• Genetics
• Premature birth
• Traumatic birth
• Glue ear

How common are hearing difficulties?

In the UK, 1 to 2 babies in every 1,000 are born with hearing loss in one or both ears, according to the NHS.

“50% of children who have a permanent hearing loss are born with hearing loss, while the other 50% develop it, usually, within the first three years of life,” explains Vicki Kirwin, Development Manager (Audiology & Health) at the National Deaf Children’s Society (NDCS).

What signs should you look out for?

All babies should be offered a hearing test just after birth, which should pick up most children who are born with a hearing loss.

After birth, it’s very much to do with the physical development of the child as well as their attention. You should be given a book called The Personal Child Health Record, which has a checklist inside of things to look out for, including reactions to sounds, to make you think, “Is my baby doing that or not?”

However, Vicki advises that you don’t try and test your child’s hearing at home, but that you ask a specialist to help you.

“If you test your baby’s hearing at home, for example, by standing behind them and banging a saucepan lid, your baby is not going to turn round after a while because they will have become used to the noise,” explains Vicki.

“I think the most important thing for parents to do is to observe your baby’s development and then ask your doctor,” adds Vicki.

Hearing developments:

Baby’s first month
During the first month, babies don’t do very much more than startle. When your baby is awake and alert, look out for your baby’s response to loud noises.

“If the door slams, for example, you might see a baby jump, or get a bit tense and you might see them blink or open their eyes really wide. That’s called a startle response,” says Vicki.

Second month onwards
After the first month, babies stop startling to loud noises and it’s often a time when parents start saying, “Oh there’s a hearing problem,” because they’re not responding to those sounds anymore. However, this is actually a normal development.

“Babies will stop responding to loud noises around this age and start listening to other, quieter noises. Then you’ll see them start to pay attention to noises, often pausing in what they’re doing. So if they were crying and they hear a loud noise, they may stop crying, and if they weren’t crying, they may start crying,” explains Vicki.

Six months
"Around the age of six or seven months, most babies will have control of their head and will start to really turn round to sounds. If they’re sitting, they will actually turn their heads around to where the sound is coming from.

“Your baby may start to get excited to hear mum or dad’s voices, even if they can’t see either of you in view,” says Vicki.

12 months
“Around the age of 12 months or so, we start to see babies often have a hand movement associated with greetings. So if a person says "bye-bye", they may wave back, even if the person hasn’t waved,” says Vicki.

If you are worried about your baby’s hearing, ask your doctor or health visitor and they will refer your baby to an audiologist for a hearing test.

What's involved in a hearing test?

While your baby can have a hearing test at any any age or stage, the tests your audiologist will carry out may vary:

Babies up to six months

The first hearing test for your baby is called otoacoustic emissions (OAE). A tiny ear piece is placed in your baby’s ear canal and emits a little clicking noise, which the cochlea (inner ear) responds to, and the ear piece picks up that response. The response will tell the audiologist whether the inner ear is working properly.

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“Hearing tests for babies can be done whilst your baby is fast asleep and will tell us whether their ears and hearing systems are working normally,” says Vicki.

If the OAE doesn’t pick up a response, the audiologist will do an auditory brain stem response test (ABR) by putting headphones on your baby and playing clicking noises again. The ABR records the response from the hearing nerve using three electrodes in the headphones. This will tell the audiologist the level of the hearing and the frequencies that your baby can hear at.

Six months and over
When your baby gets to the stage where he or she can sit up and look round to sounds, then the audiologist will carry out tests where they can actually look at your baby’s hearing responses. The most common test is where the audiologist makes noises behind your baby or to the side of your baby, using speakers, to see whether they turn towards the sounds.

Is there a hearing aid available for babies?

“Yes, the youngest I’ve ever fitted a hearing aid on a baby was aged about two weeks,” says Vicki.

The NDCS advises that babies are fitted with a hearing device and wear them consistently before the age of six months. Typically, parents will choose to wait around six to eight weeks before they get their baby a hearing aid, in order to give themselves a bit of time to get used to the idea that their baby has a hearing impairment.

“Parents need that thinking time to give them a chance to find out as much information as they need, to ask other people and to start to adapt the way they communicate with their baby. Just knowing that your baby has a hearing loss means that you as a parent start acting differently,” explains Vicki.

If your baby has permanent hearing loss, what's the best way to communicate?

Make sure you retain good eye contact and are face on when communicating with your baby as well as learning to understand that you can’t always soothe your baby from another room.

“Often if your baby is crying in another room, mum will walk down the corridor saying, ‘It’s okay, mummy’s coming,’ but this isn’t going to work if your baby has a hearing loss.

“Once parents know, it’s much less stressful for them as they will understand why their baby is still crying and will know they only need to start soothing their baby once they are closer,” explains Vicki.

For further information about your baby’s hearing, whether it be hearing aids, hearing tests or advice on communicating with your baby, visit the National Children’s Deaf Society at www.ndcs.org.uk or call their free helpline on 0808 800 8880.