Congratulations on becoming a newborn hearing screener! Your role as a newborn hearing screener is vital to the hearing and speech development of your newborns. You are responsible for performing newborn hearing screening on all infants prior to discharge and are the front line of communication with new parents. Newborn hearing screening, although easy to learn, requires specific steps and training to ensure quality screening.
Newborn Hearing Screening Outcomes
The Joint Committee on Infant Hearing (JCIH) was established in 1969 with a goal of publishing guidelines for early detection of hearing loss in children and newborn hearing screening. By the year 2001 the initiative included the 1-3-6 guidelines – defining the 3 key components of Early Hearing Detection and Intervention Programs and ultimately setting the standard which is universally accepted around the globe: Screening by one month of age, diagnosis by 3 months of age and intervention by 6 months of age.1
Permanent congenital hearing impairment is one of the most common disorders among newborns. In the developed countries around the world, statistics show that 2 to 3 infants in every 1,000 births have permanent hearing impairment affecting one or both ears. Permanent congenital hearing impairment occurs 6 times more frequency than cystic fibrosis, 12 times more frequently than hypothyroidism and 36 times more frequently than PKU abnormalities!2 Yet for many years it was routine practice to screen newborns for genetic abnormalities including PKU, hypothyroidism, and cystic fibrosis but not for congenital hearing impairment.
1 Joint Committee on Infant Hearing. Year 2000 position statement: principles and guidelines for early hearing detection and intervention programs. Pediatrics. 2000;120:921
All newborns should be screened for congenital hearing impairment as it affects newborns in the well-baby nursery (WBN) and newborns admitted to the neonatal intensive care unit (NICU). In fact, most of the newborns diagnosed with permanent congenital hearing impairment have no risk factors for this condition.
More than 90% of deaf babies are born to parents who have normal hearing! We know that certain conditions during the prenatal, perinatal and postnatal periods can increase the chances of permanent hearing impairment in the newborn. These conditions are considered high risk factors and must be taken into account when screening newborns and making recommendations for follow-up. Babies born with risk factors for late onset or progressive hearing impairment are followed more closely by their pediatrician to catch signs of hearing problems early so as to not delay intervention. Early detection of permanent congenital hearing impairment in the newborn along with timely and appropriate intervention by 6 months of age is crucial to minimize the impact of the hearing impairment on a child’s development and educational achievements.
Many research studies have compared the language development and educational achievement of hearing impaired children with their age-matched peers. Conclusions from the research provide confirmation that confirms children with hearing loss who were diagnosed at an early age and received timely intervention consistently have language skills at levels comparable to their hearing peers by age 5 – 6. Other studies have compared early diagnosed and treated hearing impaired children to those with delayed identification and treatment. Intervention by 6 months of age consistently offers advantages leading to better receptive and expressive language scores, independent of the mode of communication chosen, the degree of hearing impairment and the socio-economic status.3
3 Newborn and infant hearing screening: current issues and guiding principles for action. World Health Organization. ISBN 978 92 4 159949 6
Hospital Newborn Hearing Screening Policy & Procedure
The final newborn hearing screening policy and procedure will be provided to you by the Nurse Manager or Lead Trainer. The newborn hearing screening policy and procedure will include all the specifics related to the program workflow. Some of the specifics include: baby selection criteria, timing of screening, risk factors, screening attempts, hospital documentation, and parent communication.
Review ALGO 5 User Manual
The ALGO 5 User Manual is designed to educate you on the proper and safe use of the product. It is important that all screeners read the manual in its entirety to ensure they are familiar with all safety, operating, and troubleshooting/maintenance guidelines. Troubleshooting/maintenance guidelines should be reviewed and followed to ensure that the device remains in proper functioning order. If difficulties continue after following the troubleshooting techniques, please contact your manager, your Biomed department or call Natus Technical Service at 888-496- 2887.
The Algo 5 user manual outlines the operating instructions for selecting a baby, setting up the screener, preparing the baby, running the screening and managing results, and cleaning up and shutting down the screener. The final policy/procedure which you receive from the Nurse Manager or Lead Trainer may have additional steps/guidelines outside of what is listed in the Algo 5 manual. Additional guidelines must be adhered to per hospital policy/proced ure, but they should never contradict or override what is outlined in the user manual.
You need to be familiar with error messages that you may receive during screening and overall techniques for screening. Any questions you may have should be directed and discussed with the Lead Trainer during training.
Review Algo 10 Steps to Successful Screening
The Algo 5 quick guide provides an easy reference to the operating instructions fully detailed in the Algo 5 user manual. The quick guide does not replace the user manual, but can be used as a resource along with the user manual.
Watch the ALGO 5 Training Videos
You will find following training videos in the course
- Algo 5 – Getting Started
- Algo 5 – Admin Setup
- Algo 5 – Data Management
- Algo 5 – Tips for Successful Screening
Review ALGO Resource Documents
Hearing Screening Program Resources
- Communicating Screening Results to Parents
- Sample Screening Progress Note
- Sample UNHS Policaand Procedure
- Screening Competency Checklist
- Sample Parent PASS Letter
- Sample Parent REFER Letter
- Ten Step Algo 5 Quick Guide
- Your Baby’s Hearing – developmental milestones
- Troubleshooting Tips and FAQ (coming soon)
Hands –On Training / Competency
Follow your nursery protocol for completion of the screener competency, which may include observation by a nurse educator / nurse manager.