Congenital hearing loss is one of the common disabling diseases and has become a major public health concern worldwide. Among normal newborns, the incidence of bilateral congenital hearing loss is about 3 per 1,000, which is much higher than the incidence of phenylketonuria and hypothyroidism, ranking the top of the screenable birth defects. In China, if the annual birth of 19 million people, an average of about 50,000 new children with congenital hearing loss each year. If these children with congenital hearing loss are not detected early, it is impossible to provide early diagnosis and early intervention services for them, and they may become disabled due to hearing loss. It has been proven in practice at home and abroad that newborn hearing screening has significantly reduced the average age of diagnosis of deafness in infants and children and is considered the most effective measure to reduce the disability of congenital deafness. Therefore, in February 2009, the Ministry of Health promulgated the Measures for the Administration of Newborn Screening, which clearly listed hearing impairment as one of the three major diseases for newborns. The original concept of newborn hearing screening is to use electrophysiological techniques to screen out newborns with possible hearing impairment within one week after birth. The current meaning refers to the newborn hearing screening as a basic system engineering project, including pre-screening education and screening information, screening sessions (including initial and repeat screening), screening results and interpretation and its subsequent hearing test, diagnostic assessment, intervention and rehabilitation and follow-up, and many other components. Newborn hearing screening should implement the principles of multidisciplinary cooperation, informed parental choice, child rights protection and information and statistical services in the whole process, with the ultimate goal of rehabilitating children with hearing impairment and returning them to mainstream society. 2, Newborn Hearing Screening Techniques and Strategies Screening Techniques There are two most mature newborn hearing screening techniques: one is the otoacoustic emission recording technique that objectively reflects the physiological and pathological status of the cochlea, which is closely related to the active movement of the outer hair cells of the cochlea. The other is the automatic auditory brainstem response recording technique that can objectively reflect the function of the peripheral auditory system, the eighth cranial nerve and the brainstem auditory pathway. Currently, the two-step screening method, OAE and AABR, is widely accepted and used and is considered to be the most effective, cost-effective, and well-established screening modality. Screening Strategies There are two strategies for newborn hearing screening: universal hearing screening and targeted population hearing screening. The former is to screen all newborns at birth, and the latter is to screen newborns with risk factors for hearing loss. The recommended strategy in China at this stage is first universal screening, and in screening institutions that do not yet have universal screening conditions, target population screening can also be used to refer newborns with high-risk factors for hearing impairment to screening institutions that are in a position to do so in a timely manner. According to the WHO resolution, two models of newborn hearing screening can be used in developing countries: the hospital-based newborn hearing screening model and the community-based newborn hearing screening model. The former is mainly for hospital-born newborns, who are screened before discharge, and the latter is mainly for non-hospital-born newborns, who are screened in conjunction with planned immunization. Screening protocols The current hearing screening protocol commonly used is a two-stage screening. First, initial screening with transient otoacoustic emissions, followed by rescreening with automated auditory brainstem response for those who do not pass. This protocol does not significantly reduce sensitivity and ensures a very low false positive rate with a specificity of >90%. This screening protocol is primarily intended for newborns in the general obstetric unit. For newborns in the NICU, where the prevalence of hearing loss is much higher than in the general ward and, more importantly, where most of the neuroconduction disorders such as auditory neuropathy are concentrated, AABR screening is used first, and those who fail are referred directly to the diagnostic procedure. 3. The process of neonatal hearing screening The process consists of pre-screening science education and screening information, screening sessions (including initial and repeat screening), screening result information and interpretation and its subsequent hearing test, diagnostic assessment, intervention rehabilitation and follow-up, and many other components. Pre-screening education and information helps to disseminate knowledge about hearing care and to increase parents’ motivation and compliance and informed consent to participate in newborn hearing screening. Screening begins with initial screening with transient otoacoustic emission and is repeated within 42 days of birth with automatic auditory brainstem response. Communication and Interpretation of Screening Results Before parents are informed of the results of the hearing screening, basic information about the child being screened should be verified. There are only two types of hearing screening results: pass and refer. For children who need to be referred, information about the specific procedure and location of the referral should be provided, and the person performing the hearing screening should sign the record. In addition, parents should be fully informed and explained the results of the hearing screening. Hearing Test and Diagnostic Evaluation Children with a positive hearing screening should receive a full diagnostic evaluation with audiological testing within 1 month of screening, and no later than 3 months, to determine if they have a hearing impairment. If the child is diagnosed with a permanent hearing impairment, the parents should be provided with information regarding post intervention and rehabilitation. Intervention and rehabilitation for children with hearing impairment Children diagnosed with permanent hearing loss should receive intervention within 6 months of age. This includes auditory assistive devices and medical interventions as well as auditory and speech rehabilitation. Follow-up Newborn hearing screening is to detect infants and children with targeted hearing loss. For newborns with an average hearing loss of less than 30-40 dB HL, it is difficult to detect with conventional OAE and AABR; in addition, some hearing disorders (e.g., auditory neuropathy) are difficult to detect with OAE alone; newborn hearing screening is not effective for children with delayed hearing impairment, so it is important for Therefore, infants and children who have passed the hearing screening but have risk factors for hearing loss should be followed up.