Newborn hearing screening is the early detection of hearing impairment in newborns, early diagnosis and early intervention of effective measures to reduce the impact of hearing impairment on language development and other neuropsychiatric development, to promote the healthy development of children a strong guarantee. A, the basic requirements (a) institutional settings. Provinces, autonomous regions, municipalities directly under the Central People’s Government health administrative departments according to the actual situation of the administrative regional planning, newborn hearing screening and diagnosis and treatment, designated newborn hearing screening centers or medical institutions with the ability to undertake hearing disorders diagnosis and treatment. 1, screening institutions should be located in the medical institutions with obstetrics or pediatrics diagnosis and treatment subjects, with full-time staff and appropriate equipment and facilities, designated by the provincial, autonomous regions, municipalities directly under the Central People’s Government administrative departments of health organizations after assessment. 2, diagnosis and treatment institutions should be located in medical institutions with a strong level of otolaryngology and audiology technology, with at least one newborn hearing impairment diagnosis and treatment of senior technical title physicians and two hearing testers, and configuration of the appropriate equipment and facilities, designated by the provincial, autonomous regions, municipalities directly under the Central People’s Government administrative departments of health organizations after assessment. (B) personnel requirements. 1, screening personnel. (1) with a medical-related secondary school education or above. (2) received above the provincial health administrative departments of newborn hearing screening-related knowledge and skills training and obtain a technical certificate of competence. 2.Clinical staff. (1) personnel engaged in the diagnosis and treatment of hearing disorders must be qualified to practice medicine and have a clinical and technical title of otolaryngology above the intermediate level. (2) hearing detection personnel should have a medical-related secondary school education or above, through the provincial health administrative departments above the relevant technical and skills training and obtain a technical certificate of competence. 3, copywriters. Skilled in computer operation techniques and have experience in file management. (C) housing and equipment requirements. 1, housing. Screening institutions: set up a well-ventilated, ambient noise ≤ 45 dB (A) of the special room, and equipped with a consultation bed. Diagnostic and treatment institutions: set up at least 2 soundproof room (including a shielded room), in line with national standards (GB/T16403, GB/T16296), set up a consultation room and comprehensive room each. 2, equipment. (1) Screening institutions Equipment Usage Screening otoacoustic transmitter and / or automatic auditory brainstem response instrument Newborn hearing screening Computer and connected to the network Data entry, upload and analysis (2) Diagnostic institutions Equipment Usage Diagnostic auditory evoked potentials instrument Assessment of the degree of hearing loss, nature and hearing rehabilitation effects Diagnostic otoacoustic transmitter Diagnostic acoustic conductivity meter (including 226Hz and 1000Hz sound detection) Diagnostic audiometer, sound field test system (for behavioral observation audiometry, visual reinforcement audiometry, play audiometry and speech audiometry) Computer and connected to the network Data management (retain the original data of the results) Second, institutional responsibilities (a) screening institutions. 1, in strict accordance with the relevant provisions of the Ministry of Health “newborn disease screening management methods”. 2.Establish various screening rules and regulations, and comply with the technical operation routine. 3, do a good job of pre-screening publicity and education, follow the principle of informed consent, and respect the choice of the guardian’s personal wishes. 4.For those who enter the screening process, the screening report card should be issued to their guardians and explain the screening results, responsible for re-screening, referral and follow-up. 5, newborn hearing screening basic information registration, statistics, reporting. (B) diagnosis and treatment institutions. 1, in strict accordance with the Ministry of Health “newborn disease screening management methods”, and carefully do the diagnosis, treatment, follow-up and consultation of newborn hearing disorders. 2.Establish various rules and regulations for diagnosis and treatment, and comply with technical operation routines. 3.Accept referrals and be responsible for audiological and corresponding medical diagnosis of children who fail the screening, issue “Hearing Diagnosis Report Form”, inform the guardians and explain the diagnosis results. 4.Develop treatment plans for diagnosed children and implement them or make feasible guidance suggestions. 5.Data registration and preservation, statistical filing and reporting of relevant information. Third, the technical process (a) screening. 1, the normal birth of newborns to implement two-stage screening: 48 hours after birth to the completion of the initial screening before discharge, those who do not pass and those who miss screening should be binaural re-screening within 42 days. Those who fail to pass the re-screening should be referred to the hearing impairment clinic designated by the provincial health administrative department for further diagnosis within 3 months of age after birth. 2, the neonatal intensive care unit (NICU) infants before discharge for automatic auditory brainstem response (AABR) screening, failed to pass the direct referral to the hearing impairment clinic. 3. Newborns with risk factors for hearing loss should be followed up at least once a year for 3 years even if they pass the hearing screening, and they should be promptly seen by a hearing disorder clinic if they suspect hearing loss during the follow-up. Risk factors for neonatal hearing loss: (1) NICU stay of more than 5 days; (2) Family history of permanent hearing impairment in childhood; (3) Intrauterine infections caused by cytomegalovirus, rubella virus, herpes virus, syphilis or toxoplasmosis (toxoplasmosis); (4) Craniofacial morphological malformations, including auricular and ear canal malformations; (5) Birth weight less than 1500 grams (6) hyperbilirubinemia to the requirement of blood exchange; (7) viral or bacterial meningitis; (8) neonatal asphyxia (Apgar score 0-4 at 1 minute or 0-6 at 5 minutes); (9) respiratory distress syndrome in preterm infants; (10) extracorporeal membrane oxygen; (11) mechanical ventilation for more than 48 hours; (12) maternal use of ototoxic drugs or tab diuretics during pregnancy, or abuse of (13) clinical presence or suspicion of syndromes or genetic disorders related to hearing impairment. 4, in medical institutions that are not yet equipped to conduct newborn hearing screening, the guardians of newborns should be informed to refer newborns within 3 months of age to a screening facility that is qualified to complete hearing screening. 5. Operation steps. (1) clean the external ear canal; (2) the examined child is in a quiet state; (3) strictly in accordance with the technical operational requirements, using screening otoacoustic emission meter or automatic auditory brainstem response instrument for testing. (II) Diagnosis. 1. Newborns who do not pass the re-screening should be diagnosed within 3 months of birth. 2, screening failed NICU children should be referred directly to the hearing impairment clinic for confirmation and follow-up. 3, hearing diagnosis should be based on test results for cross-checking to determine the degree and nature of hearing impairment. Suspected of other defects or systemic disease children, direct them to the relevant departments; suspected of genetic factors causing hearing impairment, to qualified health care institutions for genetic counseling. 4.Diagnosis process. (1) history taking; (2) otolaryngological examination; (3) hearing test, should include electrophysiological and behavioral hearing test content, mainly: acoustic conductance resistance (including 1000Hz detection tone), otoacoustic emission (OAE), auditory brainstem response (ABR) and behavioral audiometry and other basic tests; (4) auxiliary examination, if necessary, relevant imaging and laboratory auxiliary tests. (C) Intervention. Children diagnosed with permanent hearing impairment should undergo appropriate clinical medical and audiological interventions within 6 months after birth. (D) Follow-up. 1, screening institutions are responsible for the initial screening of those who do not pass the follow-up and re-screening. Re-screening still failed to be timely referral to the consultation and treatment institutions. 2, the diagnosis and treatment institutions should be responsible for the follow-up of suspected children, children diagnosed with hearing impairment at least once every six months. 3. Localities should develop requirements and procedures for follow-up visits and incorporate them into the work routines of maternal and child health care. Maternal and child health care institutions should assist the diagnosis and treatment institutions together to complete follow-up visits to children diagnosed with hearing impairment, and do a good job of registering and keeping all the information, and guide community health service centers to do a good job of hearing monitoring and health care for children in their areas. (E) Rehabilitation. 1. For children using artificial hearing devices, professional auditory and speech rehabilitation training should be conducted. Regular review and commissioning. 2, the parents or guardians of children with hearing impairment are instructed to the resident local authorities and the Disabled Persons’ Federation for the record in order to receive family rehabilitation guidance services. Fourth, quality control Health administrative departments to organize the development of assessment and evaluation programs, regular supervision and inspection of screening institutions, hearing impairment diagnosis and treatment institutions, quality control of all aspects of newborn hearing screening, and take timely improvement measures to identify problems. Newborn hearing screening center or by the health administrative department designated to undertake hearing impairment diagnosis and treatment of medical institutions to establish and maintain a newborn hearing screening database, do a good job of newborn hearing screening information management work.