Newborn hearing screening methods The screening methods are mainly otoacoustic emission and auditory brainstem response, as follows: 1. Otoacoustic emission (OAE) is a non-invasive technique that is easy to perform and takes only 10 minutes to test both ears. However, it is susceptible to the state of the external auditory canal and middle ear and requires a strict testing environment. False positive results may occur if the newborn has secretions such as meconium and amniotic fluid in the ear canal after birth, or if the breathing noise and environmental noise are too high. 2. Automatic Auditory Brainstem Evoked Potential (AABR): It is commonly used to examine the presence or absence of postcochlear lesions. The AABR and OAE techniques can be used in combination to examine the functional status of the cochlea, auditory nerve conduction pathway, and brainstem of newborns. Different screening protocols are used for normal delivery and NICU newborns. 1. Normal delivery: Screening otoacoustic emission (OAE) or automatic auditory brainstem response (AABR) is commonly used as the initial screening tool, and all newborns should receive initial hearing screening before discharge from the hospital. Newborns who do not pass the initial screening should be rescreened within 42 days of birth. All newborns who do not pass the initial screening should be rescreened within 42 days of birth. Both ears should be rescreened at the time of rescreening, even if only one ear fails the initial screening. Infants who do not pass the AABR test should be referred directly to the hearing center for re-screening and a full hearing assessment as appropriate; 3. Infants and children re-hospitalized within 1 month of age (whether in the NICU or general ward): when accompanied by the possibility of delayed hearing loss, such as children with hyperbilirubinemia with indications for blood exchange, or septic children with positive blood cultures, hearing should be re-screened before discharge; 4. In addition to detecting pre-existing hearing loss during hearing screening, it is also important to analyze the medical and family history to understand whether the subject is at high risk for delayed hearing loss, and to conduct regular follow-up of hearing for those who are suspected. Parents are advised to bring their infants to the hospital for rescreening on a regular basis to prevent false positive results. If the baby does not pass the screening in one ear, he or she will also fail the newborn hearing screening and the parents will need to cooperate with the physician to handle the case accordingly. Newborn Hearing Screening Results Screening results: Passes in both ears, fails in one or both ears. What to do if you do not pass the hearing screening Newborn hearing screening, diagnosis and intervention is a complete hearing rehabilitation system. The method and timing of intervention is important for the hearing, speech and language rehabilitation of the child. Intervention includes medical intervention, hearing compensation or reconstruction, hearing function training and language rehabilitation training. 1.Medical intervention Medical intervention refers to the method in which the physician proposes a medical diagnosis, i.e., the cause, degree and location of hearing loss, and uses treatment to restore hearing. (1) External ear canal cerumen: In newborns and infants, excessive cerumen and difficulty in natural discharge can block the external ear canal. In this case, the use of otoacoustic emission examination can often affect the results of the examination, therefore, it is necessary to remove the outer ear canal cerumen. (2) Acute secretory otitis media: Acute secretory otitis media in infancy is often caused by upper respiratory tract infection as well as immune perversion, which can result in fluid accumulation in the tympanic chamber and hearing loss. It can be clarified according to clinical symptoms and otologic microscopic examination and audiometric examination. Etiological treatment, steroid hormone and anti-allergic drugs can be applied. If drug treatment is not effective, transs tympanic membrane puncture and fluid extraction, incision and drainage and installation of ventilation tube through the tympanic membrane can be used to improve and restore the hearing of the child. (3) Congenital malformation of the external ear and middle ear: Different surgical procedures are used according to the classification of the malformation, in order to reconstruct the external ear and auricle on the one hand and improve hearing on the other. For bilateral auricular and external auditory canal malformations, hearing aids should be fitted as early as possible to promote the speech-language development of the affected children. Hearing compensation or reconstruction Hearing compensation or reconstruction mainly includes hearing aids and cochlear implants. (1) Hearing aid matching: Children with permanent sensorineural hearing loss (hearing loss with lesions in the cochlea, auditory nerve or auditory center, causing sound sensory and cognitive dysfunction) should be matched with hearing aids; hearing impairment of moderate to severe degree, generally need to match hearing aids for hearing correction; unilateral hearing loss can also be matched with hearing aids; bilateral hearing loss should be matched with bilateral hearing aids. (2) Cochlear implantation: For children with bilateral severe or very severe sensorineural hearing impairment, if there is no obvious effect with hearing aids for 3-6 months, preoperative evaluation of cochlear implantation should be conducted at about 10 months of age, and early implementation of cochlear implantation is recommended. 3.Auditory function training and speech-language rehabilitation training After hearing aid selection and cochlear implant hearing correction, children need to undergo auditory function training and speech-language rehabilitation training. This requires the participation of a physician, audiologist, speech-language therapist, special educator and psychologist. It is quite important to establish a long-term relationship with the child to support the child’s hearing and speech development so that the deaf child patient can hear sounds and understand speech.