The results of the Second National Sample Survey of Persons with Disabilities show that hearing and speech disabilities top the list of five types of disabilities in China. Out of every 1000 newborns, about 1-3 have hearing impairment. There are 800,000 deaf children aged 0-7 in China, and the number of deaf children is increasing by 30,000 every year. The first three years of life are considered to be a critical period for a person’s speech and language development. A survey in the United States showed that the average age of diagnosis for children with hearing loss is three years. And the milder the hearing loss, the later it is detected. Newborn hearing screening is an effective way to detect deaf children early and intervene early. The three “don’ts” of newborn hearing screening When someone else’s baby is already articulate and speaks in a way that makes adults’ stomachs hurt from laughing, but your baby still can’t speak or speaks in a way that is incomprehensible, do you think there might be a problem with your baby’s hearing? Babies with normal hearing usually start babbling between 4 and 9 months, and no later than 11 months. If your baby has a hearing impairment and lacks speech and sound stimulation during the babbling stage, he or she will not be able to learn normal language during the most critical period of language development (1-4 years old) and will become slurred or even deaf. In the past, there was no hearing screening program, and it was often only after the child was 2 years old that parents or teachers suspected hearing abnormalities and checked the child, missing a good time for language learning. Today, as soon as a baby is born, it is possible to find out if his hearing is normal through the newborn hearing screening program. This technology is widely carried out throughout China, with diagnosis within 3 months and intervention for deaf children within 6 months. The initial screening is done in ten minutes “Will it hurt to have a hearing screening when the child is so young and has such tender ears?” This is the first reaction of some parents. Currently, the main methods used for newborn hearing screening in China are the otoacoustic emission (OAE) method or the automatic auditory brainstem response (AABR) method. Both methods are easy and non-invasive; for OAE, a special soft ear plug is inserted into the baby’s ear, which collects sound waves generated by the cochlea in response to sound stimulation, while for ABR, electrodes are applied to the forehead, behind the ear, etc. to record brain waves generated by the brain in response to sound stimulation to determine whether the baby’s hearing is normal. The test requires a quiet environment; crying, sucking, or breathing too fast are distractions. The natural time to keep your baby quiet is when he or she is asleep. Therefore, the baby will only feel his ears being gently plugged with small soft plugs, a sensation that he will not necessarily feel when he is in a beautiful sleep. However, the baby can not yet “read the mind”, sometimes he does not cooperate, has been crying, just refused to sleep, how to do? At this time, the doctor needs to give some medicine, this medicine is chloral hydrate (oral or rectal administration can be) or sodium phenobarbital intramuscular injection, it can make the baby fall asleep as soon as possible, and safe, will not have adverse effects on the baby. Parents do not need to be worried about refusal. Both at home and abroad, those tests that require quiet cooperation from the child, such as ECG and EEG, can be performed after the child has fallen asleep with chloral hydrate or sodium phenobarbital if the child does not cooperate. The most important thing for parents is “if your baby doesn’t pass the initial screening, does it mean that his or her hearing is not good? The initial screening is usually done 3-5 days after birth and before the baby is discharged from the hospital. In our country, the initial screening is mostly done by OAE, which is fast and sensitive, but it is easily disturbed and “wronged the baby”. If the fetal fat in the external ear canal is not completely eliminated, if the amniotic fluid in the middle ear is not completely absorbed, or if the baby does not cooperate properly, it is not easy to pass the test. It is quite like “I would rather kill a hundred wrongly than spare one”. Therefore, a positive initial screening does not mean that the baby has a hearing problem. If the baby has a positive initial screening, nine out of ten will pass the screening at 42 days, while those who do not will have to undergo a diagnostic hearing test within 3 months. At this point, some mothers questioned: “If it is easy to ‘wrong’ the baby during the initial screening, why do we have to wait until 42 days for the re-screening? Instead of waiting anxiously for the rescreening, why not just screen at 42 days, or skip the screening and do the diagnostic test directly at about 3 months of age?” Indeed, a survey conducted by Xinhua Hospital, affiliated with Shanghai Jiaotong University School of Medicine, found that 70% of parents of children with positive initial screening results said they would be worried and scared, and 40% said they would even be anxious. In the case of new mothers, a bad mood may even affect breastfeeding. Then, mothers and fathers hear that their children did not pass the initial screening, there is no need to rush to do a second test, these interfering factors are not removed, the second and third tests too close together may have the same result. During this time of waiting for the re-screening, mom and dad can listen to soft music for their baby to stimulate the development of their auditory system. Screening directly at 42 days is theoretically possible, but not all mothers will consciously do so. All of China’s regulations stipulate that the initial screening is done 3 days after birth, before the baby is discharged from the hospital, to avoid “missing fish” and to ensure the census of newborns. So can we “give up screening for diagnosis”? Screening and diagnosis are not the same. The cost of screening is low, only about$40, while diagnostic testing costs$200 to$300. There is no need for all children to be diagnosed and “kill the chicken with a bull”. Only children who do not pass the screening will need to be diagnostically tested, which saves a lot of social costs. The newborn screening result is “passed”, but also can not be paralyzed. There is a condition called auditory neuropathy in which the cochlea responds to sound stimulation, and the OAE does not detect a problem. Hearing screening can also be passed at birth for large vestibular canal syndrome. However, the incidence of auditory neuropathy is low (about 0.01-0.03%). There is also a case in which a child is born with normal hearing and naturally has a normal test, only to find out at a certain age that the hearing is slowly getting worse. This is a characteristic of delayed deafness. Late onset of deafness can occur as early as 8-12 months of age and as late as 4-5 years of age and beyond, and early detection of such children is only possible with regular hearing monitoring and follow-up. In addition, familial, hereditary hearing loss can occur at school age or later, with progressive exacerbation. It is more likely to require close parental observation. Therefore, if parents are in doubt about the level of their baby’s hearing, speech-language development, any time they can see the appropriate doctor (ENT or pediatric) for an audiological test. Failure to pass the screening does not necessarily mean that the baby does not respond to sound “The baby failed the initial screening, but usually when I close the door or something smashes, the baby can jump in surprise ah. He turns his head when he claps his hands, and he responds to sounds!” One mom asked for help online. Another mother immediately came out to top the post, “Same as my baby, don’t worry, it will be fine. We didn’t go for re-screening, and now the baby is developing well.” Why did the baby respond to the sound if he failed the screening test? This question has to be looked at in two ways. In one case, the child does not have a hearing problem, but the screening is “confusing” and the baby is being “wronged” by the aforementioned distractions. But in another case, the child may have a mild to moderate hearing loss. It is true that children do respond to some sounds in their daily lives, but a mild hearing loss can also affect the child’s speech and language development. If you stop reviewing your child because you think he or she is responding to sounds, you may miss a child with mild to moderate hearing loss.