Why do newborns have hearing impairment? There are many factors that can cause hearing impairment in newborns, such as: history of intrauterine infections: cytomegalovirus; rubella virus; herpes; syphilis; toxoplasmosis, etc. Exposure to ototoxic drugs during pregnancy, such as gentamicin, teratogenic drugs, such as reactive stop, or radiation prematurity, birth weight < 32 weeks of gestation < 1500 g. History of neonatal illness: riboflavin (hyperbilirubinemia); ischemic-hypoxic encephalopathy, cerebral palsy with syndromes including sensorineural deafness The above are all risk factors for hearing impairment in newborns, and the presence of these conditions should be taken seriously by the family. Why do we need newborn hearing screening? Infancy and early childhood, especially before the age of 3 years, is a critical period for learning language. During this period, deafness, even if it is mild, can lead to language impairment and even mental retardation, resulting in psychological and behavioral deficits in the child. Intervention in infants and children with hearing impairment within 6 months of birth can lead to more desirable treatment outcomes. Therefore, only early determination of the presence or absence of hearing impairment in children can be given the appropriate early treatment, thus minimizing the adverse consequences caused by hearing impairment and changing the life of the deaf child. Newborn hearing screening methods: Newborn hearing screening methods include subjective hearing test and objective hearing test. 1. Subjective hearing test: pediatric behavioral audiometry 2. Objective hearing test: otoacoustic emission (OAE), auditory brainstem response (ABR), 40Hz correlation potential, acoustic impedance testing, multi-frequency steady state (ASSR) How to perform hearing screening? 1.Phase 1: Hearing screening phase Initial screening: hearing screening during hospitalization, test technique: OAE Rescreening: newborns who failed the initial screening during hospitalization will be screened a second time 42 days after birth, test technique: OAE 2.Phase 2: Diagnostic hearing impairment phase Newborns who do not pass the initial screening and rescreening will need to undergo a comprehensive diagnostic audiological examination within 3~6 months after birth. Including: Acoustic conductance, OAE, ABR, 40Hz auditory correlation potential, behavioral audiometry and other related examinations. Children diagnosed with hearing loss should be treated according to further investigations. Newborns with risk factors for hearing loss should be followed up at least once every six months for three years, even if they pass the hearing screening. In conclusion, if a newborn fails the test, he or she should be retested around 42 days after birth, and if he or she still does not pass, a diagnostic hearing impairment test and medical evaluation should be performed, and if hearing loss is suspected, the diagnosis should generally be confirmed within 3 months of birth so that the child can receive early medical intervention. Does failure to pass the initial screening mean that hearing impairment must exist? Although current hearing tests are more advanced, false positive results can still occur due to the presence of certain influencing factors. Some of the factors that can affect the test results are: the influence of secretions from the outer middle ear, interference from environmental noise, crying, and malfunctioning or improper use of the instrument. The following methods can be used to improve the accuracy of the screening test in response to the above-mentioned influencing factors. 1. Clean up the secretions in the external ear canal Clean up the secretions in the external ear canal with cotton swabs before screening 2. Because OAE screening mainly detects the function of the outer hair cells of the inner ear, it does not fully reflect the function of the cochlea and the posterior auditory nerve pathway. Therefore, newborns with risk factors for hearing loss need to be alert to posterior cochlear deafness even if they pass the OAE screening. In such cases, families should pay attention to strengthen the observation of the child's daily speech function development, and if abnormalities are detected or suspected, they should promptly visit the hospital.