In ENT clinics, we often encounter cases where the child is more than two years old and still cannot speak or speak in a way that is incomprehensible to others. Even with intervention (such as hearing aids or cochlear implants), the child’s ability to speak will eventually be affected, and in severe cases, the child’s healthy growth will be affected and the family will be burdened. In fact, these tragedies could have been avoided by the newborn hearing screening technology that is now common in China, which can make a basic determination of whether a child’s hearing is normal or not from the moment of birth. What is newborn hearing screening? Newborn hearing screening is a rapid initial test (initial hearing screening) performed by a hearing screening technician in the obstetrics department within 48-72 hours after birth for each newborn baby. The newborns who do not pass the re-screening need to go to a nationally designated hospital ENT hearing screening and diagnostic center before 3 months of age for further hearing examinations to determine whether hearing loss really exists, and the degree and nature of hearing loss, so as to achieve the purpose of early detection and early intervention. Why do we need newborn hearing screening? Deafness is one of the most common birth defects and ranks among the top five disabilities. According to the 2nd National Sample Survey of People with Disabilities, there are 137,000 hearing impaired children aged 0-6 in China and about 20,000-30,000 deaf newborns are added every year. We know that hearing is the basis for learning language. If we cannot hear from birth, it is impossible for us to learn to speak. The so-called “deafness” is not due to problems with the articulatory organs (vocal cords) and therefore cannot speak, but because they cannot hear sounds, cannot receive and respond to them normally, and therefore cannot learn to speak. Scientific research has shown that the critical period of language development is before the age of 3. If normal language learning is not established within the most important and critical period of language development, from 2 to 3 years old, it will eventually lead to psychological and behavioral problems such as speech impairment, low social adaptation, attention deficit and learning difficulties in the lighter cases, and will lead to deafness in the heavier cases. Therefore, for newborns and infants with deafness, early detection, early diagnosis and early intervention are especially important, and hearing aids or cochlear implants can help children hear and learn to speak, so that they can be “deaf but not dumb”. At present, more than 30 provinces, cities and autonomous regions in China have carried out different degrees of newborn hearing screening. The detection rate of deaf children can reach 1‰-3‰, newborn hearing screening has made a great contribution to reducing the incidence of deaf children in China. It can be said that newborn hearing screening technology, is a magic bullet for early detection of deaf children. How is newborn hearing screening done? The process of newborn hearing screening includes initial screening, re-screening and confirmatory stages. Otoacoustic emission (OAE) and automatic auditory brainstem response (AABR) are commonly used and are internationally recognized as easy to perform and harmless to the baby. The initial screening is usually performed within 3-5 days of your baby’s birth and begins with a probe or earmuff placed in one of your baby’s ears during sleep and quiet. If your baby passes the initial screening, your baby’s hearing function is basically normal. If your baby does not pass the initial screening, your baby may have a hearing problem and will need to be rescreened within 42 days of birth. However, you should not worry too much, because in many cases, such as external auditory tract fat, incomplete absorption of amniotic fluid in the middle ear and lack of cooperation from the child, even if the screening does not pass, it does not mean that the child is hearing impaired. If your baby passes the screening, congratulations, it means that your baby’s hearing function is basically normal. If your baby does not pass the screening, he/she needs to go to a designated ENT hearing screening and diagnostic center before 3 months of age for further hearing tests to determine whether there is a hearing impairment and the nature and extent of the hearing impairment. However, it is important to note that even if the newborn hearing screening result is “passed”, it is not completely certain that the child has no hearing problems, because there is a disease – auditory neuropathy, the cochlea can also respond to sound stimulation, only passing the screening can not be ruled out. There are also diseases in which the child is born with normal hearing and is not detected until a certain age, which is characteristic of delayed deafness. Therefore, if parents are suspicious of their child’s hearing and speech level during the period of speech formation from 0-6 years of age, they should immediately go to the hospital for an audiological test. How can hearing intervention be performed for a child who has been diagnosed with a hearing impairment? For children with hearing impairment, the earlier the intervention is done, the better. Generally speaking, for children with severe deafness, it is recommended to start hearing aids at 4 months after birth; for those with moderate deafness, it is recommended to start hearing aids at 6 months of age; for some children with moderate and mild deafness, it is recommended to follow up until 8 to 10 months of age and after permanent hearing loss is determined, it is recommended to match hearing aids and conduct auditory speech training at the same time. For children with poor hearing aid results, cochlear implantation is recommended around 1 year of age, followed by auditory speech rehabilitation.