Identification of hearing loss in infants and young children.

An infant's hearing loss is detectable at any age. In spite of the importance of identifying deafness early, we do a poor job largely because the medical community is neither aware nor convinced that finding hearing loss is worth the trouble. There are two public health strategies for early detection, the high risk register (family history, hyperbilirubinemia, prematurity, rubella, and maxillofacial anomalies) and behavioral screening. The advantages and disadvantages are discussed. The incidence of handicapping hearing loss in newborns is 1 per 380 births and 1 per 61 in babies admitted to an intensive care nursery. This is higher than generally believed and may be one favorable result of using a new automated hearing screening system--the Crib-o-gram. In most deaf babies there is more than one risk factor present. Evaluating a hearing suspect baby demands a high index of suspicion, and taking the parent's suspicions seriously. The chances that a hearing loss exists at one year of age is about 1 in 4 on parental suspicion alone, regardless of what the physician's opinion might be. Immediate referral upon suspicion needs to occur more often than it does.