Risk Factors for Congenital Hearing Loss

  • Family history of permanent hearing loss in childhood
  • Maternal infections during pregnancy or delivery (Toxoplasmosis , Syphilis, HIV, Hepatitis B, Rubella , CMV, Herpes simplex, and others)
  • Physical problems of the head, face, ears, or neck (cleft lip/palate, ear pits/tags, atresia, and others)
  • Ototoxic medications given in the neonatal period
  • Syndrome associated with hearing loss (Pendred, Usher, Waardenburg, neurofibromatosis)
  • Admission to a neonatal intensive care unit greater than 5 days
  • Prematurity (< 37 weeks)
  • Hyperbilirubinemia

3-3-6 Rule

  • 3 weeks: A new born should have a hearing screening before leaving the hospital or within the first three weeks of life.
  • 3 months: If the child did not pass the initial hearing screening steps should be taken with the audiologist and pediatrician to make sure any permanent hearing loss is identified by this time.
  • 6 months: Intervention should start as soon as possible if a permanent hearing loss is found. Treatment for hearing loss can be most effective if it’s started before a child is 6 months old.

Warning Signs

  • Parent/caregiver concern regarding hearing
  • Delays in speech/language development
  • Recurrent middle ear infections or one episode lasting < 3 months
  • Head trauma associated with loss of consciousness or skull fracture
  • Bacterial meningitis and other infections (mumps, encephalitis, viral labyrinthitis)
  • Exposure to potentially damaging noise levels
  • Ototoxic medications received at any time

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