What should I do if my baby passes the hearing screening during a physical examination but is not sensitive to sound?

Babies who pass the hearing screening but are not sensitive to sound can be intervened through daily observation, auditory training, elimination of environmental interference, assessment of developmental stages, and medical follow-up. It may be related to physiological developmental differences, environmental adaptation, delayed auditory nerve development, abnormal middle ear function, or congenital hearing impairment.

1. Daily observation

Parents need to record the frequency of their baby's response to sudden sounds, such as closing doors, ringing bells, etc. Some infants may exhibit delayed responses due to deep sleep or scattered attention, but there should be clear reactions after repeated testing. It is recommended to observe in a quiet environment to avoid misjudgment.

2. Auditory training

Use high-frequency toy bells, music boxes, and other tools for directional sound source training, 2-3 times a day. Choose sound toys with significant differences in pitch and observe the baby's ability to turn their head to find the sound source. Further evaluation is needed if there is no improvement for 1-2 weeks.

3. Eliminate environmental interference

Check if there is continuous background noise such as air conditioning sound in the home, which may cause the baby's sensitivity to intermittent sounds to decrease. Electrical appliances should be turned off during testing to ensure that the ambient noise is below 40 decibels.

4. Evaluation of developmental stages

Premature or low birth weight infants may experience a delay of 2-4 months in auditory pathway development. If the corrected age of the baby is less than 6 months, it can be temporarily observed. It is recommended to conduct neurobehavioral assessments simultaneously when accompanied by delayed development of gross motor function.

5. Medical follow-up

If there is no sustained response, an auditory brainstem response test should be performed to rule out cochlear lesions. Middle ear effusion can affect sound conduction, manifested as passing screening but weak behavioral response, requiring otolaryngology for acoustic impedance testing. Congenital inner ear malformation needs to be diagnosed through temporal bone CT.

Parents should establish a sound response record form, indicating the testing time, sound source type, and response intensity. Avoid frequent replacement of testing tools and use the same sounding item to ensure comparability of results. breastfeeding mothers should pay attention to balanced nutrition and ensure the intake of DHA and zinc to promote neural development. If there is no improvement within 3 months or accompanied by delayed language development, a multidisciplinary joint evaluation must be conducted at the Child Health Department.