Newborn screening

Newborn hearing screening programme (NHSP)


If you, or your baby, are in hospital and are being tested, or have tested positive, for Covid-19 or have symptoms associated with the virus, newborn hearing screening will be deferred and you will be offered this screening at a later date.


If you, or your baby, are being tested, or have tested positive for Covid-19, or have symptoms associated with the virus, do not attend for an arranged outpatient newborn hearing screening appointment. In this instance, please contact your healthcare provider immediately, to arrange a follow up appointment.


The aim of the programme is to identify babies born with a permanent childhood hearing impairment (PCHI) at an early stage, to allow timely intervention and improved outcomes. Approximately 1 to 2 babies in every 1,000 are born with a permanent hearing loss in one or both ears. This screening test is recommended for your baby, even if there is no history of hearing loss in your family. Finding hearing loss (in one or both ears) early is important for your baby’s development.

The screening tests

Two types of newborn hearing screening tests are provided, namely an Automated Otoacoustic Emission (AOAE) test and an Automated Auditory Brainstem Response (AABR) test. The type of test that a baby requires, and is offered, will depend on which screening protocol is applicable and the results of the initial screening test. See links to screening protocols below.

The AOAE screening test involves placing a small, soft tipped earpiece in the outer part of a baby’s ear to send clicking sounds to the inner ear. Using a computer, the person carrying out the test can see how the baby’s inner ear responds to sound. If there are no clear responses in one or both ears, following up to x2 AOAE screening tests, an AABR test is then carried out. If clear responses are not found, the baby is referred to audiology services for diagnostic tests and further follow up.

An AABR is only required in certain circumstances, for example, if a baby does not have a clear response in one or both ears with AOAE testing, or has been admitted to a neonatal intensive care or special baby care unit. The AABR is a different type of test that measures electrical brain activity (rather than measuring acoustic energy within the inner ear). This screening test involves placing small sensors on a baby’s head, shoulder and nape of the neck. Soft headphones are placed over baby’s ears and a series of clicking sounds are played. A computer measures how the baby’s ears respond to these sounds.

Ongoing vigilance

The person with parental responsibility should continue to be vigilant and check baby’s hearing, as they grow up, using the checklist contained in the Personal Child Health Record (PCHR or 'red book’). Any concerns about your baby’s hearing should be discussed with your health visitor or GP.

NHSP Smart4Hearing (S4H) Privacy Notice

The privacy notice describes how your personal information will be processed within the Smart4Hearing (S4H) service for the purposes of providing the Newborn Hearing Screening Programme in Northern Ireland.

Contact details of Trust Data Protection Officers for the Smart4Hearing Privacy Notice are also available. 

NHSP leaflets

Newborn Hearing Screening Leaflets can be found at

NHSP protocols

Newborn Hearing Screening Patient Journey Protocols can be found at 


NHSP annual reports

Newborn Hearing Screening in Northern Ireland Annual Reports can be found at


Further information

Further information can be found on NI Direct

Newborn bloodspot screening

Newborn blood spot screening will continue throughout the COVID-19 pandemic. However, there have been some changes made to how you receive postnatal care. You may be asked to take your baby into your local health centre or clinic for blood spot screening. This will depend on what Trust you are from. Your midwife will discuss this with you.

In the first week after birth, all babies in Northern Ireland are offered screening for a range of inherited conditions including phenylketonuria (PKU), congenital hypothyroidism (CHT), cystic fibrosis (CF), medium chain acyl coA dehydrogenase deficiency (MCADD) and sickle cell disorders (SCD). From March 2020 this will also include the offer of screening for maple syrup urine disease (MSUD), isovaleric acidaemia (IVA), glutaric aciduria type1(GA1) and homocystinuria (HCU).

This screening test is often referred to as the ‘heel prick’ test. Most babies screened will not have any of these conditions but, for the small number who do, the benefits of screening are substantial. The programme makes a major contribution to the prevention of disability and death in our community, through early diagnosis and effective interventions.

Newborn blood spot screening is a complex programme, involving a wide range of services, from highly specialised laboratories through to individual staff in the community and in hospitals, working closely together. The Public Health Agency and partner organisations are responsible for ensuring that the population has access to safe, effective, high quality and equitable screening programmes.

Newborn Blood Spot Screening in Northern Ireland Annual Reports can be found at

Newborn blood spot screening leaflets can be found at

Newborn blood spot screening (English and translations) | HSC Public Health Agency (