| Background and ObjectiveCongenital hearing impairment is a common birth defect .In all neonates, the incidence of bilateral hearing impairment is 1-3 per 1000, severe and profound hearing impairment is about 1 per 1000, normal hearing is a premise to learn speech and language. Infant whose hearing is normal begins to learn speech and speak when he (or she) is from 4 to 9 months old. It is an important period to learn speech and language, if the infant is deafness, he (or she) can't heard sounds and words, so he (or she) can't speak. At last, when he (or she) is about 2-3 years old, He (or she) can't hear nor speak, so he becomes (or she) a disable. If we can recognize their hearing defect shortly after they are born, and have a intervention in time with auditory service, we give them more speech stimulation, they will learn speech and language more and can recovery mostly. The change for development of their speech, language, communication and academic skill are improved when the diagnosis is made before the age of 3 months .To achieve the goal, hearing screening must be carried out at neonate. If distraction screening at the age of 8 or 9 months is taken, it means that the child is at least 12-18 months (and of much older) before treatment can be started. The prevalence of profound to screen hearing impairment is approximately 1 per 1000 healthy newborns. Even though "targeted" screening of high-risk infants has a high yield. More than 40-50% of children with hearing impairment are not discounted if the hearing screening is fixed to this group. Therefore universal neonatal hearing screening is necessary.In 1990, with financial assistance provided by American nation ministry of education and ministry of health, a audile evaluation center was established in the Rhode Island; In 1993, National Institutes of Health suggests: hearing screening must be carried out in the neonatal period, when they are younger than 3 months; in 1994 Joint committee of infant Hearing point out the diagnosis of hearing impairment should be made before the age of 3 month, and treatment before the age of 6 months; In 1999, American Academy ofPediatric published the article "neonates and infants hearing impairment: examination and intervention", which demonstrated that it is necessary and feasibility to have hearing screening, and make a universal neonate Hearing Screening plan, Our government recognize the importance of neonate hearing screening .In 1999 Chinese Disabled Joint committee and Ministry of Health bring neonate hearing screening to Women and Infant Preventive Health Care. In 2002, Hygiene Agency of ZheJiang province published a document that is "The children hearing screening and the deafness children rehabilitation of ZheJiang province should be carried out" and "The hearing screening procedure of ZheJiang province," then started to do this job firstly in China.To complete neonates hearing screening, it is important to depend on multidisciplinary synergy and co-operation. In our country, hearing screening is done by Women and Infant Preventive Health Care staffs; the final diagnosis and intervention is done by audiologists and otologists; auditory rehabilitation is by language rehabilitation stuff.The article is to discuss how to diagnose hearing impairment, to find a pattern for making a final diagnosis for the infants who can't pass the hearing screening.MethodsThere were 19,302 neonates who were born between Oct 2000 to March 2002,from 11 hospitals in Hangzhou, Jiaxin, Shaoxin, Huzhou and Taizhou .they were tested by Bio-logic otoacoustic emission machine, among them 56 neonates or infants could not pass the hearing screen, who were sent to our hospital for further diagnosis. We collected the information of their perinatal history; had them done audiological tests for three time; checked the CX26 gene and temporal bone CT of 36 infants who is diagnosed deafness.ResultsOne infant recovered normal hearing after three times audiological tests at aninterval of two months during seven months,...
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