Sensorineural hearing impairment (SNHI) in children is a common clinical entity, which has tremendous personal impact on patients and economic consequences to society. Pediatric SNHI is an etiologically heterogeneous condition caused by a plethora of genetic and/or environmental factors, and for which, the outcomes of treatments such as hearing aids or cochlear implants (CIs), vary significantly among individuals. In principle, early detection, followed by appropriate management, is of paramount importance to improve personal outcomes and to reduce social costs. Although universal newborn hearing screening (UNHS) has been employed in most developed countries, current UNHS programs are limited in their ability to detect late-onset/progressive SNHI after birth and mild SNHI in children. To address this, it has been proposed to refine newborn screening protocols by incorporating genetic and cytomegalovirus (CMV) screenings into the current UNHS program. In this symposium, we will comprehensively review the etiologies and natural courses of pediatric SNHI caused by genetic etiologies and congenital CMV infection, and discuss the feasibility and potential benefits of integrating genetic and CMV screenings into UNHS. 1. The etiologic spectrum of pediatric SNHI 2. Natural course of pediatric SNHI caused by genetic etiologies and congenital CMV infection 3. The feasibility of integrating genetic and CMV screenings into UNHS and potential benefits