Screening of Infants 0-6 MonthsTo be considered a diagnostic procedure, ear specific estimates of type, degree, and configuration of the hearing loss must be obtained. This differs from a simple screening. Adequate confirmation of an infant's hearing status cannot be obtained from a single test measure; rather the initial test battery must include physiologic measures and, if possible, developmentally appropriate behavioral techniques.
Most pediatric offices provide a screening and require referral to a pediatric audiologist for diagnostic testing.
In determining whether an infant should be referred for further testing, a detailed history should be obtained.
Detailed history should include but is not limited to:
a. Parental report of auditory and visual behaviors
b. Motor development
c. Family history of hearing loss
d. History of middle ear pathologies
e. Parental concerns
f. Prenatal, birth, and neonatal history
g. Medical history including: Syndromes or other inheritable conditions, craniofacial anomalies, kidney issues, conditions of limbs/digits, pigmentation issues, exposure to ototoxic medications
Visual inspection for obvious structural abnormalities of the pinna and ear canal should be included.
Evoked Otoacoustic Emissions
• Either Transient or Distortion Product Emissions are acceptable.
• TEOAE click stimuli: One level (e.g., 80-85 dB pSPL) should be completed.
• DPOAE stimuli: Use L1/L2 of 65/55 dB SPL.
Pass criterion: An emission of 6 dB signal to noise ratio for at least three frequencies in each ear.
• At least one frequency should be located between 2000 and 3000 Hz
• A second frequency should be located between 3000 and 4000 Hz
• The third point could be at any other frequency between 1000 Hz and 6000 Hz
Auditory Brainstem Response (ABR) re-screening
Must be performed on any baby who was admitted to the NICU for more than 5 days. ABR rescreening may be performed on babies who were discharged from a well-baby nursery whether they were initially screened with OAE or ABR technology.