Newborn Hearing Screening
Interpreting Results: A Guideline for the Medical
Practitioner
1. When there is a NORMAL SCREEN
Sensitivity at or near 100 percent
Does not exclude acquired hearing loss from causes such as jaundice,
meningitis, serious otitis, familiar progressive hearing loss, cytomegalovirus infection
2. When there is a MISSED SCREEN
There is an estimated 1 in 500 risk of undetected bilateral hearing loss
The hospital determines who will retain initial responsibility for recall
and screening
Later written notice to primary care physician recommended if no return or
abnormal results on rescreening
3. When there is an ABNORMAL SCREEN
The risk of subsequently proven hearing loss is as high as 10-20 percent.
Results of the screen are shared with the family before hospital
discharge, and audiology recheck scheduled
Determine initial responsibility: Audiology department or designee
Schedule appointment
Rescreen
Recall no-shows
Track completion
Goal to complete all rescreening within 4 weeks
Secondary responsibility: Written notification to primary care physician
Continue recall attempt, especially when bilateral
Record on problem list of outpatient medical record
Critical window to confirm diagnosis and begin amplification: 2-6 months
Unilateral abnormal screen:
There is a potential impact on language development
Rescreening is technically easier to perform in the first 1-2 months of
life
Amplification may have a role in maximizing language development
Approach to aggressiveness of follow-up may be individualized
Record on problem list if rescreening or further testing is delayed
4. When the child is subsequently confirmed to be DEAF OR HARD OF HEARING
Unilateral: (20 %)
Possible role of amplification and intervention should be explored with
consultants
Bilateral: (80 %)
Early and consistent intervention (typically including amplification) is
the key to achieving normal language development
Only ten percent of these children are profoundly deaf, and will have less
predictable benefit from traditional amplification; consider opportunities for early
intervention programs, early sign language use and nontraditional amplification techniques
(e.g. cochlear implants, transonic hearing aids)
Primary care physician support is necessary
Encourage timely follow-up with audiology and other consultants
Monitor continuous use of amplification device
Evaluate ongoing development of communication and language
Evaluations recommended in addition to audiology follow-up:
Comprehensive multi-disciplinary evaluation
Speech, language, communications, cognition, motor skills, personal-social
skills
Otolaryngology or otology evaluation
Genetics evaluation
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