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Guidelines for Newborn Hearing Screeningand Evaluation

 The purpose of this document is:1• To provide a description of a suggested quality hearing screening program for

newborn.

• To provide a description of recommended procedures to audiologists performing

follow up hearing screening or audiological assessment of infants identified duringuniversal newborn hearing screening.

I. DescriptionNewborn Hearing Screening services are provided to identify newborns at risk of hearingimpairment and to assure that follow-up audiometric screening diagnosis and referral tointervention is provided.

II. Purpose:To provide a statewide comprehensive and coordinated interdisciplinary program of early

hearing screening and follow-up care for newborns identified as referring from the hearing

screening process. The goal is to screen all newborns for hearing impairment in order to

alleviate the adverse effects of hearing loss to speech and language development

academic performance and cognitive development.

 III. Definition of Targeted Hearing Loss!ongenital permanent bilateral unilateral sensory or permanent conductive hearingloss of newborns in well-infant nurseries to include neural hearing loss "e.g. auditoryneuropathy # auditory dyssynchrony$ in infants admitted to the Newborn %ntensive !are&nit "N%!&$ for more than ' days. %dentification of risk factors associated with delayedonset or progressive hearing loss.

IV. Suggested Inpatient Community Hospital Guidelines. Definition

 (n inpatient newborn hearing-screening program will be capable of providingnewborn hearing screening testing to all newborns and infants during their birthadmission or neonatal intensive care unit admission.

!. Standards for Hearing ScreeningIt is recommended that:

)The hospital designates one indi"idual "preferably an audiologist$ to serve as the contactperson for the newborn hearing screening program. The designated person is responsiblefor ensuring that persons who perform hearing screening are sufficiently trainedcoordinating follow-up services and managing all correspondence. This person will alsoserve as the liaison between the hospital family and !hildren*s +edical Services.

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C. udiological Screening GuidelinesIt is recommended that:,etermination of presence or absence of an (uditory voked otential "e.g. (/0$

and#or toacoustic missions "($ at a predetermined screening level to assessthe need for further audiological evaluation.

)Newborn hearing screening services should be performed using 2,( approved otoacousticemissions or evoked potential testing that detects mild to profound hearing loss in newborns"(/0 is to be used to screen infants with N%!& stays of more than ' days$.

&se of screening equipment should be in accordance with manufacturer*s protocols andstated norms for newborn hearing screening purposes.

The equipment should be calibrated in accordance with the manufacturer*s

recommendation and a log should be kept documenting the dates of calibration repair orreplacement of parts.

2or rescreening or a complete evaluation it is necessary to test both ears even if only oneear caused a referral from newborn hearing screening.

D. #uality Indicators of appropriate referral rateIt is recommended that:

) ( minimum of 345 of newborns born in the hospital should receive a hearing screeningprior to discharge.

 ( ma6imum outpatient referral rate of 75 of all newborns screened prior to dischargeshould be achieved.

2ollowing a two-stage screening a minimum outpatient referral rate of 15 for (/0screening and 85 for ( screening should be observed for all newborns screened prior todischarge "if the refer rate is worse than these percentages the hospital should trainscreening personnel on the importance of the two-stage "or repeat$ screening process whileavoiding e6cessive rescreening during an single encounter$.