Primary Care Physicians

How is the newborn hearing screening performed?

The two screening technologies currently available are Auditory Brainstem Response (ABR) and Otoacoustic Emissions (OAE).

ABR is an electrophysiological measure of the auditory nervous system's response to sound. A sound (e.g. click or tone bursts) is presented to the ear via earphones or probe tips, and electrodes record the response as the nerve impulse travels from the cochlea (inner ear) through the auditory nerve to the brainstem. ABR is typically performed by an audiologist as part of a diagnostic evaluation. ABR test results are best interpreted by an audiologist to determine if further testing is needed.For the purposes of hearing screening, Automated ABR (A-ABR) equipment has been developed. A-ABR screening equipment provides fully automated results interpretation (only a 'pass'/'not pass' outcome). Consequently, the A-ABR allows for others besides audiologists to perform the hearing screening. Other personnel that can be trained include nurses, midwives, technicians, support staff, and volunteers.A-ABR may miss a small percentage of hearing losses, such as a mild hearing loss or a low frequency or high frequency hearing loss.A-ABR is sensitive to identifying those children at risk for conductive, sensory, or neural (Auditory Neuropathy Spectrum Disorder) hearing loss/disorders.
OAE evaluates the integrity of the outer hair cells in the cochlea. Thus, the test can identify infants at risk for sensory hearing loss. A sound is presented into the ear canal and a small microphone measures the response from the infant's cochlea (inner ear) that is evoked by the test signal(s). The audiologist analyzes the response to determine how well the inner ear sensory cells are functioning. There are two types of OAE technologies: Transient Evoked Otoacoustic Emissions (TEOAE) and Distortion Product Otoacoustic Emissions (DPOAE).
  • OAE testing can be fully automated for the purposes of hearing screening and provide a 'pass'/'not pass' outcome.
  • OAE responses indicate the status of the peripheral auditory system extending to the outer hair cells of the cochlea.
  • OAE may miss a mild hearing loss and children that are at risk for Auditory Neuropathy Spectrum Disorder.
  • OAE results are sensitive to sensory hearing loss greater than 40 dB in addition to transient outer ear or middle ear conductive hearing loss.
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The Newborn Hearing Screening and Intervention Program of the PA Department of Health (PA DOH) works with physicians to ensure that babies receive a hearing screening no later than 1 month of age and that babies who do not pass their hearing screening receive a diagnostic evaluation by an audiologist no later than 3 months of age.

Find out more about the Newborn Hearing Screening and Intervention Program

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