Guidelines for NICU Newborn Hearning Screening


Since the incidence of sensory, as well as neural hearing loss is approximately ten times higher in the Neonatal Intensive Care Unit (NICU) versus well-baby nursery, A-ABR is the recommended screening technology for use in the NICU population.

Guidelines for conducting hearing screenings in the NICU nursery:

  • Select a time when the infant is medically stable.
  • Choose a time when the infant is not being seen by other health care professionals.
  • Test when infants are quiet or sleeping; optimally, one hour following feeding.
  • To help calm a restless infant, swaddle the infant and dim the lights.
  • Ensure a quiet environment for testing, away from background noise.
  • Follow standard precautions for infection control (e.g. hand washing, appropriate cleansing of equipment, etc).

Kansas Hearing Screening Guidelines (PDF)

A-ABR Testing

Infants in the well-infant nursery who fail A-ABR testing should not be rescreened by OAE testing and "passed" because such infants are presumed to be at risk of having a subsequent diagnosis of auditory neuropathy/dyssynchrony.

For infants who do not pass A-ABR testing in the NICU, referral should be made directly to an audiologist for rescreening and, when indicated, comprehensive evaluation, including diagnostic ABR testing, rather than for general outpatient rescreening.