The birth screening should consist of a maximum of 2 attempts on each ear. If the infant does not pass in one or both ears, rescreening is recommended.
The rescreening should be performed using Evoked Otoacoustic Emissions (OAE, TEOAE, DPOAE), Auditory Brainstem Response (ABR, AABR, BAER, ABAER), or a combination of both tests. Rescreening should occur prior to 1 month of age. Both ears should be rescreened. The rescreening should consist of a maximum of 2 attempts on each ear at the time of the screening.
Not Passing or Inconclusive Results
If an infant does not pass or results are inconclusive, the infant should be referred to an audiologist for diagnostic evaluation. 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.
Diagnostic evaluation should be coordinated by the screening facility or medical home that is referring the infant for a diagnostic evaluation. The diagnostic evaluation should occur before 3 months of age.