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Information for Physicians and Audiologists

Newborn Hearing Screening Follow-up Guidelines

By 1 Month:

  • Hearing Screen Prior to Hospital Discharge
  • If not passed on one or both ears, out-patient Rescreen at Hospital
    • Always Rescreen Both Ears
    • If initially Screened with AABR, Rescreen with AABR
    • If initially Screened with OAE, Rescreen with OAC or AABR

By 3 Months:

  • If Rescreen is not passed, diagnostic hearing evaluation by an audiologist with expertise in young infancts who has the capacity to perform:
    • Otoacoustic Emissions (OAE)
    • Click Auditory Brainstem Response (ABR)
    • Frequency Specific Tone Burst ABR
    • Air and Bone Conduction ABR
    • High Frequency Typanometry

By 6 Months:

  • If hearing loss is confirmed,
    • ENT Referral for medical evaluation
    • Hearing aid consultation with pediatric audiologist
    • Enrollment in Early Intervention Program

    Resources to learn more:

    Providing Newborn Hearing Screens / Rescreens in the Pediatric Office

    According to AAP guidelines, "Except in rare circumstances, medical homes should NOT conduct the initial newborn hearing screening. 'Rescreening in the medical office comes with an important obligation to report all normal and abnormal screening results to the EHDI system'." Detailed information about screening or rescreening in the medical home can be found on the AAP website link above or through the following documents:

    The Audiological Evaluation

    All infants who do not pass their newborn hearing screen and an out-patient rescreen in one or both ears need an audiological evaluation by a pediatric audiologist. Ideally, this evaluation should be completed prior to three months of age. To expedite the diagnosis, it is important to refer families to an audiologist who has the equipment and expertise to provide the complete test battery that is listed in the graphic above.

    The audiological evaluation should not be repeatedly postponed solely due to middle ear dysfunction. The recommended procedures can determine the impact of middle ear fluid on the infant's hearing and identify if a sensorineural hearing loss is also present.

    Finding an Audiologist

    Many Ear, Nose and Throat (ENT) physicians (otolaryngologists) and audiology offices only have equipment to provide an OAE hearing screen for infants. There are only a few offices throughout the state that can provide all of the tests listed above. The EHDI-PALS directory may be used to help find an appropriate facility. It must be noted the profiles are self-reported and may not be current. Select up to three offices and click the "compare" button to see when an audiologist's profile was created. Before referring a family, confirm the office is able to provide each test listed at the top of this page.

    Reporting Screening and Diagnostic Test Reults to Nevada EHDI

    Physicians, audiologists, and other persons or entities performing a newborn hearing screen, rescreen, or performing a diagnostic hearing assessment following-up on a newborn hearing screen which was not passed, is obligated to report those results to the Nevada EHDI Program. Please report data by filling out and faxing the following forms:

     

    Referring Children For Early Intervention

    Nevada Early Intervention Services (NEIS) provides family-centered multidisciplinary diagnostic and early intervention services. Staff includes developmental specialists, a pediatrician, speech, physical and occupational therapists, nutritionists, audiologists and social workers. Several specialty clinics are offered such as genetic and metabolic clinics. All services are provided at no cost to the family.

    The Individuals with Disabilities Education Act (IDEA), Sec. 303.321, requires that individuals who diagnose a child with permanent hearing loss make a referral directly to their Part C early intervention agency within seven working days. In Nevada, children with any degree of permanent hearing loss in one or both ears are automatically eligible for early intervention services. Referrals can be made by phone or fax at the numbers below.