Infant Audiologic Assessment
Audiologists determine whether a child is deaf or hard of hearing through a diagnostic audiologic evaluation. Babies that do not pass their newborn hearing screening should have this evaluation no later than three months of age. Habilitation, including fitting amplification if chosen, and initiation of Early Intervention services should occur no later than six months of age. These best practice guidelines
are provided by the Joint Committee on Infant Hearing (JCIH) in order to
provide the best outcomes for children who are deaf or hard of hearing.
What is the role of the audiologist in the Nebraska Early Hearing Detection and Intervention (NE-EHDI) Program?
- Completes initial diagnostic evaluation, by 1 month of age if possible, using a battery of physiological testing procedures (JCIH 2007).
- Reports the results of diagnostic audiologic hearing evaluation to the child's primary care physician, including information that an infant was not successfully tested after being referred for testing.
- Reports to the Nebraska Early Hearing Detection and Intervention Program the names of all children who received a diagnostic evaluation and those who are not successfully tested after being referred for a diagnostic evaluation.
- Makes a referral to early intervention for children identified as deaf or hard of hearing, and reports the date of referral to the NE-EHDI Program.
- Provides parents with information about hearing and childhood deafness, and communication and education options for children who are deaf or hard of hearing.
- Fits children with amplification if chosen, including hearing aids or other assistive technology; refers for consideration of cochlear implant candidacy when appropriate.
- Appropriate intervention
whether amplification or sign language immersion should be started
by 6 months of age, if possible.
How does an audiologist report to the Nebraska Early Hearing Detection and Intervention Program?
Audiologists should submit the Diagnostic form for all babies and children seen for a diagnostic evaluation. Audiologic Screening and Diagnostic Report Form
When should an audiologist report results to the Nebraska Early Hearing Detection and
All outpatient screenings on newborns/infants
Diagnostic results on children ages birth-3
Late identifications on children ages birth-3
Repeat screenings/evaluations due to risk factors for late onset or progressive hearing loss. (For a list of Risk Factors, click here.)
Behavioral Evaluations on children ages birth-3
ENT evaluations on children ages birth-3 who have not passed their newborn hearing screening.
How do I help families find support?
Nebraska Hands and Voices
Nebraska Hands and Voices is dedicated to supporting families with children who are deaf or hard of hearing without bias around communication modes or methods. They are a parent-driven, non-profit organization providing families with resources, networks, and information they need to improve communication access and educational outcomes for their children.
PTI Nebraska is a statewide resource for families of children with disabilities and special health care needs.
- PTI Nebraska's staff are parent/professionals and are available to talk to parents and professionals about special education, other services and disability-specific information.
- PTI Nebraska conducts relevant, no cost workshops statewide.
- PTI Nebraska provides printed and electronic resources.
- PTI Nebraska encourages and supports parents in leadership roles.
The NE-EHDI Program Advisory Committee makes the following recommendations:
The audiologist should conduct a battery of tests that includes a case history, documentation of risk indicators for hearing loss, otoscopic inspection, evoked Otoacoustic Emissions (OAE) assessment, Auditory Brainstem Response (ABR) assessment, and middle ear measures.
The approach to services should be family-centered by promoting family and professional partnerships, responding to needs, building on strengths and respecting the diversity of families.
The Advisory Committee strongly recommends that any audiologist accepting infants younger that six months of age for audiologic assessment should follow best practice guidelines by having the ability to complete or refer to other pediatric audiology clinics with capability to perform the following procedures:
- Auditory Brainstem Response (ABR)
ABR threshold to frequency-specific stimuli for air and bone conduction.
ABR suprathreshold to click stimuli with varied rate and polarity.
- Otoacoustic Emissions (OAE)
Transient-evoked (TEOAE) or distortion product (DPOAE) equipment capable of a variety of test parameters.
- Acoustic Immittance
Tympanometry using probe tones greater than 226 Hz
Acoustic reflex threshold
Behavioral audiometric test procedures that are developmentally appropriate.
* An otologic evaluation is also part of the assessment process but it may occur at a different facility and time.
The Audiologist should discuss the results with the family and report the audiologic assessment results to the infant's Primary Health Care Provider and the Nebraska Early Hearing Detection and Intervention Program. If a permanent deafness is identified, families should be given the Nebraska Early Hearing Detection and Intervention Program's Parent Resource Guide.
In line with JCIH guidelines, audiologists seeing infants should
adhere to the following protocols to ensure the child is receiving the most
An infant who refers with an ABR must
be rescreened with an ABR screen
An infant who refers in only one ear should have both ears
evidence based guidelines that will help to identify most minimal deafness and auditory neuropathy cases present at birth.
Over 90% of babies are screened with the AABR at birth. This
means they will need to be rescreened with ABR rather than OAE. Click here to view and download a copy of what type of screening equipment is used at all birthing facilities in Nebraska. This will help you know what type of rescreening a baby
will need at your facility.
Pediatric Audiology Clinics
Click here to view and download the listing of Audiology Clinics in Nebraska.
Relevant Research Articles