Testing hearing in newborns “early” – does it make a difference to audiology process and outcome?

Ms Melanie Jarvis2, Dr Peter Carew2, Dr Melinda Barker1,2, Ms Alison Jagger1, Dr Zeffie Poulakis1,2,3

 1Royal Children’s Hospital , Melbourne, Australia,

2The University of Melbourne, Melbourne, Australia, 3Murdoch Children’s Research Institute, Melbourne, Australia


Background: There is limited evidence regarding the earliest optimal age for audiological testing following a positive result on a newborn hearing screen. Earlier scheduling may alleviate stress on families awaiting diagnostic clarification, however later scheduling may allow the infant auditory system to mature, resulting in fewer required appointments.

Aims: To examine the relationship between age at first audiology appointment and the:

  1. i) number of appointments required to reach a diagnosis, and
  2. ii) likelihood of being diagnosed with not-normal hearing.

Results: Of the 2191 infants born between 2015 and 2017 who returned a positive result on their Victorian Infant Hearing Screening Program newborn hearing screen, 2117 (96.6%) had valid diagnostic audiology results available. Age at initial audiology appointment was categorised based on post menstrual age, with 1313 (62%) being aged less than 44 weeks.

For those infants with results and a final diagnosis (n=2112 (99.8%)) there was no difference between those aged <44 weeks versus ≥44 weeks at first audiology appointment in the number of appointments attended (mean 1.65 and 1.59 respectively (p=0.077) or the rate of diagnosis of normal hearing (58.0% and 55.6% respectively p=0.277).

For infants diagnosed with not-normal hearing, the proportion of infants with target hearing loss did not differ between the groups (9.6% in those aged <44 weeks and 10.2% in those aged ≥44 weeks (p=0.651)).

Implications: Infant age at first diagnostic testing does not impact the number of audiological appointments required to determine diagnosis, or the likelihood of normal hearing being diagnosed. These findings support the minimisation of time between newborn screening-referral and diagnostic audiology testing to reduce parental anxiety and facilitate timely access to early intervention services for those infants diagnosed with permanent hearing loss.

Future research could compare infant age at first diagnostic testing with changes to hearing status during the newborn period.