The relationship between pattern of newborn hearing screening test results and infant diagnostic audiological assessment results.

Ms Deandra Tanner2, Dr Peter Carew2, Ms Alison Jagger1, Dr Zeffie Poulakis1,2,3, Dr Melinda Barker1,2

1Royal Children’s Hospital , Melbourne, Australia,

2University of Melbourne, Melbourne, Australia,

3Murdoch Children’s Research Institute, Melbourne, Australia


Background: Empirical reports of the association between result patterns on newborn hearing screening tests and diagnostic outcome are yet to be reported in peer-reviewed literature. This study aims to identify and describe such associations.

Design: A retrospective chart review was conducted of infants born in 2016-2017 who did not pass their Victorian Infant Hearing Screening Program AABR two-stage automated auditory brainstem response (AABR) screen and underwent audiological assessment (n= 1267). Odds ratios were used to investigate the relationship between hearing screen result pattern and diagnostic outcome.

Results: Thirty-three distinct hearing screen result patterns from the two-stage AABR process were identified.  Patterns with low occurrence were excluded from analyses, leaving nine hearing screen patterns.

A bilateral positive hearing screen result pattern was found to be more predictive of a hearing loss diagnosis than unilateral hearing screening patterns.  Infants with a bilateral positive hearing screen result pattern on both hearing screens were 4.9 times more likely to have a diagnosed hearing loss (of any nature) than any other pattern.  These infants were also 30.7 times more likely to have a bilateral moderate or greater sensorineural hearing loss diagnosed.

A left unilateral positive hearing screening result pattern was most frequently observed (n= 368), nearly double the amount of the right unilateral positive hearing screening result pattern (n= 175).  Diagnostic outcomes indicated that 63% of left unilateral positive hearing screening result patterns were false positives. Infants with inconsistent results across their two hearing screens had the highest false-positive rate.

Conclusions: There is a strong association between particular patterns of hearing screen results and infant diagnostic outcomes.  Newborn hearing screening managers and diagnostic audiology providers promote diagnostic service efficiency based on screen result patterns, optimising earlier diagnosis and intervention.


Peter is an audiologist and Lecturer in the Department of Audiology and Speech Pathology at The University of Melbourne. He has a special interest in the diagnosis and management of children born with milder degrees of hearing loss. His research focuses on exploring the population-level outcomes of these children. Peter works collaboratively with researchers around Australia and internationally, with the goal of positively influencing the whole-of-life outcomes for impacted individuals and their families.