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Updated: Aug 19, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Use of a high-risk register in newborn hearing screening
Insights
This study screened high-risk newborns for hearing loss using auditory stimuli. Despite 7% failing initial tests, no hearing loss was identified, highlighting the need for improved screening effectiveness.
Area of Science:
- Neonatal care
- Audiology
- Public health
Background:
- Newborn hearing screening is crucial for early detection of hearing loss.
- High-risk infants often require specialized screening protocols.
- Previous methods relied on behavioral responses to auditory stimuli.
Purpose of the Study:
- To evaluate the effectiveness of a routine hearing screening program for high-risk newborns.
- To assess the prevalence of hearing loss in a screened high-risk newborn population.
- To identify areas for improvement in neonatal hearing screening protocols.
Main Methods:
- Behavioral observation in response to a 3000-Hz warbled tone at 90/100 dB SPL.
- Identification of high-risk infants based on Joint Committee on Infant Hearing Screening criteria or nursery care level.
- Screening of 17% of the total newborn population in the first 12 months.
Main Results:
- 7% of screened infants failed to respond to the auditory stimulus.
- Approximately 50% of infants who failed the initial screen attended follow-up testing.
- No cases of hearing loss were identified in the infants who completed follow-up.
Conclusions:
- The current screening protocol identified a significant number of infants who failed to respond but did not confirm hearing loss.
- The low follow-up rate and lack of confirmed hearing loss suggest potential limitations in the screening's effectiveness.
- Enhancements to the screening process are necessary to improve its diagnostic accuracy and yield.
Abstract:
High-risk newborns were routinely screened for hearing loss by observing their behavioral responses to a 3000-Hz warbled tone at 90 or 100 dB SPL. Infants were identified as high risk if they presented any of the conditions listed by the Joint Committee on Infant Hearing Screening or if they were placed in the special care or intensive care sections of the newborn nursery. During the program's first 12 months, 17% of the total newborn population were included in the screening, and 7% of those screened failed to respond. Approximately half of the infants who failed the screening returned for follow-up testing. No hearing loss has been identified among these infants. Special steps have been required to improve the screening's effectiveness.
