Newborn Hearing Screening: 1-3-6 Guidelines and How Well We Adhere to Them
Susan Kim1, Aviya L Levy2, Qi Gao3
1Division of Newborn Medicine, Department of Pediatrics, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Clinical Pediatrics
|July 19, 2025
Summary
Many newborns miss critical hearing tests. Maternal language barriers significantly impact adherence to auditory brainstem response (ABR) testing, highlighting a need for targeted interventions to improve newborn hearing screening follow-up.
Area of Science:
- Pediatrics
- Audiology
- Public Health
Background:
- Newborn hearing screening is crucial for early detection of hearing loss.
- Recommended follow-up includes oto-acoustic emissions (OAE) by 1 month and auditory brainstem response (ABR) by 3 months.
- Adherence to these protocols is essential for timely intervention.
Purpose of the Study:
- To investigate caregiver adherence rates to OAE and ABR testing in an urban infant population.
- To identify risk factors associated with poor adherence to newborn hearing screening follow-up.
- To inform interventions aimed at improving screening completion.
Main Methods:
- Retrospective chart review of full-term infants from 2016 and 2019 at two Bronx hospitals.
- Analysis of adherence to 1-month OAE and 3-month ABR testing following referral.
- Multivariable analysis to identify significant risk factors for non-adherence.
Main Results:
- Only about one-third of referred newborns completed the recommended 1-month OAE testing.
- Half of the infants who underwent OAE testing missed their 3-month ABR appointment.
- Maternal spoken language was identified as a significant factor influencing ABR adherence.
Conclusions:
- Adherence to recommended newborn hearing screening follow-up protocols is suboptimal in this urban population.
- Language barriers represent a significant challenge to timely audiological testing.
- Interventions addressing linguistic disparities are needed to improve newborn hearing screening completion rates.
