Receipt of Audiological Threshold Testing Among Infants Not Passing Their Newborn Hearing Screen

Purpose: This study aims to quantify how frequently infants not passing the final newborn hearing screen and diagnosed by an audiologist with typical hearing do not receive threshold testing recommended as part of a complete audiological evaluation. Method: A total of 10,821 infants born in 2022 from 22 jurisdictions did not pass the final hearing screen and received a typical hearing diagnosis, for whom we reviewed testing procedures. Infants were categorized by whether threshold testing was completed. Poisson regression was used to generate prevalence ratios assessing receipt of threshold testing at audiological evaluation among different groups. Results: Of included infants, 17.4% ( n = 1,884) did not receive an audiological evaluation with a threshold test (range across jurisdictions: 0% to 62%). Overall, 1.8% ( n = 192) were missing information on the test methods performed. Infants admitted to the neonatal intensive care unit were 1.2 (95% confidence interval [1.01, 1.40]) times as likely to receive threshold testing as their counterparts. Conclusions: Almost one in six infants not passing newborn hearing screening and diagnosed with typical hearing did not receive audiologic threshold testing. Implementing systems-level approaches to facilitate standardized audiology care following best practice recommendations may help ensure infants with minimal to mild hearing thresholds receive timely intervention services to prevent developmental delays.