Summary of Clinical Practice Guideline

Newborn Hearing Screening Programme (UK)

Neonatal Hearing Screening and Assessment: Automated Auditory Brainstem Response – Information and Guidelines for Screening Hearing in Babies
Elliott, C., Lightfoot, G., et al. (2002).
In S. Mason (Ed.), England: Newborn Hearing Screening Programme, 5 pages.

AGREE Rating: Recommended with Provisos

This guideline provides recommendations for screening and testing the hearing of babies in the first few months of life with automated auditory brainstem response (AABR).


Permanent Childhood Hearing Loss

  • Screening/Assessment

    • Screening

      • Physiologic

        • The following guidelines should be considered when screening for hearing loss with AABR:

          • For AABR screening provided outside of the designated clinic area, “levels of acoustical and electrical interference must be sufficiently low so as not to influence the results of the test. Careful selection of the local test area or room may be necessary in order to achieve satisfactory environmental conditions” (p. 2).

          • “If re-usable electrodes are employed then appropriate precautions must be taken to avoid the risk of cross infection. Since testing is often performed on very young babies extreme care must be adopted regarding preparation of the skin for placement of the electrodes. The use of harsh skin preparation materials should be avoided” (p. 2).

          • “Any comparison on the performance of different AABR systems must take into consideration the baseline calibration of the click stimulus (ppeSPL). The value of ppeSPL on which the dBnHL is based may be different for different AABR systems. The recommended value in the air conduction click protocol is 33 dBpeSPL” (p. 3).

          • Certain test parameters for data collection are a fixed part of protocol and must not be changed as this may invalidate the scoring algorithm. These include: gain or sensitivity of the amplifier, level of amplitude artifact rejection, filter bandwidth, acquisition window, and number of averaging sweeps.

          • The machine based scoring algorithm must be clinically proven in terms of its sensitivity and specificity and “provide a separate screening result for each ear so that referral of babies for further testing can be initiated using either unilateral or bilateral referral criteria” (p. 4).

          • The interpretation of the screening results should under no circumstances be performed by inexperienced personnel.

Hearing Loss, Deafness, Early Hearing Detection and Intervention

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