Guidance

Newborn hearing screening programme (NHSP): care pathways for babies in neonatal intensive care units (NICU)

Updated 29 October 2020

This flowchart (illustration and text description below) describes the care pathway for newborn hearing screening for babies in neonatal intensive care units.

1. Provide information

2. Is baby contra-indicated with atresia/microtia, bacterial meningitis, confirmed cCMV or a programmable shunt for screening?

Yes: refer for immediate audiological assessment within 4 weeks of screen completion or by 44 weeks gestational age. End of pathway.

No: offer screening. Go to question 3.

Yes: provide automated otoacoustic emission (AOAE) and automated auditory brainstem response (AABR) screening tests. Go to question 4.

No: provide checklists and inform GP or health visitor (HV). End of pathway.

4. Is AABR clear response and AOAE clear response in both ears?

Yes: go to question 5.

No: go to question 6.

5. Are risk factors present?

Yes: refer for audiological assessment at 7 to 9 months of age. End of pathway.

No: discharge and advise parents to monitor baby’s development. End of pathway.

6. Is AABR clear response and AOAE no clear response in one ear?

Yes: go to question 5.

No: go to question 7.

7. Is AABR clear response and AOAE no clear response in both ears?

Yes: refer for audiological assessment at 7 to 9 months of age. End of pathway.

No: go to question 8.

8. Is AABR no clear response or inconclusive result in one or both ears?

Yes: refer for immediate audiological assessment within 4 weeks of screen completion or by 44 weeks gestational age. End of pathway.

No: go to question 5.