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January 2023 | Issue 30

light blue background featuring four numbered blocks with the numbers 2 0 2 and a toddlers hand placing the 4 down to create 2024

New Year Welcome

As we welcome 2024, we at COEHDI would like to take a minute to express our heartfelt gratitude to the dedicated newborn hearing screening teams across the state. Your hearing screening efforts play a crucial role in the lives of our tiniest community members and their families. Cheers to you! May the new year bring you joy and continued fulfillment in your professional roles. 


New Year Welcome

What to do when you notice high refer rates in your program

What to do when you notice high refer rates in your program

The two goals of newborn hearing screening programs are to accurately identify babies who may have a hearing difference and minimize unnecessary referrals for babies who do not have a hearing difference. Monitoring your newborn hearing screening statistics, particularly the refer rate or the percentage of babies at your facility who do not pass on the newborn hearing screening, is one of the best ways to achieve these goals. Refer rates greater than 4% are considered on the high end. High refer rates may serve as a “red flag” or a sign to re-evaluate your equipment, protocol, and/or daily operations. 

Are you noticing high refer rates? Below are a couple of tips to help. By following these steps, your newborn hearing screening process can be more efficient and cost-effective. 

Schedule Screenings Smartly

Screen babies when they are relaxed (preferably asleep) in a quiet room. Choosing optimal screening times reduces the time to complete a screening and ensures a more accurate test. 

Retry Before Discharge

If a baby doesn't pass the first screening in one or both ears, wait a few hours and then perform a 2nd attempt to screen in both ears. This can significantly reduce the need for additional outpatient screening. 

Advocate for Access to Backup Equipment

Having backup equipment in case of equipment breakdowns is a good idea especially in facilities where babies are discharged quickly from the hospital. Quick replacements will prevent your program from missing newborns and reduce the need for additional outpatient rescreening. 

Pay Attention to OAE Probe Fit

If you are using Otoacoustic Emissions (OAE) as a screening tool, proper fit of the eartip or probe is crucial. Make sure that the newborn hearing screeners at your facility are properly trained on insertion of the probe into the ear; this ensures an accurate test and reduces referral rates. 

Be Mindful of Muscle Activity during AABR

If you are using automated auditory brainstem response (AABR) as a screening tool, make sure to screen when babies are relaxed or asleep. If the baby is not in a relaxed state, muscle tension can lead to increased screening time and result in high refer rates. 

COEHDI Dedicated Audiology Support

Hannah Glick is an audiologist with COEHDI who can answer any newborn hearing screening related questions that you have. If you have any questions related to your newborn hearing screening equipment or questions related to best practices in newborn hearing screening, please contact Hannah.

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Hannah Glick, AuD, PhD, CCC-A

EHDI Consultant

[email protected]



For technical questions about hearing screening, please contact:

Hannah Glick, AuD, PhD, CCC-A

EHDI Consultant

[email protected]


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