Newborn Hearing Screen Report: OAE, ABR, Pass or Refer
A refer on a newborn hearing screen means a further hearing test is needed, not that the baby has hearing loss. This guide decodes the OAE and brainstem results, explains pass, refer and repeat line by line, and gives the next step for each one on the printout.
Age bands and the short version
- Under 3 months: screening is usually offered before 4 weeks and can be done up to 3 months. A follow-up exam can start from 2 months and should be done by 3 months at the latest.
- After a refer: the appointment should be within 4 weeks of the screen. If it is not, phone the service.
- Any age: hearing loss can occur at any time of life, so keep noticing response to sound, voices and speech.
- Never: nothing goes into a baby’s ear, and a home whisper check does not replace the clinic screen.
- Rule of thumb: a refer asks for a second look, and it is not a verdict.
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What does the newborn hearing screen actually test?
The screen checks whether the inner ear and hearing nerve respond to sound. It is a screen, not the full check, and if the result needs one, the fuller test is done at an audiology clinic. The NHS describes a small soft earpiece placed in the baby’s ear while gentle clicking sounds play. It is not uncomfortable for the baby, has no known risks, and is done when the baby is settled or asleep. Reports usually name the test, such as OAE or the brainstem test, and the next two sections explain them.
What is the OAE test, and what does a pass mean?
OAE stands for otoacoustic emissions. The clicks are short sounds, and a healthy inner ear sends back a small echo that the machine can pick up. A pass means that echo was found in that ear during that test. It is a clear result for that moment, not a lifetime guarantee. If your baby did not pass, the NIDCD advises an immediate follow-up appointment with a pediatric audiologist. That is a further test, not a diagnosis.
What is the brainstem test?
The brainstem test measures how the hearing nerve and brain stem respond to sound. The baby wears small earphones, and small sensors on the head pick up the response. The NIDCD calls it ABR, for auditory brain stem response. The NHS says that when the first test gives no clear result, the baby will either be retested or offered a second, different test. Ask which one applies to your baby.
What do pass, refer and repeat mean on the report?
| Line on the report | What it usually means | Your next step |
|---|---|---|
| Pass, both ears | A clear response was found in each ear on that test | Keep noticing sound and speech, and raise any concern |
| Refer, one or both ears | No clear response after the repeats, so a diagnostic test is needed | Book the audiology appointment straight away |
| Repeat | The first result was not clear, so a second test is offered | Attend the repeat, and ask which test it will be |
Services word their slips differently. Match the words on yours to the rows above, and ask the team when you are not sure what a line means.
How do I read each ear on the printout?
- Check each ear on its own. One ear can pass while the other is referred, so read both lines.
- Find the test name. OAE or ABR tells you which test gave the answer.
- Note the screen date. Write it down with any special care stay, since you may be asked for both.
- Copy the follow-up details. Save the service name, the phone number and any appointment date on your phone.
- Ask the right question. Ask whether the repeat is the same screen or a full audiology assessment.
What happens after a refer result?
Book the appointment straight away, and do not wait for a reminder. The NIDCD advises scheduling a pediatric audiologist promptly after a result that did not pass. The NHS says that if there is still no clear result in one or both ears after the repeat, an appointment with a hearing specialist at an audiology clinic will be made for a second test, and that it should happen within four weeks of the screening test. At that appointment a hearing specialist runs the second test. If no letter arrives in the time you were given, phone the service rather than waiting.
Does a pass mean hearing is fine for life?
Not necessarily. The NIDCD says hearing loss can occur at any time of life, and some inherited forms do not appear until a child is older. A pass is a true result for the day of the test. It does not close the question. Keep noticing how your baby responds to sounds, voices and familiar people, and raise any concern with the doctor at any age, even after a clean pass. Stay alert.
A refer slip asks for a second look, not a verdict.
Is the test painful, and can I check at home?
The screen is not uncomfortable for the baby, and the NHS says it has no known risks. Home checks are a different matter, and a home whisper check is not a substitute for the clinic screen. Nothing should go into a baby’s ear, and that includes oil, onion juice and garlic. The adult home check is covered in the home whisper test guide.
You are worried about your baby’s hearing or health, or your baby seems unwell with a fever. In that case call your doctor or NHS 111 the same day, and do not wait for the next appointment. Do not wait for a letter if your baby does not seem to respond to sounds or to your voice. Call the audiology service or your doctor if a refer result has no appointment within four weeks. In an emergency, call your local emergency number.
Write it down before you leave
Ask which ear or ears were referred, whether the repeat is the same screen or a full audiology assessment, and which service will see your baby. Write the screen date and any special care stay on the same card. Confirm the appointment by phone if no letter arrives, because a refer slip is easy to misplace. Check these details with the local service.
Which newborn hearing questions do families ask?
What does a pass mean on a newborn hearing test?
A pass means a clear response was found in that ear during that screen. It is a good result for that test and that day, though it does not guarantee hearing for life. Hearing can change later, so keep noticing sound and speech as the baby grows.
Does a refer mean the baby is deaf?
No. A refer means the screen did not get a clear response from one or both ears, so a further hearing test is needed to find out. Only the diagnostic audiology test can say whether there is a hearing problem.
What is the next step after an OAE refer?
Book the audiology appointment straight away. The NHS says it should happen within four weeks of the screen, and the NIDCD advises scheduling promptly. Ask which test the audiologist will do and whether both ears are being checked.
Why does the baby need a repeat test?
A repeat is offered when the first result is not clear. The NHS says the test will be repeated, or the baby will be offered a second, different test. A repeat is a second look, not a sign of hearing loss by itself.
Is the newborn hearing test painful?
No. The NHS says it is not uncomfortable for the baby and has no known risks. A soft earpiece is placed in the ear while gentle clicks play, usually when the baby is settled or asleep.
What is the difference between OAE and the brainstem test?
OAE listens for a small echo from the inner ear after soft clicks. The brainstem test, called ABR by the NIDCD, measures how the hearing nerve and brain stem respond to sound through earphones and sensors on the head. The NHS describes a second test of this kind when the first gives no clear result, so ask which one applies.
Can a newborn pass the hearing test and still have a problem?
Yes. A pass is a result for that test and that day. The NIDCD says hearing can change at any time of life, and some inherited forms only appear later, so keep watching sound response and speech.
Does a refer in both ears mean something worse?
A refer in both ears means neither ear gave a clear result on that test, so both ears need the further assessment. The refer itself is not a diagnosis, and the audiology appointment is where the fuller check is done.
Can a home check replace the newborn hearing screen?
No. A home whisper check is not a substitute for the clinic screen, and nothing should go into a baby’s ear. Keep the clinic appointments, and raise any worry with your doctor.
Newborn hearing test kya hota hai?
Ye ek chhota aur bina dard ka test hai jo dekhta hai ki bachay ke kaan awaaz par clear response dete hain ya nahin. Refer ka matlab diagnosis nahin, balki ek aur test ki zaroorat hai. Result ke saath follow-up ki tareekh zaroor likh lein.
Other newborn reports have their own rules. Bilirubin numbers are in the newborn bilirubin levels guide, the metabolic panel from the heel prick is in the heel prick report guide, and the jaundice check at home is covered in the press test guide. The wider series sits in the Lab Reports Decoded hub, and the baby-care side is in the Bachon Ki Sehat hub.
Sources
- NHS, Newborn hearing test (soft earpiece and clicks, no known risks, repeat or second test, audiology appointment within 4 weeks)
- NIDCD, Your Baby’s Hearing Screening and Next Steps (pediatric audiologist follow-up after a fail, as early as 2 months and by 3 months at the latest, hearing loss at any age)