Newborn hearing screening — formative SAQs

SAQ 1 — Bilateral refer before rural discharge (20 marks, ~15 minutes)

A well term newborn is 28 hours old. Bilateral OAE screening is a refer. The family lives 2 hours from the regional diagnostic audiology service and wants same-day discharge. Father says, “He jumped when the door slammed, so his hearing is fine.” ^{[7] [8]}

Questions

1. Define pass, refer and incomplete in newborn hearing screening and state which applies here. (3 marks) ^[1]
2. Explain why a startle response does not exclude permanent hearing loss. (3 marks) ^[7]
3. Outline the 1-3-6 Early Hearing Detection and Intervention targets and the immediate disposition plan for this infant. (6 marks) ^[1]
4. Give four elements of plain-language counselling you would use with this family. (4 marks) ^[8]
5. List four system actions that reduce lost-to-follow-up after refer in rural families. (4 marks) ^[8]

Model answer anchors

1. Pass = screen clear for routine pathway; refer = more testing required; incomplete = not done/invalid/no owned plan. This infant is a bilateral refer. ^[1]
2. Newborn behavioural responses are crude and may reflect vibration or non-threshold pathways; they do not measure hearing thresholds. ^[7]
3. Screen by 1 month, diagnose by 3 months, intervene by 6 months. Discharge only with booked diagnostic audiology, working contacts, teach-back and a named owner. ^{[1] [8]}
4. Refer is not deafness; next test is diagnostic audiology; why timing matters for language; what to do if appointment fails; open questions welcome. ^{[3] [8]}
5. Book before discharge; transport support; interpreter if needed; dual contact numbers; active chase list; written and verbal plan. ^[8]