Short answer

If a baby does not pass a hearing screen in the maternity hospital or at a repeat screen, it does not automatically mean the baby has hearing loss. Screening is designed to identify babies who need the next level of hearing assessment.

The useful next step is not to judge hearing from reactions to household sounds. Keep the screening result and complete the recommended follow-up. The sooner the child’s hearing status is clarified, the sooner appropriate monitoring or support can be chosen if it is genuinely needed.

What does “did not pass” mean?

A screening test is not a full diagnosis. It answers a narrower question: does this baby need further hearing assessment?

Newborn screening programmes may use otoacoustic emissions (OAE) and short-latency auditory evoked responses / automated ABR, depending on the local protocol.

A refer or non-pass result means the criteria for a pass were not met during that screening session. It does not, by itself, determine the type or degree of any possible hearing loss.

The follow-up pathway in Kazakhstan

Kazakhstan includes newborn and early-childhood audiological screening in the national surdology care pathway. Current rules provide for primary neonatal screening in maternity settings and subsequent re-screening or follow-up through primary-care child services.

Objective methods used in early follow-up can include evoked otoacoustic emissions, short-latency auditory evoked potentials and tympanometry. If abnormalities are detected, the child is referred for more detailed audiological/surdology assessment.

For parents, the practical message is simple: after a non-pass result, there is no need to choose the “strongest” test on your own. Bring the discharge summary and screening result and move to the next assessment step that fits the child’s age and previous findings.

Why can a baby fail the first screen even without permanent hearing loss?

A non-pass result is not always caused by permanent hearing loss. In the first days of life, temporary factors can affect the recording, including the condition of the ear canal and middle ear, residual fluid after birth, movement or technical noise.

That is why the goal is not to guess the cause at home but to complete the recommended repeat screen or diagnostic follow-up.

A unilateral refer result should also be followed up. In many newborn screening programmes, a final pass requires both ears to meet the programme criteria.

Why household sound checks are not enough

A startle to a clap, a toy or a loud voice does not replace audiological testing. A baby may respond to some loud sounds while still having difficulty in certain frequency ranges or in one ear.

Objective infant tests are especially useful because the baby does not need to press a button, raise a hand or consciously report hearing a sound.

Which tests may be used next?

OAE

Otoacoustic emissions assess the function of the outer hair cells in the cochlea. OAE is quick, objective and widely used in screening. It is not a complete audiogram and does not answer every question about hearing by itself.

ABR / КСВП

Auditory brainstem response records electrical responses of the auditory pathway to sound using surface electrodes. It can be part of a diagnostic infant hearing assessment and does not require a conscious behavioural response.

ASSR

Auditory steady-state response may be added when the audiologist needs further frequency-specific electrophysiological information. Whether ASSR is useful for a particular baby depends on the preceding results and the diagnostic question.

Tympanometry and ear examination

In some situations it is important to assess the middle ear and eardrum. Temporary middle-ear changes can affect screening and other hearing-test results.

Not every child needs the same test battery. The protocol should be chosen according to age, previous results and the clinical question.

How quickly should follow-up happen?

The general principle is not to lose or unnecessarily delay follow-up after a non-pass newborn screen.

International early-hearing programmes often use the 1-3-6 benchmark: screening by 1 month, diagnostic evaluation by 3 months after a non-pass, and early intervention by around 6 months when hearing loss is confirmed.

For families in Kazakhstan, the priority is to follow the current local screening/re-screening pathway and attend the recommended control appointment. 1-3-6 is an international public-health timeliness benchmark, not an individual prescription or a substitute for Kazakhstan’s rules.

What to bring to the appointment

Useful documents include:

maternity-hospital discharge papers;
the first and repeat screening results, if available;
which ear had a refer result;
relevant pregnancy/birth and neonatal medical information recorded in the chart;
previous ENT or paediatric notes;
a short list of questions for the audiologist.

If ABR is planned during natural sleep, ask the clinic for its specific preparation instructions. Do not change feeding, sleep or medication routines based on internet advice alone.

If the repeat test is normal, is hearing “settled forever”?

No. Passing a hearing screen is reassuring, but it does not mean hearing can never change. Some hearing losses are acquired, progressive or become apparent later.

Hearing and communication development should continue to be monitored. New concerns justify a new hearing assessment even after an earlier pass result.

Frequently asked questions

Does a failed OAE mean deafness?

No. It means the child needs the next stage of assessment. A diagnosis and degree of hearing loss are not established from one screening result.

Should OAE be repeated, or should the baby have ABR immediately?

That depends on age, which test was already performed, the result in each ear and the follow-up pathway. In Kazakhstan, current rules provide objective re-screening and deeper assessment when abnormalities are found. The exact battery should be selected by the clinician.

My baby startles to loud sounds. Does that prove hearing is normal?

No. It only shows that the baby noticed that particular stimulus. It does not measure hearing sensitivity across frequencies or speech-related hearing.

Is ABR painful?

ABR presents sound through earphones or inserts and records electrical activity with surface electrodes. The main practical requirement is for the child to stay sufficiently calm or asleep for a clean recording.

Hearing assessment in Almaty

Ekaterina Vladimirovna Kravchenko provides paediatric hearing assessment in Almaty. Parents can bring the discharge summary and screening results so that the next audiological step can be chosen for the individual child.

/services/kompleks-rebenok — comprehensive child hearing assessment;
/services/oae — otoacoustic emissions;
/services/ksvp-screening — ABR/КСВП;
/blog/proverka-slukha-rebenku — how children’s hearing is assessed at different ages.

Baby Did Not Pass the Newborn Hearing Screen: What Happens Next