Otoacoustic Emissions (OAE) testing is a screening method used to check the function of the inner ear, specifically the cochlea’s outer hair cells. These specialized hair cells generate a faint echo, or emission, in response to sound, which is measured by a tiny microphone placed in the ear canal. The test is commonly performed on newborns as part of universal hearing screening programs, but it is also used for older children and adults who cannot participate in traditional hearing tests. Understanding the timeline for receiving and interpreting these results ensures timely follow-up care if needed.
Immediate Results: The OAE Screening Timeline
The initial OAE screening delivers results quickly. The equipment uses a probe placed gently in the ear canal, which emits quiet clicks or tones into the ear. The test instantly measures the cochlea’s echo response.
The actual testing time is short, typically taking only a few minutes per ear to complete, sometimes as little as 30 seconds. The OAE machine provides an automated result, displayed as a “Pass” or “Refer,” immediately upon completion. The healthcare professional administering the test, such as a nurse or audiologist, can generally provide the preliminary screening result right away.
This rapid result is possible because the screening is an objective measure of the inner ear’s biological function, not a subjective test relying on a patient’s behavioral response. The immediate outcome display makes OAE screening efficient for high-volume settings like hospital maternity wards. The goal is to quickly differentiate individuals likely to have normal hearing from those who require further investigation.
Interpreting Pass and Refer Outcomes
The screening result will be categorized as either a “Pass” or a “Refer,” which carries specific implications for the next steps in care. A “Pass” result suggests the inner ear is functioning as expected, meaning the hair cells in the cochlea are responding normally to sound. While a “Pass” is reassuring, it does not guarantee perfect hearing or rule out all types of hearing loss, especially mild or specific neural disorders.
Conversely, a “Refer” result means the test criteria were not met, and the machine could not detect the expected echo from the inner ear. A “Refer” does not mean a patient has a permanent hearing loss, but indicates that further investigation is recommended. Many factors unrelated to permanent hearing loss can cause a “Refer” result, leading to a false positive.
For infants, common reasons include obstructions that block the sound or the echo from returning to the probe. These factors interfere with the sensitive measurement:
- Amniotic fluid, vernix, or middle ear fluid
- Excessive patient movement
- Crying
- Environmental noise during the brief testing period
Navigating Follow-Up Testing and Secondary Timelines
If an initial OAE screening results in a “Refer” for one or both ears, the next phase involves rescreening and, if necessary, diagnostic testing, which extends the overall timeline. The standard procedure for newborns is to conduct a second OAE screening, often scheduled days to a few weeks after the initial test, typically between 2 and 8 weeks after discharge from the hospital. This delay allows temporary obstructions, like middle ear fluid or vernix, to clear, which frequently leads to a “Pass” on the second attempt.
If the patient refers again after the rescreening, the timeline moves toward comprehensive diagnostic evaluation. This evaluation is necessary to confirm or rule out a hearing loss and is typically performed by a pediatric audiologist. The standard diagnostic test following a failed OAE is the Auditory Brainstem Response (ABR) test, which measures how the auditory nerve and brainstem respond to sound.
For infants who continue to refer, the goal of early hearing detection and intervention programs is to complete the diagnostic evaluation within a specific, time-sensitive window. This comprehensive assessment is generally recommended to be completed by three months of age. If a hearing loss is confirmed, the subsequent goal is to begin appropriate intervention, such as fitting hearing aids or enrolling in therapy, no later than six months of age. This extended timeline for follow-up testing is essential to ensure that any potential hearing loss is identified and managed during the most critical period for speech and language development.