A 6-month-old infant fails newborn hearing screening. The appropriate NEXT confirmatory test is:

• A Behavioral audiometry (visual reinforcement audiometry)
• B Auditory Brainstem Response (ABR) testing under natural sleep ✓
• C Pure tone audiogram at 250-8000 Hz
• D ASSR (Auditory Steady State Response) alone without ABR

Explanation

ABR (click-evoked) is the gold-standard confirmatory test for newborn hearing screening failures in infants below 6 months (and up to 2 years), performed under natural sleep or sedation. It provides frequency-specific thresholds and is objective (no behavioral cooperation required). Behavioral audiometry (VRA) is appropriate from 6 months to 2.5 years. Pure tone audiometry requires cooperative responses (>3 years). ASSR alone is insufficient for diagnosis — ABR is always the confirmatory tool per JCIH guidelines.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.