What should I do when a child passes his BSC screening, yet I still have strong concerns about his hearing and/or speech/language development?
Use your clinical judgment regarding making a referral for comprehensive hearing testing. Remember the BSC screen is a test of physiologic function (it does not assess the child’s actual behavioral use of sound) and cannot rule out a very mild hearing loss. If the child clearly passes the OAE, tympanometry, and reflexes screens, current hearing status would not be a major contributor to substantial speech/language delay. If however, there are concerns specifically about the child’s hearing and/or more subtle speech/language deficits, make an audiology referral for comprehensive hearing assessment. When referring a child to JTC for audiological testing outside of BSC guidelines (e.g. they passed the screen; e.g. you are concerned about chronic middle ear disease), simply fill out the “Comments” section on the BSC screening results form indicating the concerns prompting you to consider more aggressive follow up. See BSC Bulletin #3.
