Dr. Christy Yoshinaga-Itano has recently shown that language develops for hearing impaired children treated before 6 months far earlier than for children who are not managed until after 1 year. In fact, some children managed early often show normal language development compared to normal hearing peers. An automated ABR which does a computer controlled screening ABR test and tells the operator whether or not to refer for full diagnostic work up. This evaluates the effectiveness of the inner ear and nerves in sending messages to the brain. An automated otoacoustic emissions screening test which also alerts the diagnostician to whether or not additional testing is appropriate.
Some organizations prefer the use of tone bursts instead of clicks to enhance accuracy.
These children will not have speech and language problems which can be helped by hearing aids. An absent response to a click however does not mean total deafness. This is consistent with a so-called auditory neuropathy where the waves obtained through the two different polarity clicks are mirror images and really come from a part of the inner ear which does not respond to hearing aids. Some children with jaundice in their backgrounds actually outgrow the hearing problem, others get worse and may respond to cochlear implants. This is a new area and many professionals disagree on management or are unfamiliar with the issues.