(a)

1. (1) All patients under the age of twelve (12) months who have failed two (2) screenings in the absence of indicators of external and/or middle ear abnormalities should receive a battery of audiological tests to minimally include:

   1. (A) A case history;
   2. (B) High frequency tympanometry;
   3. (C) Otoacoustic emissions (OAE); and
   4. (D) Click and toneburst auditory brainstem responses (ABR).
2. (2) For those patients five (5) months of age or older, developmentally appropriate behavioral assessment is also recommended.

(b)

1. (1) All patients twelve (12) to twenty-four (24) months should receive a battery of audiological tests to minimally include:

   1. (A) A case history;
   2. (B) Otoscopy;
   3. (C) Tympanometry; and
   4. (D) Behavioral pure-tone threshold assessment appropriate to the patient’s developmental abilities.

2. (2)

   1. (A) Acoustic reflex testing, OAE, and ABR, although not mandatory, are also considered appropriate to the test protocol.
   2. (B) These tests should not, however, replace behavioral threshold assessment unless the patient is physically or developmentally unable to perform behavioral testing.

(c)

1. (1) All patients twenty-five (25) months and older should receive a battery of audiological tests to minimally include:

   1. (A) A case history;
   2. (B) Otoscopy;
   3. (C) Tympanometry;
   4. (D) Pure-tone air and bone conduction;
   5. (E) Speech reception threshold; and
   6. (F) Word recognition assessment.
2. (2) Measures of acoustic reflexes and loudness discomfort levels, although not mandatory, are considered appropriate to the testing protocol.
3. (3) Exceptions to this battery include patients who are physically or developmentally unable to perform these tasks.