This investigation was undertaken to explore the feasibility of screening for hearing impairment in an intensive care nursery population with a combined acoustic stapedius reflex-ABR approach. Acoustic reflex threshold measurements (AR) were made on intensive care nursery patients in an existing ABR screening program. Pass-fail results were determined for the two methods, separately and in combination. AR screening identified all 10 ears that failed the ABR screen. The cost savings of screening with a combined AR-ABR approach was determined for various pass-fail criteria. The results suggest that the AR-ABR approach can produce a significant cost savings without compromising the sensitivity and specificity of the screening program.