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Automated auditory brainstem response in neonatal hearing screening
1Isala Clinics, Department of Neonatology, Zwolle, The Netherlands. i.straaten@wxs.nl
Insights
Early diagnosis of congenital hearing impairment is crucial for better developmental outcomes. Universal screening using automated auditory brainstem response (AABR) effectively identifies hearing loss in infants, enabling timely intervention.
Area of Science:
- Pediatrics
- Audiology
- Neonatal Care
Background:
- Congenital hearing impairment affects 0.1% of newborns and 1-2% of NICU graduates.
- Early diagnosis and intervention before 6 months improve intellectual, emotional, language, and speech development.
- Universal screening is vital as high-risk group screening misses 50% of infants with hearing loss.
Purpose of the Study:
- To evaluate the effectiveness of automated auditory brainstem response (AABR) for universal infant hearing screening.
- To assess the AABR's diagnostic capabilities and practicality in various settings.
Main Methods:
- Utilized automated auditory brainstem response (AABR) screening devices.
- AABR assesses the auditory pathway up to the brainstem, showing 98% agreement with conventional auditory brainstem response.
- Screening was conducted in hospital-based and home-based settings.
Main Results:
- AABR provides comprehensive auditory pathway information.
- Referral rates in hospital-based screening averaged 4%.
- Screening time ranged from 4 to 15 minutes with costs of $15-$25 per test.
Conclusions:
- AABR is a reliable and efficient tool for universal infant hearing screening.
- Early detection through AABR facilitates timely intervention, improving long-term outcomes.
- Universal screening with AABR offers potential healthcare cost savings through reduced need for extensive interventions.
Abstract:
Severe congenital hearing impairment is an important handicap affecting 0.1% of apparently healthy liveborn infants and 1-2% of graduates of neonatal intensive care units. The prognosis for intellectual, emotional, language and speech development in the hearing-impaired child is improved when the diagnosis is made early and intervention is begun before the age of 6 mo. Universal screening is preferable, since about 50% of infants with hearing loss are not discovered if neonatal hearing screening is restricted to high-risk groups. The automated auditory brainstem response (AABR) screener is a dedicated hearing screening device which provides information not only about the outer/middle ear and cochlea but also about the auditory pathway up to the brainstem. AABR has an agreement with conventional auditory brainstem response up to 98%. It uses a 35 dB near hearing level click. No operator interpretation is needed and it can be used on the ward and during oxygen therapy without disturbance from ambient noise. Reported referral rates in a hospital-based screening programme at the time of discharge vary, with an average of 4%. AABR has also been used in a home-based setting, with the same results. The time necessary for screening varies with the setting, but ranges from 4 to 15 min. Initial costs range from $15 to $25 per test, which is similar to neonatal screening for metabolic diseases. In addition to individual healthcare savings, early diagnosis may lead to savings on costs of intensive speech-language intervention and educational facilities.
