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Neonatal hearing screening using the auditory brainstem response.

J J Homer1, S L Linney, D R Strachan

  • 1Department of Otolaryngology, Bradford Royal Infirmary, UK.

Clinical Otolaryngology and Allied Sciences
|April 14, 2000
PubMed
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A targeted screening program for infant sensorineural hearing loss (SNHL) identified only 37% of at-risk children. Improvements in referral criteria and pediatrician liaison are needed to enhance early detection of hearing loss.

Area of Science:

  • Audiology
  • Pediatrics
  • Public Health

Background:

  • A targeted auditory brainstem response screening program for sensorineural hearing loss (SNHL) has been operational since 1987.
  • Infant hearing loss screening aims for early identification and intervention.

Purpose of the Study:

  • To evaluate the effectiveness of a targeted SNHL screening program.
  • To determine the proportion of at-risk children identified and missed by the program.
  • To identify reasons for missed cases.

Main Methods:

  • Analysis of a 4-year cohort (n=49) of children born between April 1991 and March 1995 with moderate to profound SNHL (>50 dB).
  • Assessment of risk factors present in the cohort.
  • Comparison of children identified by screening versus those missed.

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Main Results:

  • 92% of children had identifiable risk factors, exceeding rates in other studies.
  • The program could have prospectively detected a maximum of 80% of cases.
  • Only 37% of children with SNHL were actually diagnosed through the screening program.
  • Children with risk factors from in utero, perinatal, or postnatal events were more likely to be missed (P < 0.01).
  • The overall yield was 0.5/1000/year.

Conclusions:

  • The targeted screening program demonstrated limited success in identifying at-risk infants with SNHL.
  • Improvements in referral criteria and collaboration with pediatricians are crucial for better targeting.
  • While universal neonatal screening may have higher yield, targeted infant tests remain important backups.