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Updated: Jul 19, 2026
Infant Auditory Processing and Event-related Brain Oscillations
Published on: July 1, 2015
Identification of neonatal hearing impairment: a multicenter investigation
S J Norton1, M P Gorga, J E Widen
1Multicenter Consortium on Identification of Neonatal Hearing Impairment, Seattle, Washington, USA.
Insights
This study evaluated the accuracy of perinatal auditory tests for predicting infant hearing. It compared otoacoustic emissions and auditory brain stem responses against behavioral audiometry to identify factors influencing test outcomes.
Area of Science:
- Pediatric audiology
- Neonatal screening
- Auditory system development
Background:
- Accurate prediction of infant hearing status is crucial for early intervention.
- Existing perinatal auditory tests require validation against established behavioral measures.
- Multicenter studies are essential for generalizable findings in diverse populations.
Purpose of the Study:
- To determine the predictive accuracy of transient evoked otoacoustic emissions, distortion product otoacoustic emissions, and auditory brain stem responses for behavioral hearing status in infants.
- To examine the impact of infant medical status, test environment, and parameters on test performance.
- To establish a gold standard for evaluating newborn hearing screening protocols.
Main Methods:
- A multicenter study involving 7179 infants evaluated in the perinatal period.
- Follow-up behavioral testing (visual reinforcement audiometry) at 8-12 months corrected age for high-risk and screened infants.
- Collection of prenatal, perinatal, maternal history, and test environment data for comprehensive analysis.
Main Results:
- The study design facilitated a robust comparison of perinatal tests with a gold standard behavioral assessment.
- Data collection included a diverse sample to enhance the generalizability of the findings.
- Detailed analysis of factors influencing test performance was enabled by a relational database.
Conclusions:
- Longitudinal evaluation comparing newborn hearing tests with behavioral audiometry is necessary.
- Comprehensive data collection on various influencing factors is vital for accurate test outcome interpretation.
- The study design and data collection support a thorough examination of newborn hearing assessment accuracy.
Objectives:
This article describes the design of a multicenter study sponsored by the National Institutes of Health. The purpose of this study was to determine the accuracy of three measures of peripheral auditory system status (transient evoked otoacoustic emissions, distortion product otoacoustic emissions, and auditory brain stem responses) applied in the perinatal period for predicting behavioral hearing status at 8 to 12 mo corrected age. The influences of the infant's medical status, the test environment, and test and response parameters on test performance were examined.
Design:
Seven institutions participated in this study. There were 7179 infants evaluated in the perinatal period. All graduates of the neonatal intensive care unit (4478) and well babies with one or more risk factor for hearing loss (353) were targeted for follow-up testing using visual reinforcement audiometry (VRA) at 8 to 12 mo corrected age. Well babies without any risk indicators (N = 2348) were not targeted for follow-up VRA testing. However, 80 of these well babies did not pass the screening protocol and thus were targeted for follow-up VRA testing as well. Perinatal test performance was evaluated using the VRA data as the "gold standard."
Results:
The results of this study are described in a series of 11 articles following this introductory article.
Conclusions:
The evaluation of newborn hearing tests required a longitudinal study in which newborn test results were compared with a gold standard based on behavioral audiometric assessment. Such an evaluation was possible because all newborns, passes as well as refers, were followed up long enough to permit reliable behavioral measurements. In addition, prenatal, perinatal, and maternal history information, test environment, and test parameter information were collected to provide data that led to a complete description of factors affecting test outcomes. All of these data were obtained in a sample of sufficient ethnic, medical, and geographic diversity in efforts to increase the generalizability of the results. Finally, the data were combined in a relational data base to examine the factors that influence test performance. Specific information related to these issues is presented in the articles that follow.
