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Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
Published on: January 23, 2017
Volunteer-based universal newborn hearing screening program
A H Messner1, M Price, K Kwast
1Department of Pediatric Otolaryngology, Lucile Packard Children's Hospital at Stanford, 725 Welch Road, Palo Alto, CA 94304, USA. anna.messner@medcenter.stanford.edu
Insights
A volunteer-led newborn hearing screening program effectively identifies infants with hearing loss, with 91% screened before discharge. While viable, this approach did not yield significant cost savings in the initial two years.
Area of Science:
- Neonatal care
- Audiology
- Public health
Background:
- Universal newborn hearing screening (UNHS) is crucial for early detection of hearing loss.
- Identifying hearing loss in newborns, especially those without risk factors, is vital for timely intervention.
- Volunteer-based programs offer a potential model for expanding UNHS reach.
Purpose of the Study:
- To assess the effectiveness and financial implications of a volunteer-driven universal newborn hearing screening program.
- To determine the efficacy of automated auditory brainstem response (AABR) technology in a volunteer-based screening setting.
- To analyze the costs associated with screening newborns in a well-baby nursery environment.
Main Methods:
- Review of the Lucile Packard Children's Hospital at Stanford newborn hearing screening database.
- Analysis of hearing screen results and associated costs for 5771 newborns.
- Utilization of automated auditory brainstem response (AABR) by volunteers for initial screening.
Main Results:
- Nine infants (0.16%) were identified with hearing loss; seven had no known risk factors.
- Volunteers screened 91% of infants before hospital discharge, with an additional 4% screened as outpatients.
- The volunteer-based program incurred a per-baby screening cost of $27.41.
Conclusions:
- A volunteer-based hearing screening program is a feasible approach for well-baby nurseries.
- This model successfully identifies infants with hearing loss, including those without risk factors.
- Significant cost savings were not observed within the first two years of the program's implementation.
Objective:
To evaluate efficacy and costs of a volunteer-based universal newborn hearing screening program.
Methods:
The Lucile Packard Children's Hospital at Stanford newborn hearing screening program database was reviewed. Results and costs of the hearing screens were analyzed.
Results:
Hearing screens were performed on 5771 newborns treated in the well-baby nursery and nine infants from this population were identified with hearing loss, seven of whom had no risks factors for hearing loss. Using volunteers to perform the first-line screen with the automated auditory brainstem response (AABR) technology, 91% of infants registered for screening were evaluated prior to discharge. An additional 4% of infants were screened as outpatients. If an infant failed the AABR on two occasions, he or she was rescreened with the AABR or transient evoked otoacoustic emissions by a licensed audiologist, often while the infant was still in the hospital. Using this algorithm, 5% of infants tested in the well-baby nursery needed additional follow-up as an outpatient. Cost analysis of this volunteer-based program reveals a per/baby screening cost of $27.41.
Conclusions:
A volunteer-based hearing screening program is a viable option for hearing screening in well-baby nurseries but does not result in significant cost savings during the first 2 years of the program.
