Neonatal screening for hearing impairment

Area of Science:

• Neonatal care
• Audiology
• Public health

Background:

• Technological advancements over 25 years have enabled neonatal hearing impairment screening.
• Current risk-factor-based screening identifies only about 40% of congenital hearing impairments.
• Universal screening is recommended to detect moderate or worse hearing impairments in all neonates.

Purpose of the Study:

• To review the feasibility and requirements for universal neonatal hearing screening.
• To evaluate oto-acoustic emission and auditory brainstem response (ABR) for universal screening.
• To identify needs for accurate assessment and habilitation of screen-positive infants.

Main Methods:

• Review of technological developments in neonatal hearing screening.
• Evaluation of oto-acoustic emission and auditory brainstem response (ABR) testing methods.
• Analysis of false positive rates and strategies for reduction.

Main Results:

• Universal screening using oto-acoustic emission and ABR can identify moderate or worse hearing impairments.
• Oto-acoustic emission is sensitive to mild impairments, with a typical 8% false positive rate at discharge.
• A second outpatient test or ABR before discharge reduces false positives to <1%.
• Both oto-acoustic emission and ABR are necessary to identify auditory neuropathies.

Conclusions:

• Universal neonatal hearing screening is feasible with current technologies like oto-acoustic emission and ABR.
• Pilot trials are underway to facilitate widespread implementation.
• Further research is essential to address the complexities of accurate assessment and habilitation for identified cases to establish routine screening.