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Newborn hearing screening in Western Australia
Helen D Bailey1, Carol Bower, Jay Krishnaswamy
1Western Australian Newborn Hearing Screening Programme, Centre for Child Health Research, University of Western Australia, TVW Telethon Institute for Child Health Research, West Perth, Australia. helenb@ichr.uwa.edu.au
Insights
This pilot program screened 12,708 newborn babies for congenital bilateral permanent hearing loss, identifying 9 cases. The low detection rate highlights the need for instrument validation and false-negative monitoring before program expansion.
Area of Science:
- Audiology
- Neonatal Care
- Public Health
Background:
- Congenital bilateral permanent hearing loss affects newborns.
- Early detection is crucial for intervention and development.
- Pilot programs assess screening feasibility and effectiveness.
Purpose of the Study:
- To evaluate the preliminary findings of a newborn hearing screening pilot program.
- To determine the prevalence of congenital bilateral permanent hearing loss in the screened population.
Main Methods:
- Screening conducted in five major maternity hospitals in Western Australia.
- Automated auditory brainstem responses (AABR) and transient evoked otoacoustic emissions (TEOAE) used.
- Follow-up audiological assessment for infants not passing initial screens.
Main Results:
- Screening achieved 96.2% coverage of 13,214 eligible newborns.
- 99% of screened infants passed initial or follow-up screening.
- Bilateral permanent hearing loss diagnosed in 9 infants (0.68/1000).
Conclusions:
- The pilot program demonstrated a low detection rate for hearing loss.
- Further validation of screening instruments is necessary.
- A system for monitoring false negative results is required before wider implementation.
Aim:
To report the preliminary findings of a pilot program to screen newborn babies for congenital bilateral permanent hearing loss.
Setting:
The five largest maternity hospitals in Perth, Western Australia. Screening was gradually introduced over seven months from February to August 2000.
Participants:
All babies born at these hospitals after the introduction of hearing screening until 30 June 2001.
Methods:
One or both of two automated screening devices were used: one measuring transient evoked otoacoustic emissions (TEOAE) and the other automated auditory brainstem responses (AABR). If a "pass" was not obtained in both ears, screening was repeated. All babies who did not obtain a pass in either ear at follow-up were referred for audiological assessment.
Main Outcome Measures:
Prevalence of permanent bilateral hearing loss.
Results:
Of 13 214 eligible babies, 12 708 (96.2%) received screening. The main reason for missing screening was early hospital discharge (309; 2.3%). Of the screened babies, 99% had a pass response in both ears at either the initial or follow-up screen. Twenty-three babies were referred for audiological assessment, and nine were diagnosed with bilateral permanent hearing loss (0.68/1000; 95% CI, 0.31-1.28).
Conclusions:
Despite our program meeting process quality indicators, our detection rate was low. Before extending the program to smaller hospitals, we need to validate our screening instruments and put in place a system to monitor false negative results.