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Hearing screening in the neonatal intensive care unit: follow-up of referrals
Judith E C Lieu1, Roanne K Karzon, Carole C Mange
1Washington University School of Medicine, One Children's Place, Room 3S 35, St. Louis, MO 63110, USA. lieuj@ent.wustl.edu
Insights
Follow-up rates for newborn hearing screening (NHS) referrals improved by 2002. Multilevel auditory brainstem response (ABR) aids in tracking high-risk infants for hearing loss.
Area of Science:
- Pediatrics
- Audiology
- Neonatal Care
Background:
- Newborn hearing screening (NHS) is crucial for early detection of hearing loss.
- Infants in neonatal intensive care units (NICUs) are at high risk for hearing impairment.
- Timely diagnostic follow-up is essential for effective intervention.
Purpose of the Study:
- To assess diagnostic testing rates post-NHS referral.
- To evaluate the timeliness of follow-up care for infants.
- To determine the utility of multilevel auditory brainstem response (ABR) in high-risk infant screening.
Main Methods:
- Telephone interviews with parents of 206 NICU infants referred from NHS (1999-2002).
- Implementation of a multilevel ABR (40, 70, 90 dB nHL) for diagnostic screening.
- Analysis of follow-up rates and hearing loss confirmation.
Main Results:
- 69% of infants received diagnostic follow-up.
- Hearing loss confirmed in 38% of infants with follow-up.
- Follow-up by 6 months increased from 13% (1999) to 31% (2002).
- Higher rates of confirmed hearing loss in infants failing both ears or requiring higher ABR thresholds.
Conclusions:
- Follow-up timeliness after NHS referral has improved.
- Multilevel ABR can help allocate resources for high-risk infants.
- Enhanced tracking is needed to ensure timely intervention for hearing loss.
Purpose:
The goal of this study was to examine the rate of diagnostic testing after newborn hearing screening (NHS) referral, evaluate timeliness of follow-up, and evaluate the use of multilevel auditory brainstem response (ABR) in screening of high-risk infants.
Method:
Telephone interviews were conducted with parents of infants who had been admitted to a neonatal intensive care unit from 1999 to 2002 and referred on NHS. An ABR screen was combined with a multilevel ABR (40, 70, and 90 dB nHL) for referrals.
Results:
Parents of 206 infants participated; 69% of the infants underwent diagnostic follow-up. Of those with follow-up, 37% had normal hearing, 38% had hearing loss, and parents were unsure of hearing test results for 25%. Follow-up by 6 months of age occurred for 13% in 1999, increasing to 31% by 2002. Infants who did not pass their screening in both ears had confirmed hearing loss in 56% vs. 25% in those who passed in 1 ear. Also, 67% of infants with bilateral pass levels of 90 dB nHL or more had confirmed hearing loss, vs. 32% in all others.
Conclusions:
Timely follow-up after NHS referral in our program has improved over time. Multilevel ABR may facilitate allocation of appropriate resources to track and ensure follow-up in infants at high risk for hearing loss.
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