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Updated: Aug 6, 2026
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
[Follow-up examination for newborns and infants who failed hearing screening]
Jun Xu1, Shufei Chen, Zhoushu Zheng
1Department of Otorhinolaryngology, the Affiliated Hospital of School of Medicine of Ningbo University, Ningbo, 315020, China. hxdj@163.com
Insights
Infants failing initial hearing screening showed hearing improvements by six months, especially those with mild-moderate loss. Severe hearing loss remained consistent, indicating a need for ABR testing alongside DPOAE for accurate diagnosis.
Area of Science:
- Pediatric audiology
- Neonatal hearing screening
Context:
- Infants failing newborn hearing screening require further audiological evaluation.
- Early identification of hearing loss is crucial for developmental outcomes.
Purpose:
- To investigate hearing changes and threshold characteristics in infants who failed initial hearing screening.
- To compare auditory assessments at three and six months of age.
Summary:
- DPOAE screening had a 9.6% false positive rate. Severe hearing loss remained stable, while mild-moderate losses showed improvement by six months.
- Significant differences in auditory brainstem response (ABR) thresholds were observed between three and six months.
- DPOAE results alone are insufficient for diagnosing hearing loss; ABR is necessary.
- Diagnosing severe-profound hearing loss by three months allows early intervention, but mild-moderate cases require longer follow-up.
Impact:
- Highlights the importance of ABR in conjunction with DPOAE for accurate infant hearing loss diagnosis.
- Suggests a follow-up protocol differentiating between severe and mild-moderate hearing loss severity for timely intervention.
Objective:
To investigate the hearing change and the characteristic of hearing thresholds of the infants failing in the hearing screening.
Method:
ABR,DPOAE and acoustic immittance were used to test infants failing in the screening in their third month and the sixth month, whose results were compared.
Result:
In the third month the false positive rate of DPOAE test was 9.6%. Comparing with the results tested in the third month, the degree of severe hearing loss retested in the sixth month did not change much. But the percentage of the slight-moderate hearing loss improvement to normal or better was higher. Comparing ABR threshold result in the third month and that in the sixth month, t = 3.496, P <0.01 in the left ear, and t = 5.572, P <0.01 in the right ear, respectively. There was significant difference between these results.
Conclusion:
The new-borns failing DPOAE can not be just considered to identifying hearing loss,and it must be with the ABR to make the diagnosis. It is feasible to diagnose severe-profound hearing loss in the third month and interfere before the sixth month, but the infants with mild-moderate hearing loss must undertake the auditory tests more than twice and be followed up in more than half a year, then we can make diagnosis according to the audiologic evaluations results and the daily behaviors.
