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Updated: Jul 15, 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
Correlation of hearing screening with developmental outcomes in infants over a 2-year period
Charlotte Chiong1, Enrique Ostrea, Alexis Reyes
1Department of Otorhinolaryngology, College of Medicine - Philippine General Hospital, Philippine National Ear Institute, National Institutes of Health, University of the Philippines, Manila, Philippines.
Insights
Evoked otoacoustic emissions (OAE) and auditory brainstem response (ABR) show high agreement for infant hearing screening. However, correlation with developmental outcomes using Griffiths Developmental Scales needs improvement.
Area of Science:
- Pediatric Audiology
- Developmental Pediatrics
- Public Health
Background:
- Infant hearing screening is crucial for early detection of hearing loss.
- Evoked otoacoustic emissions (OAE) and auditory brainstem response (ABR) are common screening methods.
- Assessing developmental outcomes alongside hearing is important for comprehensive infant care.
Purpose of the Study:
- To correlate infant hearing screening results with developmental outcomes at 6 and 12 months.
- To evaluate the concordance of OAE and ABR in identifying hearing impairments.
- To assess the relationship between hearing status and developmental milestones in infants.
Main Methods:
- A cohort study followed pregnant women and their infants in a rural area.
- Hearing screening utilized OAE and ABR.
- Infant mental development was assessed using Griffiths Mental Developmental Scales at 6 and 12 months.
Main Results:
- OAE and ABR showed high agreement (kappa=0.79) in diagnosing hearing loss.
- The study identified a low prevalence of hearing loss (normal hearing in 97.8%).
- A small percentage of infants showed developmental delay, with inconsistent correlation to hearing screening results.
Conclusions:
- OAE and ABR are reliable for infant hearing screening with good concordance.
- The correlation between hearing screening outcomes and developmental assessments (Griffiths Scales) requires further investigation.
- Early hearing identification is vital, but comprehensive developmental monitoring is also essential.
Conclusion:
Evoked otoacoustic emission (OAE) and auditory brainstem response (ABR) results for hearing screening among infants have good concordance. However, good correlation with the Griffiths Developmental Scales remains to be desired.
Objective:
To correlate hearing screening outcomes of a cohort of infants with developmental outcomes at 6 and 12 months.
Subjects And Methods:
A cohort of pregnant women was identified in several communities in a rural area (Bulacan province) from April 2002 to February 2003 as part of a population-based study determining maternal exposure to pollutants and infant outcomes, with a total follow-up of 2 years. Pregnant mothers were identified and followed up until delivery at a secondary, provincial hospital. Hearing screening was performed with OAEs and ABR. Mental development of infants was assessed at 6 and 12 months using Griffiths Mental Developmental Scales - locomotor, personal-social, hearing and speech, hand and eye coordination, performance tests.
Results:
Among the 1086 babies recruited, there were 724 with hearing assessment. Of these 724 babies, 565 had both OAE testing and ABR. Overall in 1130 ears, OAE and ABR testing showed an observed agreement of 99%, agreement due to chance of 96%, and kappa agreement of 79% (p=0.00) in diagnosing bilateral hearing losses. OAEs had a sensitivity of 86.4% (95% CI 64-96.4%) and a specificity of 99.4% (95% CI 98.6-99.7%). At the end of the study, there were 708/724 (97.8%) infants with normal hearing, 7/724 (1.0%) with unilateral hearing loss, 8/724 (1.1%) with bilateral mild hearing loss, and 1/724 (0.1%) with bilateral profound hearing loss, who demonstrated consistent mental delay throughout. Follow-up rates for developmental examinations at 6 and 12 months were 98% and 81.25%, respectively. In these groups, there were 8 (1%) infants at 6 months and 18 (2.4%) at 12 months with developmental delay (Griffiths Mental Developmental Scales).
