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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
Infant hearing screening: effects of timeline
P W Y Tsui1, B McPherson, E C M Wong
1Centre for Communication Disorders and Division of Speech and Hearing Sciences, Faculty of Education, University of Hong Kong, Hong Kong, China.
Summary
Delaying infant hearing screening assessments after initial positive results may improve specificity. Waiting longer allows for natural resolution of temporary ear conditions, potentially reducing false positives in auditory brain-stem response (ABR) testing.
Area of Science:
- Audiology
- Pediatric Medicine
- Public Health
Background:
- Universal infant hearing screening programs aim for early identification and intervention of hearing impairment.
- Concerns exist regarding the specificity of screening methods, leading to potential false positives from temporary conditions like vernix occlusion or middle ear effusion.
- False positives incur significant healthcare costs and can cause parental anxiety.
Purpose of the Study:
- To investigate the impact of infant age and the time interval between initial screening and diagnostic assessment on hearing assessment outcomes.
- To evaluate how these factors influence the identification of persistent hearing impairment.
Main Methods:
- Analysis of 317 infants with initial positive results from a two-stage distortion product otoacoustic emission (DPOAE) screening program.
- Comparison of diagnostic auditory brainstem response (ABR) results based on infant age at testing and time elapsed since DPOAE screening.
- Assessment of the proportion of infants with persistent hearing impairment, conductive loss, and moderate or greater hearing loss.
Main Results:
- Infants assessed after 50 days of age showed a significantly higher rate of normal ABR thresholds (60% vs. 24%).
- A longer time lapse (over 20 days) between DPOAE screening and diagnostic ABR assessment also correlated with a higher rate of normal thresholds (65% vs. 42%).
Conclusions:
- Delaying diagnostic ABR assessment may increase the detection of normal hearing thresholds, suggesting improved screening specificity.
- A waiting period may allow for the spontaneous resolution of transient outer and middle ear issues.
- Balancing the benefits of delayed assessment for specificity against the goals of early intervention and parental well-being is crucial for optimizing infant hearing screening schedules.
