Auditory screening in high risk neonates: selection of a test protocol

Area of Science:

• Neonatal audiology
• Hearing screening technologies
• Clinical audiology protocols

Background:

• Neonatal intensive care unit (NICU) graduates are at higher risk for hearing impairment.
• Early detection of hearing loss is crucial for developmental outcomes.
• Evaluating the efficacy of different audiological tests is essential for optimizing screening programs.

Purpose of the Study:

• To determine the optimal test protocol for screening hearing impairment in NICU graduates.
• To compare the effectiveness and efficiency of evoked oto-acoustic emissions (EOAE) and auditory brain-stem response (ABR) tests.
• To assess the feasibility of bone conduction ABR for differentiating hearing loss types.

Main Methods:

• A study involving 250 infants, graduates of a neonatal intensive care unit.
• Administration of evoked oto-acoustic emissions (EOAE) and air conduction auditory brain-stem response (ABR) to all infants.
• Bone conduction ABR performed on infants who failed the air conduction ABR test.

Main Results:

• Screening failure rates were not dependent on age at testing but were influenced by gestational age if tested before discharge.
• Infant hearing screening coverage was 98% before discharge and 81% for out-patients tested later.
• Bone conduction ABR proved feasible for routine use, differentiating conductive and sensorineural hearing losses.

Conclusions:

• For large cohorts, initial screening with EOAE followed by ABR for failures is the most cost-effective approach.
• For smaller groups, auditory brain-stem response (ABR) alone is recommended.
• Auditory brain-stem response (ABR) is preferred for follow-up due to lower failure rates and threshold measurement capabilities.