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Updated: Apr 23, 2026
An Automated System for Sound Localization Testing in Hearing-Impaired Listeners
Published on: March 13, 2026
Targeting regional pediatric congenital hearing loss using a spatial scan statistic
Matthew L Bush1, Warren Jay Christian, Kristin Bianchi
11Department of Otolaryngology-Head and Neck Surgery, University of Kentucky, Lexington, Kentucky, USA; 2Department of Epidemiology, College of Public Health, Lexington, Kentucky, USA; 3College of Medicine, University of Kentucky, Lexington, Kentucky, USA; 4Cabinet for Health and Family Services, Commission for Children with Special Health Care Needs, Louisville, Kentucky, USA; and 5Department of Behavioral Science, University of Kentucky, Lexington, Kentucky, USA.
This study mapped congenital hearing loss and failed newborn screenings in Kentucky, identifying high-risk clusters in rural areas. These findings can help target interventions for hearing health disparities.
Area of Science:
- Public Health
- Epidemiology
- Pediatrics
Background:
- Congenital hearing loss impacts language development, necessitating early detection.
- Rural populations face barriers to timely diagnosis and intervention for hearing loss.
- Understanding spatial distribution of hearing loss is crucial for targeted public health efforts.
Purpose of the Study:
- To examine the spatial distribution of failed infant hearing screening tests and pediatric congenital hearing loss in Kentucky.
- To identify high-rate clusters of hearing loss and screening failures.
- To analyze hospital-based variations in screening outcomes.
Main Methods:
- Analysis of live birth and audiological data in Kentucky (2009-2011).
- Application of spatial scan statistics to identify high-rate clusters of failed newborn hearing screenings and permanent congenital hearing loss (PCHL).
- Examination of PCHL and screening failure rates based on birthing hospital and screening methodology.
Main Results:
- Four significant clusters of failed newborn hearing screenings were identified, two in the Appalachian region.
- Hospitals using two-stage otoacoustic emission testing had higher failed screening rates (p=0.009) than those using automated auditory brainstem response.
- A significant cluster of PCHL was found in Western Kentucky, with five hospitals showing higher relative risk, two in a rural area.
Conclusions:
- Spatial analysis revealed specific regions in Kentucky with high rates of congenital hearing loss and failed newborn screenings.
- Further research into causative factors for identified clusters is warranted.
- This spatial analysis method can effectively guide efforts to address hearing health disparities in high-incidence regions.
