An eight-year follow-up on auditory outcomes after neonatal hearing screening
Jolien J G Kleinhuis1, Karin de Graaff-Korf2, Henrica L M van Straaten2
1Pento Speech and Hearing Centers, Leeuwarden, The Netherlands.
Insights
Neonatal Auditory Brainstem Response (ABR) accurately predicts long-term hearing loss in children. This click ABR test is a reliable starting point for hearing rehabilitation, showing equivalence with later audiometry results.
Area of Science:
- Audiology
- Pediatric Medicine
- Neuroscience
Background:
- Neonatal hearing screening identifies infants at risk for hearing loss.
- Early detection and accurate assessment of hearing loss are crucial for timely intervention and rehabilitation.
- Auditory Brainstem Response (ABR) is a key diagnostic tool for assessing auditory function in newborns.
Purpose of the Study:
- To evaluate the correlation between neonatal click Auditory Brainstem Response (ABR) results and subsequent mean hearing loss (HL) at specific frequencies.
- To determine the long-term predictive value of early ABR assessments for childhood hearing thresholds.
- To assess the equivalence of ABR with later audiological evaluations.
Main Methods:
- Follow-up data from Visual Reinforcement Audiometry (VRA) and play audiometry were collected from newborns who failed initial hearing screening.
- Hearing levels at 1, 2, 4, and 8 years of age were compared with neonatal ABR threshold levels.
- The Two One-Sided Tests equivalence procedure was used to compare paired means within a 10 dB range.
Main Results:
- Hearing loss was confirmed in 135 out of 172 referred children.
- Sensorineural hearing loss (SNHL) was identified in 53 children (13 unilateral, 40 bilateral).
- Neonatal ABR levels demonstrated equivalence (within 10 dB) to VRA and play audiometry results at ages 1, 2, 4, and 8 years.
Conclusions:
- Initial click ABR measurements in newborns are equivalent to hearing thresholds assessed up to 8 years of age.
- Click ABR serves as a reliable indicator for long-term hearing status in children.
- The findings support the use of click ABR as a foundational tool for initiating long-term hearing rehabilitation programs.
Objective:
The aim of this study is to assess the neonatal click Auditory Brainstem Response (ABR) results in relation to the subsequently determined mean hearing loss (HL) over 1, 2 and 4 kHz, as well as over 2 and 4 kHz.
Methods:
Between 2004-2009, follow-up data were collected from Visual Reinforcement Audiometry (VRA) at 1 and 2 years and playaudiometry at 4 and 8 years of newborns who had failed neonatal hearing screening in the well-baby clinics and who had been referred to a single Speech and Hearing center. Hearing Level data were compared with ABR threshold-levels established during the first months of life. The Two One-Sided Tests equivalence procedure for paired means was applied, using a region of similarity equal to 10 dB.
Results:
Initially, in 135 out of 172 children referred for diagnostic procedures hearing loss was confirmed in the neonatal period. In 106/135 of the HL children the eight-year follow-up was completed. Permanent conductive HL was established in 5/106 cases; the hearing thresholds were predominantly stable over time. Temporary conductive HL was found in 48/106 cases and the loss disappeared by 4 years of age at the latest. Sensorineural hearing loss (SNHL) was found in 53/106 cases, of which 13 were unilateral and 40 bilateral. ABR levels were equivalent (within a 10 dB range) to VRA levels at age 1 and 2 and play audiometry levels at age 4 and 8, both when VRA and play audiometry were averaged over both frequency ranges.
Conclusion:
Long term follow-up data of children with SNHL suggest that the initial click ABR level established in the first months of life, are equivalent to the hearing threshold measured at the age of 1, 2, 4 and 8 years for both mean frequency ranges. Click ABR can reliably be used as starting point for long-term hearing rehabilitation.
