Crib-O-Gram vs. auditory brain stem response for infant hearing screening.

Area of Science:

• Neonatal screening
• Audiology
• Pediatric audiology

Background:

• Neonatal hearing loss affects 1-3 per 1000 live births.
• Early detection and intervention are crucial for language and cognitive development.
• High-risk infants in the NICU require specialized screening protocols.

Purpose of the Study:

• To longitudinally evaluate Crib-O-Gram (COG) and auditory brain stem response (ABR) screening effectiveness in a high-risk neonatal population.
• To compare the reliability and failure rates of COG and ABR in NICU infants.
• To identify the underlying causes of screening failures.

Main Methods:

• Administered COG and two-intensity ABR (70 dB and 30 dB) to 190 NICU infants.
• Assessed COG reliability through multiple screenings.
• Followed up with repeated ABR and behavioral observation audiometry at 6 months for infants who failed screening.

Main Results:

• COG showed inconsistent results in 25% of infants.
• COG failure rate was 27.9% using a 2 out of 3 pass criterion.
• ABR failure rates were 17.9% (30 dB bilateral) and 30.0% (unilateral).
• One infant with significant hearing loss was identified from 78 infants undergoing follow-up.
• Middle ear problems were common in infants failing COG (66%) and ABR (over 50%).

Conclusions:

• Both COG and ABR have limitations in high-risk neonatal populations.
• Middle ear dysfunction is a frequent cause of false-positive results in neonatal hearing screening.
• Careful interpretation and follow-up are essential for accurate diagnosis of hearing loss in NICU infants.