Newborn Hearing Screening: 1-3-6 Guidelines and How Well We Adhere to Them
Susan Kim1, Aviya L Levy2, Qi Gao3
1Division of Newborn Medicine, Department of Pediatrics, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Insights
Many newborns miss critical hearing tests. Maternal language barriers significantly impact adherence to auditory brainstem response (ABR) testing, highlighting a need for targeted interventions to improve newborn hearing screening follow-up.
Area of Science:
- Pediatrics
- Audiology
- Public Health
Background:
- Newborn hearing screening is crucial for early detection of hearing loss.
- Recommended follow-up includes oto-acoustic emissions (OAE) by 1 month and auditory brainstem response (ABR) by 3 months.
- Adherence to these protocols is essential for timely intervention.
Purpose of the Study:
- To investigate caregiver adherence rates to OAE and ABR testing in an urban infant population.
- To identify risk factors associated with poor adherence to newborn hearing screening follow-up.
- To inform interventions aimed at improving screening completion.
Main Methods:
- Retrospective chart review of full-term infants from 2016 and 2019 at two Bronx hospitals.
- Analysis of adherence to 1-month OAE and 3-month ABR testing following referral.
- Multivariable analysis to identify significant risk factors for non-adherence.
Main Results:
- Only about one-third of referred newborns completed the recommended 1-month OAE testing.
- Half of the infants who underwent OAE testing missed their 3-month ABR appointment.
- Maternal spoken language was identified as a significant factor influencing ABR adherence.
Conclusions:
- Adherence to recommended newborn hearing screening follow-up protocols is suboptimal in this urban population.
- Language barriers represent a significant challenge to timely audiological testing.
- Interventions addressing linguistic disparities are needed to improve newborn hearing screening completion rates.
Abstract:
Newborns who do not pass hearing screening in the newborn nursery should undergo oto-acoustic emissions (OAE) testing before 1 month with confirmatory auditory brainstem response (ABR) before 3 months. This study investigates caregiver adherence rates to OAE and ABR testing in newborns who were referred for hearing screening in an inner-city urban population, with the aim of identifying risk factors for poor adherence. A retrospective chart review of full-term infants in 2016 and 2019 at 2 Bronx hospitals found nearly one third of newborns did receive the recommended 1-month OAE, and half of those referred following OAE missed timely 3-month ABR testing. Combining data from both years, multivariable analysis found maternal spoken language as a significant variable affecting ABR adherence. This study suggests future interventions should target language barriers to increase adherence rates for timely newborn hearing screening.
