Barriers to Timely Infant Hearing Loss Diagnosis Utilizing Auditory Brainstem Response

Area of Science:

• Pediatric Audiology
• Hearing Science
• Health Services Research

Background:

• Access to timely Auditory Brainstem Response (ABR) testing for infants is crucial for early hearing loss diagnosis but often limited by health system constraints.
• Identifying barriers to ABR testing is essential for improving adherence to Early Hearing Detection and Intervention (EHDI) guidelines.

Purpose of the Study:

• To identify common barriers affecting the number of ABR tests required for a definitive infant hearing loss diagnosis.
• To explore factors influencing delays in diagnosis and subsequent hearing aid fitting.

Main Methods:

• Retrospective review of infant ABR data from 2019-2024 at a tertiary children's hospital.
• Univariate and multivariable regression analyses to identify barriers associated with diagnostic delays.

Main Results:

• Of 630 infants, 92% received a diagnosis via ABR. 55.6% required one ABR, while 14.7% needed three or more.
• Delays in diagnosis significantly impacted hearing aid fitting age (diagnosed after 3 months: 11.2 months vs. by 3 months: 5.9 months).
• Otolaryngology consultation was associated with delayed diagnosis (>3 months).

Conclusions:

• Common barriers include infant sleep state, provider coordination, middle ear dysfunction, facility distance, and scheduling.
• Addressing these barriers is critical for timely diagnosis and intervention, aligning with EHDI guidelines.
• Timely diagnosis by 3 months of age is associated with earlier hearing aid fitting.