Related Experiment Videos
Outcomes of neonatal screening for hearing loss by otoacoustic emission
1Audiology Services, Forest Healthcare, Whipps Cross Hospital, Leytonstone.
Insights
Transient evoked otoacoustic emission (TEOAE) screening effectively identifies neonatal hearing impairments. This universal neonatal screening method proved more efficient and cost-effective than distraction testing for early intervention.
Area of Science:
- Audiology and Hearing Science
- Neonatal Health and Screening
- Public Health Interventions
Background:
- Early identification of hearing loss in newborns is crucial for developmental outcomes.
- Universal neonatal hearing screening aims to detect hearing impairments at birth.
- Transient evoked otoacoustic emissions (TEOAE) are a common method for neonatal hearing screening.
Purpose of the Study:
- To evaluate the effectiveness of universal neonatal screening for bilateral hearing impairments using TEOAE testing.
- To compare the performance of TEOAE screening with traditional distraction tests.
- To assess the cost-effectiveness of the TEOAE screening program.
Main Methods:
- A three-year cohort study of 14,353 infants screened using TEOAE.
- Follow-up included hearing surveillance and distraction tests from 7 months of age.
- Analysis compared TEOAE screening outcomes with subsequent hearing assessments and evaluated cost-effectiveness.
Main Results:
- 1.3/1000 infants failed the neonatal TEOAE screen; 1.5/1000 had targeted hearing impairment by analysis.
- TEOAE screening identified infants with profound and moderate hearing loss, facilitating timely hearing aid fitting.
- TEOAE screening outperformed distraction tests in efficiency and yield, at 25% lower cost.
Conclusions:
- TEOAE screening is a valuable and effective method for universal neonatal hearing impairment detection.
- The TEOAE screen will continue as a universal neonatal program.
- Distraction testing will be retained as a selective screening method for later infancy.
Aim:
To assess universal neonatal screening for bilateral hearing impairments averaging 40 dBHL or worse in the better ear, using transient evoked otoacoustic emission screening (TEOAE) testing.
Methods:
A three year cohort (14,353 infants born from January 1992 to 1995) was screened and subsequently followed up by hearing surveillance methods, including a distraction test screen from 7 months of age. The entire cohort was used to evaluate the outcome of the screen. A subcohort of 8172 district residents was used to evaluate the continuing worth of the distraction test programme.
Results:
Nineteen infants (1.3/1000) with a targeted hearing impairment failed the neonatal TEOAE test. Six profoundly deaf infants identified by the TEOAE screen, were fitted with hearing aids at a median age of 16 weeks. One remained without an aid. Of 12 infants with a moderate impairment, only seven accepted hearing aid fitting and the median age of being fitted with an aid increased to 42 weeks. By the time of the analysis 22 children with a targeted hearing impairment (1.5/1000) had been identified from the cohort. Of the three missed neonatally, one was cared for elsewhere, another had a progressive loss, and the third had central deafness. Twenty children were ascertained with a congenital peripheral deafness. Of these, eight (40%) had risk factors identifiable neonatally. Only the child with central deafness was missed by TEOAE screening and subsequently identified by behavioural tests in infancy. The TEOAE screen outperformed the distraction test in terms of processes and yield and was 25% less expensive.
Conclusions:
The analysis confirmed the worth within the district of the TEOAE hearing screen. It will thus be continued as a universal neonatal screen with the distraction test being retained as a selective screen in the latter half of infancy.