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Feasibility of community-based hearing screening using transient evoked otoacoustic emissions
1Department of Speech Pathology and Audiology, University of Queensland, Brisbane, Australia.
Insights
Transient evoked otoacoustic emissions (TEOAE) show promise for infant hearing screening in community clinics. Further improvements are needed to reduce testing failures and differentiate hearing loss causes.
Area of Science:
- Audiology
- Pediatric Health
- Public Health Screening
Background:
- Community-based hearing screening is crucial for early detection in infants and children.
- Transient Evoked Otoacoustic Emissions (TEOAE) offer a non-invasive method for hearing assessment.
- Child health clinics are ideal settings for integrating routine hearing screenings.
Purpose of the Study:
- To evaluate the feasibility of TEOAE screening for hearing in young children within a community clinic setting.
- To identify factors influencing the success rates of TEOAE hearing screenings.
- To assess the referral rates and diagnostic outcomes following TEOAE screening.
Main Methods:
- A prospective study involving 2305 children aged two weeks to 11 years 11 months undergoing TEOAE screening.
- Screenings were conducted during routine child health clinic visits, primarily at two-month immunizations.
- Follow-up screenings and diagnostic assessments were performed for children who did not pass initial tests.
Main Results:
- 7.9% of children could not complete the screening within the allotted clinic time.
- 15.7% failed the initial TEOAE screening, with 4.6% referred for further assessment.
- Of those assessed, 77 out of 94 children (81.9%) were diagnosed with some degree of hearing impairment, predominantly middle ear disorders.
Conclusions:
- TEOAE screening is a potentially effective tool for community-based hearing assessment in children.
- Instrumentation improvements are necessary to minimize 'could not test' results and improve diagnostic specificity.
- Middle ear disorders were the most common finding among children referred for assessment.
Abstract:
This study investigated the feasibility of obtaining transient evoked otoacoustic emissions for hearing screening purposes from infants and children at seven child health clinics. Factors affecting the outcomes of the community hearing screening program were examined. The subject group comprised 2305 children aged two weeks to 11 y 11 mon. Many children were attending the clinics for initial immunisation at two months of age. While there were no exclusion criteria for the 1305 young infants tested who were in this category, all other children were screened only upon receipt of a referral from clinic nurses. Results indicated that 182 children (7.9%) did not complete the screening for both ears within the time constraint (usually 15 min) of a child health clinic visit. Three hundred and sixty-two children (15.7%) failed the first screening. Of the 226 children who returned for a second screening test, separated from the first by at least two weeks, 121 children failed. With parents' consent, 107 children (4.6% of all participants) were referred for diagnostic or medical assessment. Subsequently, 77 out of 94 children who received audiological or medical assessment were found to have some degree of hearing impairment. The majority of positive screening results were associated with middle ear disorder. The results suggest that TEOAE screening has potential as a technique in the community health setting but improvements in instrumentation are required to reduce 'could not test' cases and to separate probable conductive hearing loss from cases likely to have other disorders.