A Multisite Study to Examine the Efficacy of the Otoacoustic Emission/Automated Auditory Brainstem Response Newborn Hearing Screening Protocol

2005 ◽  
Vol 14 (2) ◽  
Author(s):  
Karl R. White ◽  
Betty R. Vohr ◽  
Sally Meyer ◽  
Judith E. Widen ◽  
Jean L. Johnson ◽  
...  

Purpose: Most newborns are screened for hearing loss, and many hospitals use a 2-stage protocol in which all infants are screened first with otoacoustic emissions (OAEs). In this protocol, no additional testing is done for those passing the OAE screening, but infants failing the OAE are also screened with automated auditory brainstem response (A-ABR). This study evaluated how many infants who failed the OAE and passed the A-ABR had permanent hearing loss (PHL) at 8–12 months of age. Method: A total of 86,634 infants were screened at 7 birthing centers using a 2-stage OAE/A-ABR hearing screening protocol. Of infants who failed the OAE but passed the A-ABR, 1,524 were enrolled in the study. Diagnostic audiologic evaluations were performed on 64% of the enrolled infants (1,432 ears from 973 infants) when they were 8–12 months old. Results: Twenty-one infants (30 ears) who passed the newborn A-ABR hearing screening were identified with PHL when they were 8–12 months old. Most (71%) had mild hearing loss. Conclusions: If all infants were screened for hearing loss using a typical 2-stage OAE/A-ABR protocol, approximately 23% of those with PHL at 8–12 months of age would have passed the A-ABR.

2005 ◽  
Vol 14 (2) ◽  
Author(s):  
Jean L. Johnson ◽  
Karl R. White ◽  
Judith E. Widen ◽  
Judith S. Gravel ◽  
Betty R. Vohr ◽  
...  

Purpose: This article is the 1st in a series of 4 articles on a recently completed multistate study of newborn hearing screening. Method: The study examined the efficacy of the 2-stage otoacoustic emission/automated auditory brainstem response (OAE/A-ABR) protocol for identifying hearing loss in newborns. Results: The study found that the 2-stage OAE/A-ABR protocol did miss a significant number of babies who exhibited a permanent hearing loss by 1 year of age. Three subsequent articles will describe the research design and results in detail, discuss the behavioral assessment of infants, and summarize the implications of the study for policy, practice, and research.


2005 ◽  
Vol 14 (2) ◽  
Author(s):  
Judith E. Widen ◽  
Jean L. Johnson ◽  
Karl R. White ◽  
Judith S. Gravel ◽  
Betty R. Vohr ◽  
...  

Purpose: This 3rd of 4 articles on a study of the efficacy of the 2-stage otoacoustic emission/automated auditory brainstem response (OAE/A-ABR) newborn hearing screening protocol describes (a) the behavioral audiometric protocol used to validate hearing status at 8–12 months of age, (b) the hearing status of the sample, and (c) the success of the visual reinforcement audiometry (VRA) protocol across 7 sites. Method: A total of 973 infants who failed OAE but passed A-ABR, in one or both ears, during newborn screening were tested with a VRA protocol, supplemented by tympanometry and OAE screening at age 8–12 months. Results: VRA audiograms (1.0, 2.0, and 4.0 kHz) were obtained for 1,184 (82.7%) of the 1,432 study ears. Hearing loss was ruled out in another 100 ears by VRA in combination with OAE, for a total of 88.7% of the study sample. Permanent hearing loss was identified in 30 ears of 21 infants. Sites differed in their success with the VRA protocol. Conclusions: Continued monitoring of hearing beyond the newborn period is an important component of early detection of hearing loss. Using a structured protocol, VRA is an appropriate test method for most, but not all, infants. A battery of test procedures is often needed to adequately delineate hearing loss in infants. Examiner experience appears to be a factor in successful VRA.


2005 ◽  
Vol 14 (2) ◽  
Author(s):  
Judith S. Gravel ◽  
Karl R. White ◽  
Jean L. Johnson ◽  
Judith E. Widen ◽  
Betty R. Vohr ◽  
...  

Purpose: This article examines whether changes in hearing screening practices are warranted based on the results of the recent series of studies by J. L. Johnson, K. R. White, J. E. Widen, J. S. Gravel, B. R. Vohr, M. James, T. Kennalley, A. B. Maxon, L. Spivak, M. Sullivan-Mahoney, Y. Weirather, and S. Meyer (Johnson, White, Widen, Gravel, James, et al., 2005; Johnson, White, Widen, Gravel, Vohr, et al., 2005; White et al., 2005; Widen et al., 2005) that found a significant number of infants who passed an automated auditory brainstem response (A-ABR) screening after failing an initial otoacoustic emission (OAE) screening later were found to have permanent hearing loss in one or both ears. Method: Similar to the approach used by F. H. Bess and J. Paradise (1994), this article addresses the public health tenets that need to be in place before screening programs, or in this case, a change in screening practice (use of a 2-step screening protocol) can be justified. Results: There are no data to suggest that a 2-step OAE/A-ABR screening protocol should be avoided. Conclusion: Research is needed before any change in public policy and practice surrounding current early hearing detection and intervention programs could be supported.


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