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

Autor: Sally Meyer, Karl R. White, Antonia B. Maxon, Betty R. Vohr, Lynn Spivak, Teresa Kennalley, Michele James, Judith E. Widen, Jean L. Johnson, Yusnita Weirather, Maureen Sullivan-Mahoney, Judith S. Gravel
Rok vydání: 2005
Předmět:
Zdroj: American Journal of Audiology. 14
ISSN: 1558-9137
1059-0889
DOI: 10.1044/1059-0889(2005/021)
Popis: hirty-three children are born every day in the UnitedStates with congenital hearing loss—more than anyother birth defect with such serious developmentalconsequences (Leonard, Shen, Howe, & Egler, 1999;Stierman, 1994; White, 1997). In March of 1993, when theNational Institutes of Health (NIH) recommended that allnewborns be screened for hearing loss, less than 3% ofnewborns in the United States were being screened. Sincethat time, the number of infants screened for hearing losshas grown exponentially, and as of January 2005, 93% ofnewborns in the United States were being screened forhearing loss based on data collected by the National Centerfor Hearing Assessment and Management (NCHAM, 2005).In fact, with the help of federal funding, every state hasnow established an early hearing detection and interven-tion program with a goal of ensuring that all newborns arescreened for hearing loss before 1 month of age and thatthose who fail the screening receive audiologic diagnosisbefore 3 months of age and are enrolled in appropriate earlyintervention programs before 6 months of age (White, 2003).Even though almost all newborns in the United Statesare now screened for hearing loss, significant problemsremain in ensuring that infants who do not pass the hearingscreening test are quickly diagnosed and that those withpermanent hearing loss (PHL) receive timely and appro-priate early intervention services. Indeed, the Centers forDisease Control and Prevention (CDC, 2005) estimated that44% of the infants referred from newborn hearing screen-ing programs are ‘‘lost to the system’’ before completing adiagnostic evaluation. Given how difficult it has been tocomplete diagnostic evaluations for all referred infants, it isnot surprising that newborn hearing screening programshave tried various strategies to reduce the number of infantswho fail the hospital-based screening test and consequentlyneed some type of follow-up (Clemens & Davis, 2001;Finitzo, 2000; Isaacson, 2000).One frequently used strategy is a two-stage screeningprotocol prior to hospital discharge. In this protocol, new-borns are screened first with either distortion product ortransient evoked otoacoustic emissions (OAEs), and thosewho fail are screened with automated auditory brainstemresponse (A-ABR). Those who pass the first-stage OAEtest or the second-stage A-ABR test are considered tohave minimal risk for hearing loss and are not followedfurther, as recommended by the Joint Committee onInfant Hearing (JCIH, 2000; see also Prieve, 2000).According to White (2003), 17.3% of all newborns werebeing screened with this two-stage OAE/A-ABR protocolin January 2003, and the percentage seems to be increasing.One of the primary reasons this protocol is being used morefrequently is the belief that it will lead to substantiallylower referral rates at the time of hospital discharge, oftenas low as 1% of all newborns (Clemens & Davis, 2001).Despite the fact that such a protocol can substantiallyreduce the referral rate (making follow-up easier), thereis some concern that it might be missing babies with PHL(see Johnson, White, Widen, Gravel, Vohr, et al., 2005).The purpose of this study was to determine how manyinfants who fail the OAE but pass the A-ABR in a typi-cally implemented two-stage newborn hearing screeningprotocol have a PHL when they are 8–12 months old.
Databáze: OpenAIRE
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