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

Research Design and Results of the Study

¹ National Center for Hearing Assessment and Management, Utah State University, Logan
² Women and Infants Hospital, Providence, RI
³ University of Kansas Medical Center, Kansas City
⁴ University of Hawaiì, Honolulu
⁵ Albert Einstein College of Medicine and Jacobi Medical Center, Bronx, NY
⁶ Arnold Palmer Hospital for Children and Women, Orlando, FL
⁷ Via Christi Regional Medical Center, Wichita, KS
⁸ New England Center for Hearing Rehabilitation, Hampton, CT
⁹ Long Island Jewish Medical Center, New Hyde Park, NY
¹⁰ Good Samaritan Hospital, Cincinnati, OH
¹¹ Kapiòlani Medical Center for Women and Infants, Honolulu, HI

jeanj{at}hawaii.edu

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.

Key Words: newborn hearing screening, otoacoustic emissions, automated auditory brainstem response, false-negatives, congenital hearing loss

Submitted on May 7, 2005
Accepted on November 14, 2005

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