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Response to Sauter (2007)

St. Louis Children's Hospital, St. Louis, MO

Judith E. C. Lieu

Washington University School of Medicine, St. Louis, MO

Contact author: Roanne K. Karzon, St. Louis Children's Hospital, Audiology 3S23, One Children's Place, St. Louis, MO 63110. E-mail: roannekk{at}bjc.org.

Purpose: To respond to the companion letter by T. B. Sauter (2007) commenting on "Initial Audiologic Assessment of Infants Referred From Well Baby, Special Care, and Neonatal Intensive Care Unit Nurseries" by R. K. Karzon and J. E. C. Lieu (2006).

Method: Sauter states that he is in agreement with the article by Karzon and Lieu with respect to the 2-hr time for the initial diagnostic appointment and the reliance on auditory brainstem response (ABR) as the primary method for threshold estimation in young infants. However, he questions the order of test stimuli within the ABR protocol and the order of tests within the test battery. Our comments reflect the clinical experience of the authors and are supported by evidence from the literature.

Conclusions: Development of a protocol for the initial evaluation of infants referred from newborn screening poses diagnostic challenges. A 2-hr appointment with a battery of tests works well with this population.

Key Words: auditory brainstem response, hearing loss, initial assessment