Initial Audiologic Assessment of Infants Referred From Well Baby, Special Care, and Neonatal Intensive Care Unit Nurseries

Author:

Karzon Roanne K.1,Lieu Judith E. Cho2

Affiliation:

1. St. Louis Children’s Hospital, Washington University School of Medicine, St. Louis, MO

2. Washington University School of Medicine, St. Louis, MO

Abstract

Purpose The purpose of the study was to evaluate the effectiveness of a 2-hr initial audiologic assessment appointment for infants referred from area universal newborn hearing screening (UNHS) programs to a clinical audiology department in an urban hospital. Method A prospective auditory brainstem response (ABR)-based protocol, including clicks, frequency-specific tone bursts, and bone-conducted stimuli, was administered by 10 audiologists to 375 infants. Depending on the ABR findings, additional test options included distortion product otoacoustic emissions (DPOAEs), high-frequency tympanometry, and/or otologic examination. Results In 88% of the 2-hr test sessions, at least 4 ABR threshold estimates were obtained (i.e., bilateral clicks and either a 500- or 1000-Hz tone burst and a 4000-Hz frequency tone burst for the better ear). The incidence of hearing loss was significantly different across nursery levels: 18% for Level I (well baby), 29% for Level II (special care), and 52% for Level III (neonatal intensive care unit). Hearing loss type was defined at the initial assessment for 35 of the 51 infants with bilateral hearing loss based on bone-conduction ABR, latency measures, DPOAEs, high-frequency tympanometry, and/or otologic examination. Conclusions Our findings indicate that a 2-hr test appointment is appropriate for all nursery levels to diagnose severity and type of hearing loss in the majority of infants referred from UNHS. Examination by an otolaryngologist within 24–48 hr further defines the hearing loss and facilitates treatment plans.

Publisher

American Speech Language Hearing Association

Subject

Speech and Hearing

Reference60 articles.

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3. Evaluation of hearing thresholds in 3-month-old children with a cleft palate: The basis for a selective policy for ventilation tube insertion at time of palate repair;Andrews P. J.;Clinical Otolaryngology,2004

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5. Pediatric auditory brainstem response assessment: The cross-check principle twenty years later;Bachmann K. R.;Seminars in Hearing,1998

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