Newborn Screening Tests For Hearing Loss

Children should be tested for hearing loss as soon as possible, preferably before they leave the hospital. Current hearing screening tools include the otoacoustic emissions and auditory brainstem response testing. Both tests are objective, safe, noninvasive, and have a fairly high degree of accuracy. The otoacoustic emissions tests evaluate outer hair cell efficiency and how the inner ear produces energy during the hearing process. Readings are separated into two categories, spontaneous and evoked. “Thus, the EOAE (Evoked Otoacoustic Emissions) screening program is identifying almost 5 children per 1,000 with a sensorineural hearing loss. This prevalence of sensorineural hearing loss is two to three times what is typically expected in the general population. This is strong evidence that EOAE can be successfully used to identify children who have a hearing loss” (Bess and Hall). Dr. Fred H. Bess is a professor of hearing and speech science at the Vanderbilt Kennedy Center. Dr. James W. Hall III is a clinical professor in the department of speech, language, and hearing sciences at the University of Florida in Gainesville. 

 The Auditory Brain response testing (ABR) monitors brain activity that occurs in response to sound and does not require any cooperation by the child. Children undergoing the ABR test must be kept very still, as any movement will invalidate the test results. Therefore, young patients are usually sedated for the administration of this procedure. The American Speech-Language-Hearing Association (ASHA) recommends this newborn screening test prior to hospital discharge. “Based on our experience, we believe that accurate identification can be enhanced when the ABR is applied as a diagnostic procedure to those infants who fail its administration as a screening test. For the infants, immediate diagnostic application permits prediction of both degree of sensitivity loss and probable site of dysfunction” (Bess and Hall).

As a result of the newborn hearing screening, there are greater educational opportunities for children who are born deaf or hard of hearing. Technological advances for the future will improve upon the assessment methods already being used to accurately screen and confirm hearing loss in newborns. "Both ABR and OAEs will continue to be refined as methods for UNHS (Universal Newborn Hearing Screening). Promising new technologies are emerging which combine OAE and AABR methodologies into a simple, handheld device permitting rapid measurement of both responses. These devices hold promise for rapid testing with a two-stage protocol for all infants, thereby reducing refer (false positive) rates associated with transient external or middle ear dysfunction, and improving identification of infants with more unusual forms of hearing impairment such as auditory neuropathy." This information was taken from an academic journal discussing the current screening tests and their effectiveness for the future.