Neonatal hearing screening of high-risk infants using automated auditory brainstem response: a retrospective analysis of referral rates

Abstract

The past decade has seen the widespread introduction of universal neonatal hearing screening (UNHS) programmes worldwide. Regrettably, such a programme is only now in the process of nationwide implementation in the Republic of Ireland and has been largely restricted to one screening modality for initial testing; namely transient evoked otoacoustic emissions (TEOAE). The aim of this study is to analyse the effects of employing a different screening protocol which utilises an alternative initial test, automated auditory brainstem response (AABR), on referral rates to specialist audiology services. A retrospective analysis was performed of all neonatal hearing screening in Letterkenny General Hospital over 5 years, from January 2008 to December 2012, which was confined to infants possessing one or more known risk factors for permanent childhood hearing impairment. 1,163 infants were screened using AABR during this period and subsequent re-test and referral rates to specialist audiology services were examined. Of the infants screened, 50 (4.3%) failed the initial AABR. A further 16 of these (32%) failed the repeat AABR, resulting in an overall referral rate to specialist audiology services of 1.38%. Our results demonstrate strikingly low overall referral rates in this cohort, falling well below both the international benchmark and the initial results of the Irish UNHS programme. This provides a convincing argument for examining AABR as a potential alternative to TEOAE in the nationwide UNHS.