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T R Behrens

Publications and source records attributed to T R Behrens.

6 recordsLinked to original sources

Referral rates and cost efficiency in a universal newborn hearing screening program using transient evoked otoacoustic emissions.

Recently, a National Institutes of Health Consensus Statement recommended that all infants be screened for hearing prior leaving the birthing hospital using a two-stage screening process based on transient evoked otoacoustic emissions (TEOAEs). Although the value of identifying hearing loss before 1 year of age is widely recognized, the feasibility of universal newborn hearing screening using TEOAE is sometimes questioned because it is presumed that the technique has a high false positive rate and is not cost efficient. This paper presents new data for 4253 infants from an operational universal newborn hearing screening program using a TEOAE procedure that answers those arguments.

Acoustic Stimulation↗

Screening all newborns for hearing loss using transient evoked otoacoustic emissions.

The importance of identifying hearing loss before 12 months of age is well established. Although recent research provides some evidence for the value of transient evoked otoacoustic emissions (TEOAEs) in newborn hearing screening, data are needed from large-scale clinical evaluations about the value of using TEOAE for screening high-risk and healthy babies. A cohort of 1850 infants from the well-baby nursery (WBN) and neonatal intensive care unit (NICU) were screened with TEOAE using a 2-stage process. Infants referred from the first stage prior to being discharged from the hospital were rescreened 4 to 6 weeks later. Those who did not pass the second-stage TEOAE screening were referred for diagnostic auditory brainstem response (ABR) and/or behavioral audiological evaluation for confirmation of hearing loss, fitting with amplification, and enrollment in early intervention programs. Eleven infants with unilateral or bilateral sensorineural hearing loss > 25 dB (a prevalence of 5.95 per 1000) and 37 with unilateral or bilateral recurrent conductive hearing loss > 25 dB (a prevalence of 20.0 per 1000) were identified from this cohort. These results suggest that TEOAE is a promising technique for screening newborns for hearing loss and should be evaluated further as a tool for universal newborn hearing screening.

Acoustic Stimulation↗

Using transient evoked otoacoustic emissions for neonatal hearing screening.

The Rhode Island Hearing Assessment Project was developed to determine the feasibility of establishing a valid cost-effective method of screening newborn hearing through a universal early identification programme. In a sample of 1850 infants, sensorineural hearing loss was identified in 11 infants using transient evoked otoacoustic emissions (TEOAEs). A second sample of 1451 infants showed similar trends in hearing loss identification. TEOAE was shown to have significant potential as a newborn screening tool when used in a carefully designed hospital-based early identification programme.

Acoustic Stimulation↗

The effectiveness of screening programs based on high-risk characteristics in early identification of hearing impairment.

Prompt identification of educationally significant hearing loss is yet an unattained goal. However, there is some evidence that the ability to identify and diagnose hearing loss at an early age has been significantly improved through the use of carefully designed screening protocols such as birth certificate-based high-risk registries. To evaluate the efficiency of birth certificate-based screening programs, 70 parents and guardians of 6- to 9-yr-old children with significant sensorineural losses were surveyed regarding their child's identification history. Each of these children was born in the state during the time a birth certificate-based screening program was in full operation. Results indicate that children with at least one risk factor for hearing impairment were identified an average of 7.7 mo earlier than children with no risk history. However, only 50% of the children with sensorineural hearing losses exhibited any of the risk factors and a significant number of children with risk factors were missed by the system. Had admission to a neonatal intensive care unit been considered a risk factor, 63% of the children would have exhibited at least one risk factor. More extensive implementation of high-risk registries in conjunction with more widespread education of parents and primary care providers regarding early behavioral indicators of hearing loss, procedures for referral, and appropriate intervention and management services needs to be considered.

Age Factors↗