Initial Audiologic Assessment of Infants Referred From Well Baby, Special Care, and Neonatal Intensive Care Unit Nurseries 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, ... Clinical Focus: Innovation
Clinical Focus: Innovation  |   June 01, 2006
Initial Audiologic Assessment of Infants Referred From Well Baby, Special Care, and Neonatal Intensive Care Unit Nurseries
 
Author Affiliations & Notes
  • Roanne K. Karzon
    St. Louis Children’s Hospital, Washington University School of Medicine, St. Louis, MO
  • Judith E. Cho Lieu
    Washington University School of Medicine, St. Louis, MO
  • Contact author: Roanne K. Karzon, St. Louis Children’s Hospital, One Children’s Place, Room 3S23, St. Louis, MO 63110. Email: roannekk@bjc.org
Article Information
Hearing Disorders / Healthcare Settings / Clinical Focus / Innovations
Clinical Focus: Innovation   |   June 01, 2006
Initial Audiologic Assessment of Infants Referred From Well Baby, Special Care, and Neonatal Intensive Care Unit Nurseries
American Journal of Audiology, June 2006, Vol. 15, 14-24. doi:10.1044/1059-0889(2006/003)
History: Received July 7, 2005 , Revised November 24, 2005 , Accepted January 24, 2006
 
American Journal of Audiology, June 2006, Vol. 15, 14-24. doi:10.1044/1059-0889(2006/003)
History: Received July 7, 2005; Revised November 24, 2005; Accepted January 24, 2006

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.

Acknowledgments
The audiologists who followed the protocol and dutifully logged data are commended for their efforts: Kristina Shilts, Pamela Koprowski, Lauren Storr, Elizabeth Kohl, Sue Hayashi, Colleen Hruska, Tammy Fredrickson, Robin Hudson, and Carole Mange. In addition, Lauren Pfaender’s efforts at data entry and records review were invaluable to the project.
Order a Subscription
Pay Per View
Entire American Journal of Audiology content & archive
24-hour access
This Article
24-hour access