Universal Newborn Hearing Screenings: A Three-Year Experience

Abstract

ABSTRACT. Objective. To perform hearing screenings on all newborns before hospital discharge, using auditory brainstem evoked responses with analysis of time, cost, and failure rates to evaluate and determine the screening practicality.Method. Over a 3-year period from January 1, 1993 to December 31, 1995, auditory brainstem evoked response screenings were performed on 15 749 infants born at Saint Barnabas Medical Center, Livingston, New Jersey, before their hospital discharge by certified/licensed audiologists. The auditory brainstem evoked response screenings were conducted using the Nicolet Compass Evoked Potential System.Results. A 3-year experience of testing 15 749 infants proved to be a cost-effective program with costs less than $30.00/baby. To date, 46 babies have been identified with bilateral sensorineural hearing loss and 6 babies with unilateral sensorineural hearing loss.Conclusions. The universal newborn hearing screening program at Saint Barnabas Medical Center has proved to be effective, beneficial, and necessary for an institution with more than 5000 births, annually. Early identification of hearing loss has resulted in infants receiving early intervention, and the screening program has provided education and follow-up services to both parents and physicians. Pediatrics 1997;99(6). URL: http: //www.pediatrics.org/cgi/content/full/99/6/e4; auditory brainstem evoked responses, early hospital discharge of newborns, early identification of hearing loss, screening auditory brainstem evoked responses, universal newborn hearing screening.

Newborn and Infant Hearing Loss: Detection and Intervention

“…A minimum of 95% of newborns must be screened successfully for it to be considered effective. 16,19,21 • The methodology should detect, at a minimum, all infants with significant bilateral hearing impairment, ie, those with hearing loss Ն35-decibel in the better ear. 1,16,19 • The methodology used in screening should have a false-positive rate, ie, the proportion of infants without hearing loss who are labeled incorrectly by the screening process as having significant hearing loss, of Յ3%.…”

“…11,12 Although additional studies are necessary, review of both published and unpublished data indicates that all five of these criteria currently are achievable by effective universal newborn hearing screening programs (UNHSP). 5,13,[15][16][17][18][19][20][21][22][23][24][25][26][27][28] Therefore, this statement endorses the implementation of universal newborn hearing screening. In addition, this statement reviews the primary objectives, important components, and recommended screening parameters that characterize an effective UNHSP.…”

The current status of EHDI programs in the United States

“…Other than the report of the Rhode Island Hearing Assessment Project [White and Behrens, 1993], research about newborn hearing screening available at that time was based on small samples of infants (primarily from NICUs) over a short period of time. The recommendations of the NIH Consensus Panel and the controversy generated by the Bess and Paradise article stimulated a great deal of activity over the next five years, and by the late 1990s an impressive body of research about the feasibility, costs, and benefits of newborn hearing screening had been reported [e.g., Maxon et al, 1995;Barsky-Firkser and Sun, 1997;Finitzo et al, 1998;Mason and Herrmann, 1998;Mehl and Thomson, 1998;Vohr et al, 1998], and dozens of large-scale universal newborn hearing screening programs had become operational in various states [White, 1997].…”

Minimizing False-Positives in Universal Newborn Hearing Screening: A Simple Solution

“…4 -6 In fact, rates reported in the literature vary from ϳ2.5% to 8% and produce correspondingly poor positive predictive values of 4.0% to 12%. [7][8][9][10][11][12] Assuming that all 4 million infants born each year in the United States received UNHS, a 3% false-positive rate would cause 120 000 families of newborns to leave the hospital questioning the hearing ability of their infant and needing to return for follow-up. Similarly, assuming a positive predictive value of 5%, 95 of every 100 infants failing UNHS would subsequently be found to have normal hearing.…”