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    Otoacoustic emissions hearing screening: Update and review

    Today’s technology makes it easy to screen kids for hearing loss quickly and easily, even in babies or children with developmental disabilities.

    Are you attending the American Academy of Pediatrics’ National Conference and Exhibition in San Diego, October 11-14? Don’t miss Dr. Andrew Schuman, Contemporary Pediatrics' tech guru, as he presents the best new technologies for your practice, including the latest mobile apps, screeners, and diagnostic/therapeutic devices: Interactive Group Forum Sessions, #I3137: Must-have gadgets, gizmos, and technology for the pediatric office; Monday, October 13, 2014; 4:00-5:30 pm; Convention Center. For more information, go to www.aapexperience.org.

     

    According to the Centers for Disease Control and Prevention, 2 of every 1000 babies are born with a permanent hearing loss.1 In 1994, the Joint Committee on Infant Hearing (JCIH), composed of members from the American Speech-Language Hearing Association, the American Academy of Ophthalmology and Otolaryngology, and the American Academy of Pediatrics, first recommended universal newborn hearing screening.2 Now 2 decades later, newborn hearing screening is being performed in every state in the country, and 95% of newborns are screened.

    Unfortunately despite universal screening, we still fail to identify many babies born with a permanent hearing loss because approximately 39% of newborns who are referred by the newborn screening programs are lost to follow-up.1 Therefore, it is imperative that pediatricians ensure that all babies in our care undergo appropriate screening for hearing loss and that we remain diligent in identifying patients who may be at risk for developing permanent hearing loss in childhood. This month’s Peds V2.0 discusses using otoacoustic emissions (OAE) hearing screeners in your practice to identify children who may need follow-up and intervention with an audiologist.

    Revised recommendations

    In 2007, the JCIH revised its recommendations regarding newborn hearing screening to include 2 separate protocols: 1) for babies born in well nurseries, and 2) for those admitted to a neonatal intensive care unit (NICU) for more than 5 days.3 All NICU babies (representing 10% of the entire newborn population) may be at risk for neurosensory hearing loss and should undergo hearing screening using an automated auditory brainstem response (ABR) test prior to discharge. Those babies who do not pass should be referred to a pediatric audiologist for evaluation and rescreening with automated ABR. When indicated, these babies will undergo diagnostic ABR testing.

    In the well nursery, there are 2 options for screening. Babies can undergo a 1-stage screening using either automated ABR testing or OAE, or a 2-stage screening with automated ABR testing used for those who do not pass an initial OAE screen. All babies who refer from the well nursery should be rescreened by the hospital before 1 month of age, or, if this is not possible, they should be referred to a pediatric audiologist for rescreening follow-up. It should be noted that some newborns later discovered to have hearing loss (known as delayed onset hearing loss) would not be identified by newborn screening.

     

    Andrew J Schuman, MD, FAAP
    Dr Schuman, section editor for Peds v2.0, is clinical assistant professor of Pediatrics, Geisel School of Medicine at Dartmouth, ...

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