Early detection of hearing loss in high risk children using brain stem electrical response audiometry

[Hearing screening in children with risk factors of hearing loss in the area 3 of Madrid]

The early identification of the hearing loss is very important to begin a early rehabilitation and to get a normal development of the language. Because of reason, the newborn hearing screening started, mainly in cases with risk factors. The objective of this report is to study the incidence of hearing loss in children with risk factors in the area 3 of Madrid. We realized hearing screening in 138 children in a period of 3.5 years, by otoacoustic emissions in younger 1 year and auditory brain stem evoked response in older 1 year. The results show that the incidence of sensorineural hearing loss is 4.34% of cases in children with risk factors, and more specifically 2.8% of bilateral profound hearing loss, and too, we detected 6.5% of transmisive hearing loss. The age of identification of hearing loss decreased to 6 months with the hearing screening programs. These results support the need of realization of hearing screening programs with obligatory character, though we advocate for the universal screening to include all cases of hearing loss without risk factors.

The Bradford and Airedale baby hearing project. An assessment of the impact of screening on the earlier detection of infant hearing loss

An infant screening programme based on auditory brain stem response testing (ABR) to detect hearing loss in high-risk babies has been introduced in West Yorkshire. In the 3 year period prior to the introduction of the screen hearing loss was diagnosed by the age of 9 months in only 12%. This increased to 85% for children screened by a high-risk register and ABR.

Evaluation of a deaf child

One should be aware that the measurement of hearing is really an evaluation of a child's behavioural responses in a controlled setting to the presentation of various acoustic stimuli. The determination of hearing loss in some children is an ongoing process and may require more than one test session. Difficult to test children should be evaluated with as many techniques as possible for accurate cross checking of test results. Flexibility, patience and understanding and persistence are the watch words of successful hearing testing with children. For the bulk of patients who require audiological assessment however, the test battery (BOA, IMPEDANCE & BSER) approach seems to be the best available present day approach coupled with long term follow ups and careful management.

Hearing screening of infants at King Fahd Hospital of the University

The detection of hearing impairment in neonatal life and prompt intervention prevents the hazards of physical and developmental delay in speech. During a 12-month period between April 1987 and March 1988, the hearing of 151 well babies and 30 high-risk babied aged 6 to 12 months attending the pediatric clinics of King Fahd Hospital of the University (KFHU), Al-Khobar, were screened. The modified Ewing-Stykar test was performed on all babies. Tympanometry, stapedial reflex, and brainstem evoked response (BERA) were carried out in the well babies who failed the screening test and in all high-risk babies. The failure rate was found to be 4.6% and 43.3% and the validity index 71.4% and 92.3% for the well and high-risk babies, respectively. The results of this limited study encourages us to recommend the implementation of this screening test in all the well baby and the high-risk baby clinics in the Kingdom of Saudi Arabia.

An evaluation of ABR audiometry for the screening and detection of hearing loss in ex-SCBU infants

The study aimed to use auditory brainstem response (ABR) audiometry to test ex-SCBU infants born during 1986 in West Berkshire. Two hundred and forty-three babies were tested as out-patients, thus achieving a coverage rate of 86% of the target population. Mean post-conceptional age at test was 48 weeks. Whenever possible, full ABR threshold determination was performed on both ears and the mean ABR threshold was found to be 14 dB nHL. Of those babies attending, 85% showed ABRs at less than or equal to 30 dB nHL bilaterally and the remaining 15% were referred for further assessment. Approximately two-thirds of these were recalled successfully for repeat testing. The estimated prevalence rate for bilateral sensorineural hearing impairment was 1.4% with four confirmed cases. Two additional permanent unilateral hearing losses were also detected. On the basis of recorded ABR data, sensitivity, specificity and positive predictive values were estimated for click intensities which could be used for single-intensity ABR screens. It is concluded that delaying screening until the post-neonatal stage is a viable alternative to screening neonates prior to discharge from the SCBU.

BERA in the diagnosis of deafness in children. A retrospective survey of its use in a district general hospital

Brainstem Evoked Responses have been used in the Audiology Unit in Crosshouse Hospital since it opened in 1984, and have now come to form a vital asset in our assessment and diagnosis of the hearing threshold in children. This particular survey is a retrospective study of the BERA used in determining the hearing threshold in children. The survey has been limited to the BERA performed on children from January, 1985 until December, 1986.