The Rhode Island Hearing Assessment Program: experience with statewide hearing screening (1993-1996)

OBJECTIVE The objective of this study was to evaluate key outcomes of a universal hearing screen/rescreen program for all births with transient evoked otoacoustic emissions in all 8 maternity hospitals in the state of Rhode Island over a 4-year period. STUDY DESIGN This was a retrospective analysis of the hearing screen/rescreen refer data collected prospectively for 53,121 survivors born in Rhode Island between January 1, 1993, and December 31, 1996. Primary outcomes included the first-stage refer rates, rescreen compliance, diagnostic referral rates, identification rates, and the age of amplification. RESULTS During this 4-year time period 11 infants were identified with permanent hearing loss, resulting in an impairment rate of 2 per 1000. The mean age of hearing loss confirmation decreased from 8.7 months to 3.5 months, and the age at amplification declined from 13.3 months to 5.7 months. CONCLUSION We conclude that time and experience are important factors in the development and refinement of a universal hearing screen program. Hearing screen outcome data collected over a 4-year period in Rhode Island reveal a steady improvement in the percent of infants completing the 2-stage screen process, the stage 1 and stage 2 refer rates, compliance with rescreen and diagnostic testing, and significant improvement in the age of identification and age of amplification.

[1]  F. Bess,et al.  Universal screening for infant hearing impairment: not simple, not risk-free, not necessarily beneficial, and not presently justified. , 1994, Pediatrics.

[2]  D. Kemp.  Stimulated acoustic emissions from within the human auditory system. , 1978, The Journal of the Acoustical Society of America.

[3]  B. Vohr,et al.  Operating a Hospital-Based Universal Newborn Hearing Screening Program Using Transient Evoked Otoacoustic Emissions , 1993 .

[4]  B. Vohr,et al.  Factors Affecting the Interpretation of Transient Evoked Otoacoustic Emission Results in Neonatal Hearing Screening , 1993 .

[5]  R. Heidel,et al.  Healthy People 2000: national health promotion and disease prevention objectives (excerpts). US Public Health Service. , 1991, Journal of allied health.

[6]  Mark E. Lutman,et al.  Field Sensitivity of Targeted Neonatal Hearing Screening by Transient‐Evoked Otoacoustic Emissions , 1997, Ear and hearing.

[7]  Konkle Df,et al.  Delayed-onset hearing loss in respiratory distress syndrome: case reports. , 1993 .

[8]  L W Sullivan,et al.  Healthy People 2000 , 1990, Environmental Health Perspectives.

[9]  C. Yoshinaga-Itano.  Efficacy of Early Identification and Early Intervention , 1995 .

[10]  J S Reilly,et al.  Sensorineural hearing loss. , 1989, The Pediatric clinics of North America.

[11]  B R Vohr,et al.  Referral rates and cost efficiency in a universal newborn hearing screening program using transient evoked otoacoustic emissions. , 1995, Journal of the American Academy of Audiology.

[12]  N. Kraus,et al.  Brainstem Abnormalities in Neonates With Normal Otoacoustic Emissions , 1996 .

[13]  K R White,et al.  The effectiveness of screening programs based on high-risk characteristics in early identification of hearing impairment. , 1991, Ear and hearing.

[14]  A. Stredler-Brown,et al.  Learning to Communicate: Babies with Hearing Impairments Make Their Needs Known. , 1992 .

[15]  W. J. Kelly,et al.  Fluctuating and/or progressive sensorineural hearing loss in children , 1994, The Laryngoscope.

[16]  J. Walton,et al.  Hearing loss in infants with persistent fetal circulation. , 1988, Pediatrics.

[17]  Gottfred Ch,et al.  An inevitable fact of life. , 1994 .

[18]  C. Strong,et al.  The Relationship of Hearing‐Loss Severity to Demographic, Age, Treatment, and Intervention‐Effectiveness Variables , 1994, Ear and hearing.

[19]  N. Sculerati,et al.  Progressive Sensorineural Hearing Loss in Children , 1994, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[20]  B. Vohr,et al.  External and middle ear status related to evoked otoacoustic emission in neonates. , 1993, Archives of otolaryngology--head & neck surgery.

[21]  R. Gliklich,et al.  Failure to Clinically Predict NICU Hearing Loss , 1995, Clinical pediatrics.