Hearing Loss: Newborn Screening

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Guest:  Dr. David White – Pediatric Otolaryngology

Host:  Dr. Linda Austin – Psychiatry

Dr. Linda Austin:  I’m Dr. Linda Austin.  I’m talking with Dr. David White who is a pediatric ear, nose and throat doctor here at the Medical University of South Carolina.  You work in the Children’s Hospital?

Dr. David White:  Yes, I do.

Dr. Linda Austin:  Let’s talk about failed newborn hearing test.  First of all, which children get screened for hearing?

Dr. David White:  Well, there’s a law in South Carolina that mandates that newborn hearing screens be provided to all children in South Carolina.  So, any child that’s born in a hospital in South Carolina should undergo a newborn hearing screen.  

Dr. Linda Austin:  How is that test performed?

Dr. David White:  There are two different ways to do it.  One is called ABR (auditory brain stem response) which presents a sound to the baby and picks up the brain waves as to whether or not the brain responds to the sound.  The other way is something called otoacoustic emissions (OAE) where a probe detects whether or not the cochlea, inner ear, is working properly.  

Dr. Linda Austin:  Are those tests equally sensitive?

Dr. David White:  Of the two, the OAE test is probably the more common, but it probably comes up with the most false positives.  It’s quite a bit quicker and a little bit cheaper and, therefore, a little bit more common.  The ABR is actually a better test in the long run as far as the number of false positives that it comes up with.

Dr. Linda Austin:  When you say, false positives, you mean kids who actually have very intact hearing, or quite intact hearing, but look as if they have failed the test?

Dr. David White:  That’s true.  Or, they failed the test for other reasons.  So, when a child fails the newborn hearing screen, that can occur for many different reasons.  Babies have very small ear canals and sometimes they’re filled up with dead skin and other stuff that is present immediately after they’re born.  That can cause a failed hearing test.  Usually, as that clears over the next several weeks, that will improve.  Other things that can cause a failed hearing test would be fluid behind the eardrum, which can be present when children are born or shortly after and

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