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Newborn Infant Hearing Screening (cont.)

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OAEs and ABRs, is one test better than the other?

Both tests have advantages and disadvantages when used for screening, and depending on the program and experience of the audiologist, either one can be utilized successfully. The OAE is easy and cost-effective. However, the false-positive rate (for example, an infant fails a hearing test but actually has normal hearing) may be higher for an OAE than for an ABR. The false-positive rate for ABR testing is approximately 4% when testing is done during the first three days of life. The false positive rate for OAE testing is 5%-21% for testing done during the first three days of life. This large variation between ABR and OAE testing is commonly felt to reflect the OAE testing device's increased sensitivity to residual amniotic fluid and vernix that is commonly found in the neonate's ear canal.

The two tests, however, rely on different mechanisms of hearing for the screening. For in-depth testing and a complete hearing evaluation of infants, these tests work best together as a complement to each other.

What does it mean when an infant does not pass the hearing screen?

A newborn who fails an initial hearing screen may not necessarily have a permanent hearing loss or a hearing loss at all. There are many possible reasons why an infant may fail a hearing screening test. One common reason is that fluid from the birth may still be present in the ear canal. This fluid blocks the sound stimulus, preventing it from reaching the inner ear, and therefore causes the newborn to fail. Similarly, fluid in the middle-ear space behind the eardrum (a common site for infection in children) can also block the sound stimulus and lead to a false failed test. After these problems resolve, the infant usually passes the rescreen. Therefore, it is important to have at least one week between the initial hearing screen and the rescreen to allow the newborn a chance to "dry out."

Another possible reason for a false failure is excessive noise or movement from the infant during the test. The responses that are recorded with an ABR or OAE are very, very small. Any movement or crying from the infant can prevent the equipment from detecting the response. Therefore, it is important that the newborn is quiet or sleeping for the hearing screen. Feeding the infant just prior to the screening is often very helpful. Although neither test is painful, they are novel experiences for the newborn and can be momentarily upsetting.

If it becomes evident that an infant has a hearing loss, then a full diagnostic exam is necessary to determine the type and amount of hearing loss.

Medically Reviewed by a Doctor on 2/18/2014

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Newborn Infant Hearing Screening - Experience Question: Please describe your experience with newborn infant hearing screening test.
Nerve Conduction Velocity Test - Causes Question: What caused your newborn's hearing loss?
Source: MedicineNet.com
http://www.medicinenet.com/newborn_infant_hearing_screening/article.htm

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