Presenter Information:
Presenter 1: Name: Samantha Kleindienst
Affiliation: Gallaudet University
Presenter 2: Name: Wendy Hanks
Affiliation: Gallaudet University
Author Information:
Author 1: Name: Samantha Kleindienst
Affiliation: Gallaudet University
Author 2: Name: Wendy Hanks
Affiliation: Gallaudet University
Author 3: Name: Carmen Brewer
Affiliation: National Institutes of Health
Author 4: Name: Kenneth Henry
Affiliation: Inova Fairfax Hospital for Children
Author 5: Name: Spencer Brudno
Affiliation: Inova Fairfax Hospital for Children
Abstract Information:
Title: Including High Frequency (1000 Hz) Acoustic Stapedial Reflexes in UNHS: Pros and Cons
Primary Track: 2-Audiological Assessment and Intervention
Keyword(s): Infant hearing, immittance, acoustic stapedial reflex, high-frequency probe-tone, universal newborn hearing screening


The measurement of acoustic stapedial reflexes is a routine diagnostic test for children and adults, however this reflex is not often measured in the neonatal population as limited normative data is currently available. Acoustic reflexes are contractions of the stapedius muscle to loud stimuli. Measurement of this reflex is primarily used to determine the health of the middle ear and neural function. Differences in size, stiffness, and mass of the neonatal ear require adjustments to the test parameters used for children and adults, specifically the probe-tone used for measurement. Previous research on acoustic reflexes in neonates indicates higher frequency probe-tones are more effective with this population. Currently, little research has looked at 1000 Hz, a high frequency probe-tone that is commercially available today. This study presents normative data for acoustic stapedial reflex thresholds using a 1000 Hz probe-tone with 4 different elicitor stimuli (500, 1000, and 2000 Hz pure tones and broadband noise) for full-term, well-baby neonates aged 12-60 hours old. All neonates passed a transient evoked otoacoustic emissions (TEOAE) screen and had peaked high-frequency tympanometry. A total of 266 ears (138 neonates) were examined of which approximately 66% (176 ears) passed the inclusion criterion. The acoustic reflex was present for at least one elicitor stimulus in 97% of the ears tested, while acoustic reflexes were present for all elicitor stimuli in 87%. Normative values for acoustic reflexes, measured with a 1000 Hz probe-tone, will be presented as well as the role of this assessment in universal newborn hearing screening (UNHS). The long-term benefits of this diagnostic tool include, 1) more specific and time-sensitive diagnoses for middle ear pathology, auditory neuropathy, and other central and peripheral pathologies in neonatal hearing assessment, 2) decreasing the percentage of false-positives in UNHS programs, 3) improving the follow-up process, and 4) reducing parent anxiety.
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