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ABSTRACT INFORMATION
Title: 'Detection of Middle Ear Dysfunction Using Wideband Acoustic Tests in Newborn Hearing Screening and Diagnostic Follow-Up'
Track: 2 - Audiological Services
Keyword(s): Screening, diagnosis, middle ear
Learning Objectives:
  1. Define how transient middle ear problems affect newborn screening.
  2. Discuss effectiveness of wideband immittance for diagnosis of newborn hearing referrals.
  3. Explain how middle ear problems affect OAE and ABR screening.

Abstract:

Background: More than 80% of newborn hearing screening (NHS) referrals are due to transient middle ear conditions. A major challenge in achieving diagnosis by age 3 months is determining if the referral is due to temporary or permanent hearing loss. A wideband (WB) acoustic test has the potential to improve hearing screening and diagnosis of middle-ear and cochlear dysfunction in newborns referred from hearing screening. Goals: This study was designed to assess whether a WB test battery improves accuracy of distinguishing between CHL and SNHL, compared to gold standard diagnostic air and bone conduction ABR. Methods: Infants (N=691) were enrolled from well-baby (N=545) and NICU nurseries (N=146). Well newborns were tested with the newborn hearing screening protocol of Stage I screening with transient evoked otoacoustic emission (TEOAE) and Stage II screening with automated auditory brainstem response (AABR) if TEOAE was referred. NICU newborns were tested with TEOAE or DPOAE and automated or diagnostic ABR. All infants were tested with the wideband acoustic test battery. Infants who attended a follow-up diagnostic evaluation (N=393) were assessed with toneburst air and bone conduction ABR, DPOAE and the wideband acoustic test battery. Results: The study enrolled infants who referred on Stage I or II, and a similar sample of infants who passed Stage I screening. 274 infants referred on TEOAE in one or both ears (40%), 144 infants referred on AABR in one or both ears (21%), and 272 (39%) passed initial screening with OAE. The wideband test battery effectively predicted infants who referred on Stage I or II screening due to temporary middle ear problems, or who had conductive hearing loss, as determined by the diagnostic ABR. Results will be discussed relative to screening and diagnostic applications of the WB test.
Presentation: 1307LisaHunter.pdf

Handouts: Handout is not Available
PRESENTER(S) / AUTHOR(S) INFORMATION
Lisa Hunter - Primary Presenter
Cincinnati Children's Hospital
     Credentials: PhD
      Lisa Hunter is Scientific Director of Audiology and Professor at Cincinnati Children's Hospital Medical Center and the University of Cincinnati. She collaborates on a number of funded studies including evaluating physiologic factors associated with risks for hearing loss and understanding mechanisms for improved follow-up with newborn hearing screening in high risk famlies. She is a faculty with the Leadership Education in Neurodevelopmental and related Disabilities at Cincinnati Children's Hospital Medical Center.
      ASHA DISCLOSURE:

Financial - Receives Salary for Employment from Cincinnati Children's Hospital.   Receives Grants for Other activities from NIH/NIDCD.   Receives Speaker for Teaching and speaking from Interacoustics, Inc.  

Nonfinancial - No relevant nonfinancial relationship exist.
Jareen Meinzen-Derr - Author
Cincinnati Children's Hospital Medical Center
     Credentials: PhD, MPH
      Dr. Meinzen-Derr is quantitative epidemiologist at the Cincinnati Children's Hospital Medical Center. She has focused her research on outcomes of children who are deaf or hard of hearing, and specifically those who have additional developmental disabilities.
      ASHA DISCLOSURE:

Financial - No relevant financial relationship exist.

Nonfinancial - No relevant nonfinancial relationship exist.
Patrick Feeney - Author
National Center for Rehabilitative Audiology Research, Portland OR
     Credentials: Ph.D.
      Dr. Feeney is the Director of the National Center on Rehabilitative Auditory Research at the Portland Veteran's Administration. His research interests involve the evaluation of peripheral auditory function, hearing screening, and central auditory function in aging.
      ASHA DISCLOSURE:

Financial - Receives Grants for Independent contractor from NIH NIDCD grant.  

Nonfinancial - No relevant nonfinancial relationship exist.
Douglas Keefe - Author
Boystown National Research Center
     Credentials: PhD
      Douglas Keefe, Ph.D. is a Senior Scientist at Boystown National Research Hospital. Dr. Keefe is an acoustical physicist who has worked in hearing research, musical acoustics and related signal processing, acoustics and vibration fields.
      ASHA DISCLOSURE:

Financial - Receives Ownership interest,Royalty options or other ownership interest,Hold patent on equipment for Management position,Ownership from Sonicom, Inc..  

Nonfinancial - No relevant nonfinancial relationship exist.
David Brown - Author
Pacific University
     Credentials: PhD
      David Brown, PhD is an Associate professor and the Director of AUD SimLab at Pacific University. Dr. Brown has expertise and has completed many studies in diagnostic audiology, speech in noise, otoacoustic emissions, wideband immittance, and newborn screening. He has numerous publications and presentations on these topics.
      ASHA DISCLOSURE:

Financial - No relevant financial relationship exist.

Nonfinancial - No relevant nonfinancial relationship exist.
Kelly Baroch - Author
Cincinnati Children's Hospital Medical Center
     Credentials: Kelly A. Baroch, Au.D., FAAA, CCC-A Pediatric Audiologist III Infant Hearing and Screening Program Coordinator
      Kelly A. Baroch is a clinical audiologist with the Division of Audiology and the coordinator of the Infant Hearing and Screening Program, which she developed in 2003. She completes Auditory Brainstem Response Evaluations (ABR), Ototacoustic Emissions Evaluations (OAE), high frequency tympanometry, and hearing aid fittings on inpatient newborns and infants. She has given numerous state and national presentations on early identification and intervention of hearing loss in the medically complex population, auditory development in infants, and the effects of the NICU environment on sensory development. She provides clinical support on multiple research projects.
      ASHA DISCLOSURE:

Financial - No relevant financial relationship exist.

Nonfinancial - No relevant nonfinancial relationship exist.