Title: 'Combined AABR and OAE for Newborn Hearing Screening'
Track: 1 - EHDI Program Enhancement
Keyword(s): Pass AABR fail OAE, AABR, OAE, tandem screening,
Learning Objectives:
  1. Discuss evidence regarding the benefits of doing combined AABR and OAE testing in the Delaware population.
  2. Apply the data regarding combined OAE and AABR testing to their indiv1dual program


In Delaware, tandem (both AABR and OAE) newborn hearing screening has been enacted after our EHDI Advisory Board 2007 recommendation. In two years, tandem newborn hearing screening was performed in 12,369 babies in 4 Delaware birthing hospitals as part of their routine newborn hearing screening. This included 2,864 NICU babies and 9,505 well newborn from 2011 until 2012. Infants who passed the AABR and failed the OAE were enrolled in the state Newborn Tracking program and were followed until diagnosed as having either normal hearing, or hearing loss. After discharge the babies were referred to one of the 7 recommended follow up centers, and if they failed re-screen they were then referred to one of the three Diagnostic centers. There were 613 babies who failed OAE, but passed AABR. After follow up, 476 (78%) babies were diagnosed as having normal hearing; 16% were lost to follow up and 4 (0.6%) were diagnosed with hearing loss. All four diagnosed babies had mild hearing loss; two had clinically abnormal ear canals, one had a sibling with hearing deficit requiring amplification, and one was a NICU baby with possible motor delays and flat tympanogram. All four of these babies required outpatient follow up and testing because of their risk factors, and should have been diagnosed with hearing loss, even though they passed the AABR before discharge home. In this population, no children with congenital hearing loss would have been missed by exclusive AABR screening, in combination with outpatient follow up and testing of babies with congenital risk factors. We plan to stop doing tandem screening and change to only AABR testing for all Delaware newborns. We anticipate being able to diagnose all babies with auditory neuropathy and all babies with significant hearing loss.
Presentation: 1280CarlosDuran.pdf

Handouts: Handout is not Available
Carlos Duran - Primary Presenter
Christiana Care Neonatologist
     Credentials: MD, FAAP Medical Director Delaware Early Intervention-North
     Other Affiliations: Chair EHDI Advisory Board, Delaware AAP Chapter Champion
      Dr. Duran is a neonatologist, graduate of Hershey Medical Center of Penn State. He has had a lifelong interest in hearing screening of the newborn. He is the founder of the Delaware Infant Hearing Assessment and Intervention Program and the chair of the current advisory Committee. He has been instrumental in the maintenance of the Delaware EHDI Program.

Financial - No relevant financial relationship exist.

Nonfinancial - No relevant nonfinancial relationship exist.
Kate Tullis - Co-Presenter
Delaware Divsion of Public Health
     Credentials: PhD
      Kate Tullis received her PhD in Toxicology from the University of California, Davis. Following a fellowship in Human Genetics at the University of Michigan she worked as a program coordinator for NYMAC, a regional genetics collaborative. In 2011 she became the Newborn Screening and Genetics Administrator for the State of Delaware where she directs the Newborn Metabolic and Hearing Screening Program.

Financial -

Nonfinancial -