March 13-15, 2016 • San Diego, CA


3/15/2016  |   3:00 PM - 3:30 PM   |  Topical Session 7   |  Sunrise   |  2 - Audiological Services

Hear this! Lower cost Automated ABR for Newborn Hearing Screening.

Birth centers nationwide implement different screening protocols to identify hearing loss in infants. These protocols incorporate otoacoustic emissions (OAEs), automated auditory brainstem response (AABR) testing, or a combination of these techniques. Each protocol has advantages and disadvantages related to test time, test cost, and refer rate. Although AABR has generally been associated with longer test time and higher cost, it has been found to have the lowest refer rate and is more sensitive to identifying Auditory Neuropathy Spectrum Disorder (ANSD) than OAE methods [1,2,3]. However, some programs have opted for OAE screening due to the higher disposable supply costs for AABR [2,3,4]. A commercially-available AABR screener allows for the use of either proprietary supra-aural ear domes or a standard insert earphone transducers for testing. Insert earphone use reduces per-patient disposable supply cost from $10.92 to $2.81, increasing affordability of AABR testing. However, to our knowledge, no published data is available regarding whether AABR refer rates differ between supra-aural and insert earphone transducers. To investigate potential differences in refer rate, screening data from 1151 babies from the newborn nursery at Vanderbilt University Medical Center were retrospectively reviewed. Seventeen percent of babies (n=198) were screened using supra-aural earphones, and the remaining 83% (n=953) were screened with insert earphones. Average age at screening was 15.75 hours. Refer rate (initial and rescreen results combined) was 27% for supra-aural earphones versus 21% for inserts. This difference was not significant (Chi2(1)=3.25, prob=.07 NS), suggesting that insert earphones are a viable, low-cost option for AABR screening even in very young infants. Insert earphones save $8.11 per baby, resulting in approximately $8,000 savings per 1000 babies. These findings support the viability of using insert earphones as a low-cost ABR option within newborn hearing screening protocols.

  • describe differences between AABR and OAE test methods in newborn hearing screening (NHS) protocols.
  • describe potential effects of age at screening for various NHS protocols.
  • describe cost differences associated with different NHS protocols.

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Alison Kemph (Primary Presenter), Vanderbilt Bill Wilkerson Center, alison.kemph@vanderbilt.edu;
Alison Kemph, AuD is the Newborn Hearing Screening Coordinator at Vanderbilt University Medical Center. She manages a program that provides screenings for over 4400 infants in the newborn nursery and neonatal intensive care units (NICU) annually.


Financial - No relevant financial relationship exist.

Nonfinancial - No relevant nonfinancial relationship exist.

Andrea Hillock-Dunn (Co-Presenter), Vanderbilt Bill Wilkerson Center, andrea.h.dunn@vanderbilt.edu;
Andrea Hillock-Dunn, AuD, PhD is an Assistant Professor of Hearing and Speech Sciences and Associate Director of Pediatric Audiology at the Vanderbilt Bill Wilkerson Center. Her clinical and research interests include diagnosis and treatment of childhood hearing loss, newborn hearing screening, and auditory and audiovisual speech perception in children with normal and impaired hearing. She is currently working on an American Speech-Language-Hearing Foundation grant investigating speech recognition ability in children with asymmetric hearing loss wearing frequency compression hearing aids.


Financial -

Nonfinancial -