February 26-28, 2017 • Atlanta, GA


2/28/2017  |   9:40 AM - 10:10 AM   |  Two Part Re-Screening Proposed to Better Triage Patients   |  Hanover D

Two Part Re-Screening Proposed to Better Triage Patients

The goal for any newborn hearing screening protocol is to have a high level of sensitivity and specificity to hearing loss. Here, the author proposes that using a two-part hearing re-screen can add a diagnostic element to this stage of screening, which may reduce the time between re-screen and diagnosis by more accurately triaging each infant. Brashears et. al. (EHDI 2013) presented Nemours data on 375 infants which showed the sensitivity of distortion product otoacoustic emissions (DPAOE) to middle ear effusion was 80% with a specificity of 40%. The sensitivity of Automatic Auditory Brainstem Response (AABR) to permanent hearing loss was 92% with a specificity of 93%. We propose that a two-part hearing screening using AABR and DPOAE together can help practitioners determine which infants need an Audiology / ENT follow up verses Audiology only. Middle ear effusion is one of the most common reasons for a delay in the diagnosis of permanent hearing impairment. Early identification of infants at risk for chronic otitis media can lead to better speech and language outcomes for a great number of babies. In addition, the use of these technologies in combination can help uncover suspected Auditory Neuropathy Spectrum Disorder (ANSD) early on. The diagnosis of ANSD requires the use of a diagnostic ABR using at least one rarefaction and one condensation polarity click. The differential diagnosis and management considerations for ANSD, which is responsible for 10-15% of permanent hearing losses, will also be discussed.

  • Attendees will be able to list 3 reason to do OAE and AABR for the re-screen
  • Attendees will be able to state when to suspect Auditory Neuropathy based on a re-screening result
  • Attendees will be able to state when to suspect otitis media based on a re-screen result


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Shanda Brashears (), Nemours duPont Hospital for Children, sbrashea@nemours.org;
Shanda Brashears is a Pediatric and Rearch Audiologist with the Nemours, duPont Hospital for Children. She received her Masters Degree in Communication Disorders at the Louisiana State University School of Health Sciences and began her career in audiology at the Kresge Hearing Research Laboratory. She received her AuD from the CMU/Vanderbilt Distance Learning Program and has published in the areas of Auditory Neuropathy, Genetics of Hearing Loss, Efferent Suppression, and Auditory difference in Musicians.


Financial - No relevant financial relationship exist.

Nonfinancial - No relevant nonfinancial relationship exist.