Using Otoacoustic Emissions to Screen Young Children for Hearing Loss in Primary Care Settings

OBJECTIVES: Otoacoustic emissions (OAE) technology, used widely in newborn hearing screening programs and validated by professional organizations as a reliable and objective tool, is beginning to be recognized as superior to subjective methods when screening young children in a variety of settings. This study examines the efficacy of integrating OAE hearing screening into services routinely provided in health care settings.

METHODS: Three federally funded clinics serving low-income and uninsured people in a metropolitan area participated in the 10-month study. Subjects included 846 children (842 in the target population <5 years of age and 4 older siblings) who were screened during routine visits to their primary care providers using a distortion product OAE instrument. A multistep screening and diagnostic protocol, incorporating middle ear evaluation and treatment, was followed when children did not pass the initial screening. Audiological evaluation was sought for children not passing a subsequent OAE screening.

RESULTS: Of the 846 children screened, 814 (96%) ultimately passed the screening or audiological assessment and 29 (3%) exited the study. Three children (1 was <5 years of age and 2 were >5) were identified with permanent hearing loss.

CONCLUSIONS: The rate of identification of permanent hearing loss in this study is similar to findings from a study of OAE screening in early childhood educational settings. OAE screening holds the potential for being an effective method for helping to identify young children with permanent hearing loss in primary care settings.