title: Screening of hearing impairment in the newborn using the auditory response cradle.
abstract: The Auditory Response Cradle (ARC) is a fully automated microprocessor controlled machine that was designed for the hearing screening of full term neonates. In order to evaluate the ARC, 6000 babies were screened at a district maternity hospital over a period of three years. Every infant subsequently entered a three year follow up programme. One hundred and two babies (1.7%) failed the ARC screen (that is, they failed two ARC tests) and 20 of these were found to have some hearing impairment: in 10 it was severe (80-90 dBHL), in seven moderate (45-60 dBHL), and in three it was mild to moderate (less than 45 dBHL). In addition, of the 20 babies who failed a first test and were discharged before a second could be performed, two were confirmed to have a severe hearing loss; 79 infants failing the screen were cleared on further testing, giving the ARC a false positive rate of 1.3%. On following up all 6000 infants for three years, seven children who passed the neonatal screen were subsequently found to have a hearing loss. For two babies the aetiology was unknown but for five the hearing impairment was either due to a hereditary progressive loss or definite postnatal factors. Progressive and acquired hearing losses cannot be detected at a neonatal screen and this emphasises the need for follow up screens at other stages in the child's life. In this long term study the ARC has been found to have a high detection rate for severe hearing loss and confirms the practical possibility of using a behavioural technique for the universal screening of hearing in neonates.
authors.affiliation: Hillingdon Hospital Postgraduate Centre, Uxbridge, Middlesex.
authors.forename: S M
authors.initials: SM
authors.lastname: Tucker
authors.forename: J
authors.initials: J
authors.lastname: Bhattacharya
mesh_terms: D004739:England / Q000453:epidemiology; D005069:Evaluation Studies as Topic; D005189:False Positive Reactions; D005500:Follow-Up Studies; D006311:Hearing Disorders / Q000453:epidemiology / Q000517:prevention & control*; D006320:Hearing Tests / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D007231:Infant, Newborn; D008838:Microcomputers; D015997:Neonatal Screening / Q000295:instrumentation* / Q000379:methods; D011795:Surveys and Questionnaires