The auditory brain stem response reliably predicts hearing loss in graduates of a tertiary intensive care nursery.

Babies (N = 642) were tested for auditory disorder, using the auditory brain stem response (ABR), at the time of their discharge from a tertiary intensive care nursery (ICN). Of those with ABR threshold elevation in one or both ears (N = 97), 61% (N = 59) were retested some months later by a battery of audiological tests; 21 (N = 3.3% of the 642) suffered binaural peripheral loss and 11 (1.7%) now wear hearing aids. These new data, when combined with similar data previously reported from the same ICN, yield a sample of 1613 babies examined during a 5.8-year period from which these conclusions emerge: (1) About 16% of our ICN babies leave the hospital with reduced sensitivity in one or both ears; (2) the hearing deficiency is permanent for 8 to 10%; (3) the loss is sensorineural, bilateral, and so severe for about 4% that hearing aids will be required to optimize their language and psychosocial development. Use of the ABR procedure for neonatal hearing testing is the target of several criticisms: it is being applied too early in life; its predictions about permanent hearing loss are unacceptably inaccurate; or/and it is too costly. We discuss these and still other objections that have been raised.