A neonatal hearing screening research program using brainstem electric response audiometry.

Results of brainstem electric response audiometry (BERA) for intensive care nursery graduates and babies from the general nursery are described. At-risk babies received both screening and more detailed BERA before hospital discharge. The latter test was repeated after four months. From 2,597 risk assessments, 421 were at risk and 379 have been tested. The specificity of 40 dB click screening is good, but its sensitivity is only moderate. Follow-up BERA detected 25 cases of hearing loss, 12 having moderate loss in at least one ear. Discrepancies between predischarge and follow-up tests occurred, especially for mild losses. There was substantial resolution of hearing loss, but also some emergent mild loss. These changes support BERA at about four months as the determinant of habilitation, as opposed to predischarge testing. Differences between click and frequency-specific BERA were found, suggesting that click evaluations alone are insufficient.