Feasibility of community-based hearing screening using transient evoked otoacoustic emissions.

This study investigated the feasibility of obtaining transient evoked otoacoustic emissions for hearing screening purposes from infants and children at seven child health clinics. Factors affecting the outcomes of the community hearing screening program were examined. The subject group comprised 2305 children aged two weeks to 11 y 11 mon. Many children were attending the clinics for initial immunisation at two months of age. While there were no exclusion criteria for the 1305 young infants tested who were in this category, all other children were screened only upon receipt of a referral from clinic nurses. Results indicated that 182 children (7.9%) did not complete the screening for both ears within the time constraint (usually 15 min) of a child health clinic visit. Three hundred and sixty-two children (15.7%) failed the first screening. Of the 226 children who returned for a second screening test, separated from the first by at least two weeks, 121 children failed. With parents' consent, 107 children (4.6% of all participants) were referred for diagnostic or medical assessment. Subsequently, 77 out of 94 children who received audiological or medical assessment were found to have some degree of hearing impairment. The majority of positive screening results were associated with middle ear disorder. The results suggest that TEOAE screening has potential as a technique in the community health setting but improvements in instrumentation are required to reduce 'could not test' cases and to separate probable conductive hearing loss from cases likely to have other disorders.