Audiology

Published on 03/06/2015 by admin

Filed under Neonatal - Perinatal Medicine

Last modified 22/04/2025

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CHAPTER 27 Audiology

Garry Inglis

Routine audiology screening for all babies, ideally just prior to discharge from hospital, was introduced in Queensland in 2004. Prior to the introduction of screening, the average age at detection of permanent hearing impairment was 30 months. It is hoped that screening will allow earlier detection and therefore improved speech and language development in those affected. Keep in mind that screening will not usually detect mild hearing impairment.

• Babies become eligible for screening at 34 weeks gestational age.
• Screening is done using automated auditory brainstem response (AABR).
• Babies who have risk factors for progressive or delayedonset hearing loss are referred for diagnostic audiology in the first year (see list below).

Other health authorities may use targeted surveillance, in which infants with certain risk factors are referred for audiology.

Risk factors include:

1. A family history of permanent hearing loss in childhood in first-degree relatives (this does not include acquired conditions such as recurrent ear infections or trauma).
2. Syndromes associated with hearing loss (e.g. Down syndrome, CHARGE).
3. Birth weight (e.g. in Queensland, ≤1500 g).
4. Bacterial meningitis.
5. Severe perinatal asphyxia.
6. Craniofacial anomalies (excluding simple pre-auricular tags and cleft lip).
7. Significant hyperbilirubinaemia (e.g. in Queensland, ≥450 μmol/L at ≥37 weeks; ≥340 μmol/L <37 weeks).
8. Congenital infection (cytomegalovirus, herpes, rubella, toxoplasmosis, syphilis).
9. Professional concern about hearing.
10. Prolonged respiratory support (e.g. in Queensland, ≥5 days).
11. Other reason for prolonged admission to a neonatal intensive care unit.
12. Parental or caregiver concern about hearing or delayed development.

Risk factors 1–10 are those used for diagnostic audiology referral in Queensland. Note that the use of aminoglycoside antibiotics is generally not considered a criterion for referral in the absence of other risk factors.

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