Performance of two hearing screening protocols in the NICU.

We recently started a hearing screening program for the newborns of the neonatal intensive care unit (NICU) of Shanghai Children's Medical Center. The program consisted of a two-step screening stage using DPOAE and automated ABR (AABR) at the age of a few days, and a diagnostic stage including otoscopy, measuring middle ear impedance and click evoked ABR at the age of two months. Babies who were referred on either the basis of DPOAE or DPOAE-AABR screening were referred for diagnostic work-up. Of the 200 NICU infants, twenty-nine (14.5%) were referred by a single session DPOAE screening. Of these, nine (4.5%) were identified by the DPOAE-AABR screening. At the age of two months, six NICU babies (3%) had a significant hearing loss based on click-evoked ABR. None of the infants who were referred by DPOAE but had passed the AABR screening were found to have actual hearing loss. Our study reports the successful implementation of a two-step screening protocol for 'at risk' babies in Shanghai. We hope that our efforts represent a first step towards the implementation of universal hearing screening throughout the People's Republic of China.