An evaluation of BERA for hearing screening in high-risk neonates.

Brain stem electric response audiometry (BERA) is evaluated for early detection of hearing loss in high-risk newborns selected from a general hospital population. They receive screening BERA in the nursery and detailed frequency-specific BERA in the Audiology clinic, just before discharge. Three months later, testing is repeated and recommendations are made. From 1364 assessments, 321 at-risk babies were identified; 234 received predischarge tests, and 200 had follow-up tests. Screening BERA with 40 dB nHL clicks is appropriate in the nursery. Screening sensitivity is good, and only 8% of babies failed. Several of these had mild hearing loss, resolving in the first trimester. Follow-up BERA confirmed hearing loss in 8 babies. Parental compliance is high, and the program is well-accepted. In conjunction with the high-risk register, BERA is useful both for screening and for quantitative audiometry in the infant.