PP1111 - A Survey Study on Trends in Infant Hearing Assessment Practice in the United States

Abstract:
Audiologists employ various testing procedures to assess auditory function in infants. In certain countries, such as the United Kingdom and Canada, infant hearing programs have established mandatory protocols to which audiologists must adhere to minimize inconsistencies in hearing test results. Currently, what specific practices are used for infant hearing assessment in the United States is unclear. In this study, we aim to explore the infant hearing assessment methods employed by audiologists throughout the United States through an electronic survey. The findings of the survey revealed that procedures used to assess auditory function in infants varied among audiologists.

Summary:
Rationale/Purpose
Audiologists employ various testing procedures to assess auditory function in infants. In certain countries, such as the United Kingdom and Canada, infant hearing programs have established mandatory protocols to which audiologists must adhere to minimize inconsistencies in hearing test results. These protocols outline the specific types of tests and parameters that should be used when evaluating hearing in infants.

Currently, what specific practices are used for infant hearing assessment in the United States is unclear. To gain insight into the testing procedures used by audiologists, one must examine the existing literature. Another approach to understanding current practices is through surveys. In this study, we aim to explore the infant hearing assessment methods employed by certified audiologists in the United States.

Methods
An anonymous survey was designed and distributed electronically (via social media platforms) to audiologists in various places of practice throughout the United States. A total of 119 audiologists who currently practice in different states in the U.S. completed the survey, and a descriptive analysis was conducted on the current results. (The questionnaire data collection is currently ongoing but will be completed by February.)

Results/Conclusions
Audiologists reported following seven different guidelines published, with some of them following more than one of these guidelines. A large portion (86%) of audiologists' responses indicated that they follow JCIH guidelines. It was interesting to learn that 61% of infant hearing assessments were being conducted in a regular clinic room without any sound treatment.

Most audiologists use an appropriate probe frequency (1000 vs. 226 Hz) to record tympanometry in infants but do not always record acoustic reflexes. In addition, most of them use the DPOAE test to check the function of outer hair cells.

A large portion of audiologists reported that air and bone conduction hearing thresholds are estimated using the auditory brainstem response (ABR) test. Many of the audiologists reported that they use traditional tone burst stimuli and not narrowband chirp stimuli. However, the ABR recording protocol (stimulus rate, filters, step size, polarity, etc.) varied among audiologists. Seventy-nine percent of audiologists reported that they do not use the air and bone conduction auditory steady-state response test for infant hearing assessment, nor do 91% typically use the cortical evoked response test in infant hearing assessment.

The audiologists indicated that the reasons they feel others do not perform infant assessments are that they require additional periodic training, lack access to the required equipment, receive inadequate reimbursement, and need more time for testing this patient population. The findings of this survey suggest that the various protocols that audiologists use may contribute to inaccuracies in threshold prediction as well. Hence, cohesive standard guidelines and protocols may aid in accurate and reliable hearing assessment in infants.