I shared the recent thread regarding implications of routine newborn hearing
screening with a friend of mine who is a state EHDI coordinator and
audiologist, and thought you all might be interested in her  perspective on
this.  For background, each state has an EHDI coordinator - EHDI is the
Early Hearing Detection and Intervention Program.  More information about
the program can be found at http://www.cdc.gov/ncbddd/ehdi/default.htm

For those who were curious about referral rates and false positives, etc.
Each state has a profile of data which is searchable from the above website.

She shared her thoughts with me so that I could share them with this forum.
Following were her thoughts on pacifiers, etc. from the audiologist
perspective.

"I was just at a meeting with audiologists and we were discussing that some
of us try to obtain tests while the mother is nursing.  This is of course
after checking with the mother if she is comfortable nursing while an
audiologist is attaching electrodes or inserting probes into her infant's
ear near her breast.  Most of the units used in a hospital are handheld and
could be done in the room or have mother go to the area they usually
perform the test whichever is the most quiet.

Using a pacifier or breastfeeding will result in the same problem of
myogenic activity for the testing, that is sucking, and it depends on how
hard the infant is sucking.  The harder the suckling the less likely to
obtain a result.  This is why the infant needs to be sleeping or very quiet
without a lot of movement, during the test.  Allowing the infant to suckle
during the test may allow for the infant to calm down just long enough to
obtain a result but it will take longer than if the infant is asleep and not
sucking during the test.   A screener may feel it is easier to insert a
pacifier than having the mother present.   I would hope that a mother can
calm the baby better than a pacifier if they are not able to screen at the
best time when the infant is asleep versus using the pacifier.  The infant
must be in the "ready" state for the testing, not when the screener is
ready, which will result in the best possible outcome, low referral rate.

Although the burden of the initial testing is the hospital it is an uglier
head that rises when a hospital does not screen a baby and an infant is
identified late or worse yet (for the hospital) the hospital is sued.
Screening prior to hospital discharge is the best time to screen infants as
is the case with other neonatal screening tests.  Once they have left the
hospital it is all that much more difficult to have the infant return for
testing."

Katherine Shealy

for disclaimer purposes - I have no connection with the EHDI program aside
from being friends with an incredibly competent, dedicated, wise, underpaid,
underappreciated (hmm, sounds like most LCs I know) state coordinator.  It
is run out of the National Center for Birth Defects and Developmental
Disabilities, which is a center with which I am not affiliated.

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