Evoked Otoacoustic Emissions It is now possible to screen an infant's hearing in the well baby and special care nursery using either transient or distortion product OAE instruments at an average time of 75 seconds/ear. Disposable supplies cost less than $1.00 per baby. The sensitivity of OAE screening methods is reported to be nearly 100% (99.99%). The chance of having a false negative result based upon a sensitivity of 99.99% is approximately 1 in 16,000. Referral rates for OAE screening programs nationally average 7-8% at birth admission discharge. If a second stage OAE screening is conducted, the final referral rate is typically less than 2% (1% as reported by the Rhode Island Hearing Assessment Project). The key to using OAE instruments for screening neonates is quality training emphasizing proper probe insertion techniques. Testers can be trained to properly insert the test probe and recognize signs that are consistent with a poorly fit probe (most of the newer OAE devices will automatically stop when the probe is inappropriately inserted). If a satisfactory probe fit is achieved and the test environment is controlled for noise interference, then a valid measurement is likely to be obtained. Several sytems are now available that provide immediate feedback alerting the tester of a PASS, REFER, of TECHNICAL FAILURE result.

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