Minor Morbidity Hearing		Mild HL not requiring hearing aids occurs in 11% of ELBWs. Any HL > 30 dB increases the risk of speech delay, communication deficit and educational handicap. The pediatrician needs to follow up on newborn hearing screening results, assuring that any appropriate referrals are made and carried out. The pediatrician also needs to ensure that repeat screening every 6 months until age 3 years is carried out for children with a normal newborn hearing screen but at risk for delayed HL. Remember, the goal is to identify HL by 3 months and begin appropriate treatment by 6 months. At St. John, newborn hearing screening is done with automated ABRs. Babies with a "refer" result are rescreened within 2-4 weeks with OAEs. Those still failing the screen are tested with high-frequency tympanometry and finally, as necessary, diagnostic ABR. When a HL is definitely diagnosed, the child is referred to the Holley Ear Center for amplification (hearing aids, cochlear implants), parental education and setting up with the local intermediate school district for longterm therapy and educational planning. Our newborn hearing screening referral rate is 4-5% and our incidence of HL is about 3/1000, both figures well within the range of national benchmarks. Our 2005 incidence of HL in the NICU was 2%. It has been noted that 30-40% of children with HL have additional disabilities, emphasizing the need for developmental follow-up in these babies. A recently described disorder, termed auditory neuropathy, involves mild-to-severe HL, poor speech perception, normal OAEs with abnormal ABRs. This suggests an abnormality of the auditory nerve and/or lower brainstem. It is seen in ELBWs, those with a family history of HL and infants with hyperbilirubinemia. Neither the incidence nor the outcome of this disorder are yet known. Return to top of page