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UNHS greatly increases the proportion of children whose hearing impairment is diagnosed before six months of age. However, in some 20% of children, hearing impairment was diagnosed later than one year of age, despite having failed the screening. Additionally, data from this study suggest that about 15% of childhood hearing losses manifest themselves after the hearing screening period. Efforts are thus required for the early detection of these children as well.

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One of the major drawbacks using transient evoked otoacoustic emissions (TEOAEs) for hearing screening in newborn infants is the high fail rate in normal-hearing children. The purpose of the present study was to improve the overall performance of the test procedure and reduce of the fail rate. Improvement was obtained by 3 modifications: (1) change of the pass criterion in healthy newborns by requiring TEOAEs in at least one ear and nor both ears, (2) performing the test only after the second post-partum day, and (3) using a second-stage screening prior to hospital discharge in newborns who failed the initial test. In all, 3980 newborns from 2 well-baby clinics and 243 newborns from a neonatal intensive care unit (NICU) were screened using an system ILO-88 system program mode quick-check test was completed in 3820 infants. Considering these modifications, the pass rate of healthy newborns was improved from 79.5% to > 99%, and only 0.7% of the false negative (healthy) newborns required further audiological evaluation. Babies from the NICU failed in 3.8% of the screening tests. Overall, the number of newborns who failed the ILO-88 screening test was significantly reduced and the fail rate minimize when compared to previously published experiences with TEOAEs in new-born hearing screening.