The echo that rolled into thunder: Otoacoustic emissions and newborn hearing screening

Kemp’s 1978 publication that described “stimulated acoustic emissions” changed the basic understanding of the cochlea and provided a window to assess cochlear mechanics non-invasively in humans. The emissions, referred to early on as “Kemp’s echoes,” were adopted as the measure of choice by the Rhode Island Hearing Assessment Screening Program, a clinical research study that boldly investigated the ability to screen every baby for hearing loss. This presentation will review how a new, slightly suspicious, physiological measure was used as an integral part of improving hearing healthcare in newborns. The use of distortion-product and transiently evoked otoacoustic emissions as screening tools to identify hearing loss in newborns and their use in the differential diagnosis of hearing loss will be discussed. Clinical findings from infants with and without hearing loss will be presented that support current otoacoustic emission models, and new measures tied to cochlear physiology will be suggested that could lead to improved clinical use. This presentation emphasizes that the science of basic measures from the auditory system has fueled the national and international movement of improving hearing healthcare and habilitation in newborns.