Newborn Auditory Brainstem Responses in Children with Developmental Disabilities.
Christine F Delgado, Elizabeth A Simpson, Guangyu Zeng and 2 others
PMID 34181140WHAT IT FOUND
Newborn hearing tests showed delayed brain responses in infants later diagnosed with autism or speech impairment, but not in those with language impairment or general developmental delay.
The test is not accurate enough to screen for these conditions alone, but suggests early neurological differences exist.
Key findings
01Infants later diagnosed with autism spectrum disorder or speech impairment had greater ABR phase values (indicating delayed brainstem response) in both ears compared to the comparison group.
02The predictive model for identifying these disabilities using newborn ABR data had an area under the curve of .64 and a positive predictive value of .014, indicating low diagnostic accuracy.
03Children later diagnosed with language impairment or developmental delay did not show significant differences in newborn ABR phase values compared to the comparison group.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study relied on secondary datasets, which restricted the ability to collect detailed clinical information, such as the severity of the disability or specific risk factors. The diagnosis categories were based on preschool eligibility codes, which may not align perfectly with clinical diagnostic criteria. Some children may have had comorbid disabilities that were not captured by the primary exceptionality code. The newborn screening protocol did not include frequency-specific ABR or threshold testing, so mild hearing impairments in the disability groups may have gone undetected and could influence ABR results. The predictive model had a very low positive predictive value, meaning most infants flagged as high-risk would not actually have the condition.
Declared interests
The authors declare no conflicts of interest. The study used data from Pediatrix Medical Group and the Florida Department of Education.
The easy way to misread this
Do not interpret the significant group differences as evidence that newborn ABR screening can currently diagnose or predict autism or speech impairment in individual patients. The positive predictive value was only .014, meaning the test is far too inaccurate for clinical screening purposes.