For several years now, it is possible to test the cochlear function immediately after birth in an easy way by means of click evoked otoacoustic emissions. Thanks to this early detection, hearing aid fitting and appropriate hearing rehabilitation can now be started at a very young age, which significantly enhances the possibility of integration of the congenitally hard of hearing in society. An international consensus is growing to endorse a universal neonatal hearing screening in western societies. Setting up screening programs necessitates good preparation, continuous quality control and regular analysis of procedures and results. The present paper evaluates the procedure as organised from January 1993 till December 1994 in the University ENT-Department of the Sint-Augustinus Hospital. Of the 907 included neonates who were considered not to be at risk for hearing loss, 81% passed the test immediately, and 93% passed after maximum 3 tests. Some changes in the initial procedure increased the prevalence of emissions from 69% to 84%. The practical problems of the screening program and especially the importance of a stringent follow-up procedure in case of failure, are discussed.
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