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THIS ISSUE of the Archives contains an article by Downs and Sterritt on detection of hearing loss in neonates. The authors prefer a 90-db warbling tone in the region of 3,000 cycles, the infant being watched for eye blink, cessation of movement, induced movement of the hands, head turn, or startle response. Of nearly 10,000 newborn infants screened in this manner, 150 failed to respond to the tone. Only 4 of the 150 have been confirmed as having true hearing impairments.
The reader should be informed that disagreement exists as to the practicability and reliability of neonatal testing. As in any screening program, the real issue becomes that of effective follow-up. Exception can be taken to the statement by Downs and Sterritt that "the number of false positives does not represent any real problem for the physician, who can determine often by simple tests ... whether a true loss exists." Even