Hearing screenings for preschool children: A comparison between whispered voice and pure tone audiogram tests
Abstract
Introduction: This prospective study compares the efficiency of two hearing screening tests performed on preschool children. These tests are known as whispered voice test and pure tone audiometry.
Methods: Standard hearing screenings were performed on five-year old children using a whispered voice test followed by ENT examination with pure tone audiometry. Results: A total of 827 children were included in the study.
Hearing loss (> 25 dB) was observed in 5.8% of the evaluated children (n = 48), being bilateral in only 1.6% (n = 13) of these cases. Slight hearing impairment (hearing loss of 16-25 dB) was observed in 25.4% (n = 210) of the children, with 14.5% bilateral cases (n = 120).
Interestingly, 62 children (7.5%) were under suspicion of hearing loss by their parents; however, an audiogram revealed the poor consistency of this diagnosis (sensitivity 20.8%, Cohen's kappa coefficient of 0.048). The whispered voice test (6 m distance) throwed a hearing impairment diagnosis in 807 (48.8%) of examined ears; however, its sensitivity was of only 56.5%, with a specificity of 51.6% and Cohen's kappa coefficient of 0.0254 (poor).
Conclusion: The hearing loss incidence in preschool children coupled with the low efficacy of whispered voice tests and the parents' unreliability during the hearing impairment survey advocate for a more efficient audiometric hearing screening before beginning school attendance.