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Published on: January 23, 2017
Preschool hearing screening: pass/refer rates for children enrolled in a head start program in eastern North Carolina
Rose L Allen1, Andrew Stuart, Deborah Everett
1East Carolina University, Greenville, NC 27858, USA. allenro@mail.ecu.edu
Insights
A hearing screening program for preschoolers had a high refer rate, with only 76% passing overall. Methodological factors and poor follow-up compliance contributed to undetermined hearing status for many children.
Area of Science:
- Audiology
- Public Health
- Pediatrics
Background:
- Preschool hearing screening is crucial for early identification of hearing loss.
- Underserved populations, such as those in rural areas, often face barriers to audiological services.
- The American Speech-Language-Hearing Association (ASHA) provides guidelines for effective hearing screening protocols.
Purpose of the Study:
- To investigate the pass/refer rates in a preschool hearing screening program.
- To identify factors contributing to high refer rates in a medically underserved population.
- To assess follow-up compliance after audiological referrals.
Main Methods:
- A 4-year prospective study involving 1,462 preschool children (3-4 years old) in Head Start centers.
- Screening included pure-tone audiometry, tympanometry, and otoscopy, adhering to ASHA guidelines.
- Referral and follow-up compliance data were collected and analyzed.
Main Results:
- Only 76% of children passed the comprehensive hearing screening (initial + rescreening).
- Initial pass rates were 90% (otoscopy), 71% (tympanometry), and 71% (pure-tone audiometry).
- Follow-up compliance for recommended evaluations was poor, with 18.3% of hearing statuses undetermined.
Conclusions:
- The hearing screening program exhibited a high refer rate, potentially due to multiple screening components and specific criteria.
- Poor follow-up compliance significantly hindered the determination of hearing status for a substantial number of children.
- Methodological factors and child demographics may influence screening outcomes in underserved populations.
Abstract:
This 4-year project investigated the pass/refer rates of preschool children in a hearing screening program. Three- and 4-year-old children who attended Head Start centers in rural, traditionally medically underserved, eastern North Carolina participated (n = 1,462). Screening procedures and pass/refer criteria were based on the Guidelines for Audiologic Screening (American Speech-Language-Hearing Association [ASHA], Panel on Audiologic Assessment, 1997). Only 54% (n = 787) of children passed the initial screening (i.e., passed all three of the screening components, which included pure-tone audiometry, tympanometry, and otoscopy), and an additional 22% (n = 323) passed the rescreening, for an overall pass rate of 76%. The initial pass rate was 90%, 71%, and 71% for otoscopy, tympanometry, and pure-tone audiometry, respectively. After the initial screening, 675 children were referred (i.e., 83%, 2%, and 15% for audiologic rescreening, medical evaluation, or both, respectively). About 71% (n = 478) received the recommended evaluation. Follow-up assessment compliance after the rescreening was poor. Slightly more than 10% of children were evaluated. The hearing status of 267 (i.e., 18.3%) children was never determined. Six (i.e., 0.5%) of the 1,195 children who completed the audiologic screening and/or received diagnostic audiologic assessment were confirmed to have hearing loss. Methodological factors that may have contributed to this high refer rate include the use of all screening techniques (pure tones, tympanometry, and otoscopy), procedural considerations in testing protocol and pass/refer criteria, and the demographic characteristics of the children screened.
