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Updated: Jul 27, 2026

Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
Published on: January 23, 2017
Longitudinal study of hearing impairment in children
I R Johansen1, A-M Hauch, B Christensen
1Department of Audiology, Bispebjerg Hospital, H:S, Bispebjerg Bakke, 2400 Copenhagen, Denmark.
Insights
Progression in permanent childhood hearing impairment (PHI) is most common in early childhood. Genetic factors are the main cause of progressive PHI, with only 5.7% of cases showing progression after age 4.
Area of Science:
- Audiology
- Pediatrics
- Genetics
Background:
- Permanent childhood hearing impairment (PHI) affects numerous children globally.
- Understanding PHI progression is crucial for early intervention and management.
- Longitudinal data on PHI progression is limited, especially concerning specific etiological factors.
Purpose of the Study:
- To determine the frequency of hearing loss progression in children.
- To identify factors associated with the progression of permanent childhood hearing impairment.
- To analyze hearing threshold changes over time in a pediatric audiological registry.
Main Methods:
- Analysis of longitudinal hearing data from 1373 children with PHI.
- Children were categorized into four observation period groups (1-3, >3-5, >5-10, >10 years).
- Audiometric thresholds were analyzed across various frequencies and time intervals, with a focus on progression exceeding 15 dB.
Main Results:
- Progression of PHI was most frequent in early childhood.
- Genetic factors were identified as the predominant cause of progressive PHI.
- Only 5.7% of children exhibited PHI progression after the age of 4 years.
Conclusions:
- Permanent childhood hearing impairment progression is primarily a concern in early childhood.
- Genetic etiology plays a significant role in progressive hearing loss.
- Late-onset or continued progression of PHI beyond early childhood is relatively uncommon.
Abstract:
The aim of this study is to evaluate the frequency of progression in permanent childhood hearing impairment (PHI) and to relate potential specific factors to the eventual progression. A description is made of the true longitudinal hearing thresholds in four groups of children according to different observation periods and being part of a prospective pediatric audiological registry-based study established in 1989. At the time of data collection the registry included 1373 children born after 1/1-1970 with a PHI > 20 dB in either the right or the left ear at any pure tone frequency. The children were subdivided according to the following observation periods: 1-3 years (N=266), >3-5 years (N=148), >5-10 years (N=212) and >10 years (N=62). The differences from the first to the most recent audiometric thresholds were analysed for the right and left ears separately, at the pure tone frequencies 250, 500, 1000, 2000, 4000 and 8000 Hz, for the average of 500, 1000, 2000 and 4000 Hz, for the average of 2000 and 4000 Hz and for the average of 4000 and 8000 Hz. Those showing a progression >15 dB for the average across 500-4000 Hz were analysed for age at onset and aetiology of hearing impairment, showing that genetic factors are predominant in progressive PHI. It was also found that progression in PHI is most frequent in early childhood but found only in 5.7% after the age of 4 years.
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