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Updated: Aug 22, 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
[Hearing screening at nursery schools: results of an evaluation study]
Viktor Weichbold1, Monika Rohrer, Cornelia Winkler
1Klinische Abteilung für Hör-, Stimm- und Sprachstörungen, Medizinische Universität Innsbruck, Innsbruck, Osterreich. viktor.weichbold@uklibk.ac.at
Insights
This hearing screening in Austrian preschools identified 21% of children with potential ear issues, mostly temporary conductive hearing loss. Early detection through preschool hearing screening is crucial for timely intervention and monitoring of hearing problems.
Area of Science:
- Pediatric audiology
- Public health screening programs
- Early childhood development
Background:
- Hearing impairment in early childhood can significantly impact development.
- Preschool-aged children are a critical group for early detection of hearing issues.
- Systematic hearing screening programs are essential for identifying at-risk children.
Purpose of the Study:
- To evaluate the effectiveness of a hearing screening program for preschool children in Tyrol, Austria.
- To determine the prevalence of hearing problems in this age group.
- To assess the diagnostic yield and follow-up rates of the screening.
Main Methods:
- A total of 2199 preschool children from 47 nursery schools were enrolled.
- Audiometric screening using portable audiometers presented tones at various frequencies.
- Failure to respond to any tone indicated screening failure, prompting parental referral to an ENT specialist.
Main Results:
- Screening covered 83% of enrolled children (1832 total).
- A referral rate of 21% was observed (390 children failed the screening).
- Of those examined by specialists, 64% had confirmed hearing issues, primarily temporary conductive loss.
Conclusions:
- Preschool hearing screening effectively identifies children needing intervention for ear and hearing problems.
- While many issues are temporary, some permanent sensorineural hearing loss may be detected.
- Improving follow-up rates is crucial to maximize the efficacy of preschool hearing screening.
Objective:
This study aimed to evaluate the hearing screening of pre-school children at nursery schools in Tyrol, Austria.
Methods And Sample:
47 nursery schools with a total of 2199 enrolled children participated in the study. At the screening, the children were presented a series of tones at frequencies 0.5 kHz (25dB), 1 kHz, 2 kHz, 3 kHz, and 4 kHz (20 dB each) from portable audiometers. The tones were presented over headphones for each ear separately and at irregular intervals. Failure to respond to any of the frequencies was considered failure of the screening. Parents were then advised in written form to have the child examined by an ENT-specialist.
Results:
1832 individuals were screened (coverage: 83% of nursery school children; corresponding to at least 63% of all Tyrolean children aged 3 to 5 years). Of these, 390 failed the test (referral rate: 21% of all screened). Examination through an ENT-specialist occurred with 217 children, and this confirmed the positive test in 139 children (hit rate: 64%). In most cases, a temporary conductive hearing loss due to external or middle ear problems (glue ear, tube dysfunction, cerumen, otitis media) was diagnosed. A sensorineural hearing loss was found in 4 children (in 3 of them bilateral). The need for therapy was recognized in 81 children (4% of all screened).
Conclusion:
Pre-school hearing screening identifies children with ear and hearing problems that need therapeutical intervention. Although the hearing problems are mostly of a temporary nature, some may require monitoring over some period. Also some children with permanent sensorineural hearing loss may be detected through this measure. Hearing screening is an efficient means of assessing ear and hearing problems in pre-school children. However, the follow-up rate needs to be improved for optimizing the efficacy.
