["Audio 4": a simple and quick speech audiometry test for moderate hearing loss screening in four-year-old children]

The need for repeated auditory screening throughout early childhood faces the obstacle of the lack of objective validated material.

The goal of this two-year prospective study was to create and validate frequency-based word/picture lists appropriate for four-year-olds. Words were chosen not on the basis of the acoustic frequency of phoneme production, but on frequencies corresponding to their optimal recognition. Responses thus were to predict pure-tone threshold curves.

First of all, the linguistics laboratory created lists. Next, we proceeded to validate the form of the test: this involved verifying that the words selected on the basis of their frequency characteristics were common and well-known to children of this age. During the first year of the study, the picture boards were tested in a hospital otolaryngology service (66 children) and in a public health service (500 children) and corrected.

All of the words and pictures were known during the next year by 5088 children. The second step was the audiometric validation of the test in a paediatric otolaryngology service. We compared classification of normal and impaired ears according to tonal audiograms and according to "Audio 4": 360 children were tested. Results were the following ones: Se: 0.81, Sp: 0.96, PPV: 0.91, NPV: 0.93. "Audio 4" therefore allows for prediction of pure-tone curves.

This gives us hope that, directly interpretable by physicians, Audio 4, a rapid test which is attractive to children, will be used in diagnostic paediatric examinations whenever necessary.