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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
Audiologic evaluation of infants and preschoolers: a practical approach
Ioannis Psarommatis1, Theodoros Valsamakis, Maria Raptaki
1Department of Otorhinolaryngology, P. & A. Kyriakou Children's Hospital of Athens, Athens, Greece. ipsarommatis@hotmail.com
Insights
A new hearing evaluation method for children significantly reduces testing time. This approach combines history, speech assessment, and otoacoustic emissions (OAEs) for faster, reliable results in pediatric audiology.
Area of Science:
- Pediatric Audiology
- Diagnostic Techniques
Background:
- Pediatric hearing loss diagnosis requires comprehensive audiological evaluations.
- Current methods, including physiologic tests, immittance measurements, and behavioral responses, often exceed 90 minutes.
- Efficient screening is needed due to high referral rates and limited departmental resources.
Purpose of the Study:
- To introduce and validate a faster, reliable audiological assessment protocol for young children.
- To reduce the time and resources required for hearing evaluations in pediatric audiology.
- To improve patient compliance and applicability in very young children.
Main Methods:
- A proposed triad of history/otoscopy, speech evaluation, and otoacoustic emissions (OAEs) was implemented.
- This method was tested on children aged 1.5 to 5 years suspected of hearing loss.
- The new approach was compared to conventional multi-test evaluations.
Main Results:
- The history/otoscopy --> speech evaluation --> OAEs triad effectively identified children with normal hearing bilaterally.
- The proposed method significantly shortened evaluation time compared to conventional approaches.
- The triad demonstrated safety, cost-effectiveness, and non-invasiveness.
Conclusions:
- A streamlined audiological assessment using a triad of history, speech evaluation, and OAEs is effective for pediatric hearing screening.
- This approach offers a faster, more compliant, and resource-efficient alternative to traditional methods.
- The validated method allows for better allocation of diagnostic resources to children requiring further investigation.
Abstract:
Many children suspected of having hearing loss are referred for audiologic evaluation every day. Cross-checking the results from more than one audiologic tests is considered crucial in pediatric audiology, preferably combining subjective and objective methods. The current recommended approach for hearing assessment of infants and preschoolers is based on physiologic tests, immittance measurements, and behavioral responses. As a consequence, a full examination usually takes more than 90 minutes. Because the number of referrals may be much greater than the actual performance of a modern audiologic department, it would be desirable to shorten the evaluation time without reducing its validity. The largest part of the population referred to our department for hearing evaluation consists of children 1(1/2) to 4 to 5 years old suspected of having hearing loss. The proposed triad history/otoscopy --> speech evaluation --> otoacoustic emissions (OAEs) has been proven very effective in sorting out all those children with normal hearing bilaterally. The suggested algorithm shows several advantages compared to the conventional approach. It is safe, inexpensive, noninvasive, and gives reliable results in a significantly faster way, thus increasing compliance and applicability in very young children. In this way, we can save time, "money," and "diagnostic energy," which could be used for those children who really need them.
