Related Experiment Video
Updated: Jul 5, 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
Screening for hearing loss and middle-ear effusion in school-age children, using transient evoked otoacoustic
C Georgalas1, J Xenellis, D Davilis
1Department of Otolaryngology, Academic Medical Centre, Amsterdam, The Netherlands. cgeorgalas@amc.uva.nl
Insights
Transient evoked otoacoustic emissions (TEOAEs) show promise for screening school-aged children for hearing loss. This method demonstrated high sensitivity in detecting hearing impairments, suggesting its potential as a valuable audiological screening tool.
Area of Science:
- Audiology
- Pediatric Health
- Otoacoustic Emissions
Background:
- Otoacoustic emissions (OAEs) are effective for newborn hearing loss screening.
- Their utility for older children, specifically school-age populations, warrants investigation for middle-ear disorders and hearing loss detection.
Purpose of the Study:
- To assess the role and effectiveness of otoacoustic emissions in screening school-age children for hearing loss and middle-ear disorders.
Main Methods:
- A cross-sectional, preliminary screening study conducted in primary schools.
- Transient evoked otoacoustic emissions (TEOAEs) were used to evaluate 196 school children.
- Otoscopy and tympanometry were employed for correlational analysis.
Main Results:
- 20% of children failed TEOAEs in both ears; 32% had absent emissions in at least one ear.
- Absent TEOAEs correlated with tympanic membrane abnormalities and Type B tympanograms.
- TEOAEs alone showed 100% sensitivity for hearing loss >30 dB and 90% sensitivity for loss >25 dB, outperforming combined testing.
Conclusions:
- Otoacoustic emission testing shows significant potential for screening school-age children for hearing loss.
- Further research, including cost-effectiveness analysis, is recommended to validate its widespread use.
Introduction:
The characteristics of otoacoustic emissions that make them ideally suited for universal newborn hearing loss screening could potentially be useful for the screening of older children. This study was performed in order to assess the role of otoacoustic emissions in a screening programme for middle-ear disorders and hearing loss in school-age children.
Methods:
Cross-sectional, preliminary screening study.
Setting:
Primary schools of Argolida municipality, south-east Greece, between December 2004 and March 2005. PATIENT SELECTION AND RECRUITMENT: All the primary school students of Argolida were invited, by press releases and individually by their teachers, to attend a session of otological and audiological screening.
Results:
One hundred and ninety-six children were evaluated using transient evoked otoacoustic emissions. Twenty per cent failed in both ears, while in 32 per cent otoacoustic emissions could not be produced in at least one ear. Younger children had higher rates of absent transient evoked otoacoustic emissions. The absence of otoacoustic emissions was highly correlated with tympanic membrane changes seen on otoscopy and the presence of a type B tympanogram. As a single screening modality, otoacoustic emissions had a 100 per cent sensitivity in diagnosing hearing loss worse than 30 dB, and a 90 per cent sensitivity and 64 per cent specificity in diagnosing hearing loss worse than 25 dB, which did not improve by adding tympanometry to the screening protocol.
Conclusion:
These results strongly suggest the potential usefulness of otoacoustic emission testing in screening school-age children for hearing loss. Further studies, taking into account cost-effectiveness issues, are indicated.
