A new hearing screening system for preschool children
Wenjin Wu1, Jingrong Lü1, Yun Li1
1Department of Otolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China; Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China.
Insights
The Smart Hearing system effectively screens preschool children over 4 years old, identifying hearing loss. However, its low sensitivity requires system improvements for broader application in early childhood hearing screening.
Area of Science:
- Pediatric Audiology
- Hearing Screening Technologies
- Early Childhood Health
Background:
- Early detection of hearing loss in preschool children is crucial for development.
- Existing hearing screening methods can be time-consuming and require specialized personnel.
- Smart Hearing offers a novel automated approach to hearing assessments.
Purpose of the Study:
- To evaluate the practical application and accuracy of the Smart Hearing system for preschool children.
- To determine the prevalence of hearing loss in a large cohort of preschool-aged children.
- To assess the system's suitability for universal hearing screening.
Main Methods:
- The Smart Hearing system was used to screen 6288 preschool children aged 3-6 years.
- Automated hearing threshold testing was conducted at 1kHz, 2kHz, and 4kHz with a 30dB HL pass criterion.
- Children with positive results were referred for audiological evaluation; a subset (n=312) received comprehensive audiology assessments for accuracy evaluation.
Main Results:
- 9.3% of children screened positive, with referral rates decreasing by age (18.8% at 3 years to 4.0% at 6 years).
- Permanent hearing loss was diagnosed in 1.91‰ and temporary conductive hearing loss in 1.19% of evaluated children.
- The system demonstrated high specificity (92.6%) but low sensitivity (37.5%).
Conclusions:
- The Smart Hearing system is appropriate for universal hearing screening in preschool children aged 4 and above.
- Improvements are necessary to enhance the system's sensitivity for more comprehensive early detection.
- Further development is recommended to optimize the system for younger preschool populations.
Objectives:
This study aimed to investigate the practical application of Smart Hearing, a new hearing screening system for preschool children.
Methods:
The screening system was applied to 6288 preschool children. The system auto-tested hearing thresholds at three frequencies: 1kHz, 2kHz, and 4kHz; a 30dB hearing level (HL) was the critical intensity for passing. Children with positive results were referred for audiological evaluation (pure tone audiometry, tympanometry and distortion product otoacoustic emissions assessment, etc.). To evaluate the test accuracy, 312 children (5%) were randomly selected to receive audiology assessment.
Results:
In this study, 582 children (9.3%) tested positive in the screening, and the referral rate of the four age groups from 3 to 6 years old was 18.8%, 11.9%, 6.5% and 4.0%, respectively. A total of 463 children underwent audiological assessment, of which 12 cases (1.91‰; 95% CI: 0.83‰, 2.99‰) were diagnosed with permanent hearing loss, and 75 cases (1.19%; 95% CI: 0.92%, 1.46%) were diagnosed with temporary conductive hearing loss. No mixed hearing loss was found in this study. The specificity of the system was 92.6% and the sensitivity was only 37.5%.
Conclusions:
This screening system is suitable for the universal hearing screening of preschool children above 4 years old, and further improvements of the system are needed to increase its sensitivity.
