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Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
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School-Age Hearing Screening Based on Speech-in-Noise Perception Using the Digit Triplet Test
Sam Denys1, Michael Hofmann1, Heleen Luts1
1Department of Neurosciences, KU Leuven, ExpORL, Leuven, Belgium.
Ear and Hearing
|March 21, 2018
Summary
The Digit Triplet test (DTT) is a reliable hearing screening tool for school children aged 9-16. Optimized criteria improve accuracy and reduce unnecessary referrals for audiology follow-up.
Area of Science:
- Audiology
- Public Health
- Pediatric Medicine
Background:
- School-age hearing screening is crucial for early detection of hearing impairments.
- Traditional pure-tone screening methods may have limitations in large-scale application.
- The Digit Triplet test (DTT) offers a potential alternative for efficient hearing screening.
Purpose of the Study:
- To evaluate the large-scale applicability and reliability of the DTT for hearing screening in elementary and secondary school children.
- To determine optimal pass/fail criteria for the DTT, considering age, training, referral rates, and audiometry results.
- To establish reference values for the DTT in children aged 9-16 years.
Main Methods:
- The DTT replaced pure-tone screening in 11 school health centers, involving 3412 fifth graders (5E) and 3617 third-year secondary students (3S).
- Initial pass/fail criteria were established, and children with speech reception thresholds (SRT) below specific dB signal-to-noise ratio (SNR) levels were referred.
- Diagnostic accuracy was assessed using audiograms for referred children, and optimal criteria were determined by analyzing referral rates and hearing loss detection.
Main Results:
- Population SRTs did not require correction for training or age, with test-retest reliability of 0.6 dB.
- Initial criteria led to referral rates of 2.9% (5E) and 3.5% (3S), with 31% (5E) and 53% (3S) of referred children having mild peripheral hearing loss.
- Optimized criteria ( -6.5 dB SNR for 5E, -8.1 dB SNR for 3S) reduced referral rates to 1.3% (5E) and 2.4% (3S) while maintaining diagnostic accuracy.
Conclusions:
- The DTT is successfully implemented as the new hearing screening methodology in the Flemish school-age program.
- Optimized pass/fail criteria enhance the efficiency and accuracy of DTT for systematic hearing screening.
- The DTT provides reliable SRTs for monitoring hearing over time, crucial for identifying noise-induced hearing loss.
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