The Role of Cognitive Evaluation in Predicting Successful Audiometric Testing among Children
Taylor B Teplitzky1, Kristen Angster2, Lauren E Rosso3
11 Department of Otorhinolaryngology-Head and Neck Surgery, University of Maryland Medical Center, Baltimore, Maryland, USA.
Insights
Cognitive testing using the DAYC-2 can help predict if young children will complete an age-appropriate hearing test. This tool aids in identifying children likely to pass audiometry, improving audiological assessments.
Area of Science:
- Pediatric audiology
- Developmental psychology
- Child health screening
Background:
- Accurate hearing assessments are crucial for early childhood development.
- Cognitive abilities can influence a child's ability to participate in audiological testing.
- Predicting success in audiometry can optimize pediatric audiology workflows.
Purpose of the Study:
- To evaluate the predictive role of cognitive testing in children aged 30-42 months for age-appropriate audiometric responses.
- To determine if the Developmental Assessment of Young Children-Second Edition (DAYC-2) can identify children likely to complete audiometry.
- To assess the accuracy of DAYC-2 scores in predicting successful audiometric outcomes.
Main Methods:
- Prospective study conducted in a tertiary care audiology clinic.
- Children aged 30-42 months underwent cognitive assessment using the DAYC-2 and age-appropriate audiometry.
- Speech reception threshold (SRT) and pure tone average (PTA) agreement was analyzed against DAYC-2 scores.
- Sensitivity, specificity, and predictive values were calculated for optimal DAYC-2 thresholds.
Main Results:
- Data from 37 children were analyzed; 87% showed SRT-PTA agreement in audiometry.
- Children with audiometric agreement had significantly higher mean DAYC-2 raw scores (39.4) and age-equivalent scores (29.6) compared to those without agreement.
- Optimal DAYC-2 cut points demonstrated moderate prediction performance (AUC 0.73-0.77) with 100% positive predictive value.
Conclusions:
- The DAYC-2 serves as a valuable screening tool for identifying children likely to complete age-appropriate audiograms.
- Cognitive assessment can aid in optimizing the audiological evaluation process for young children.
- Early identification of children who may struggle with audiometry can lead to more efficient and effective hearing healthcare.
Objective:
To determine the role of cognitive testing in predicting age-appropriate audiometric responses among children aged 30 to 42 months.
Study Design:
Prospective.
Setting:
Tertiary care audiology clinic.
Subjects And Methods:
Subjects included primary English-speaking children aged 30 to 42 months. A certified pediatric audiologist performed the cognitive aspect of the Developmental Assessment of Young Children-Second Edition (DAYC-2). A second, blinded audiologist performed age-appropriate audiometry. The raw, age-equivalent, percentile, and standard DAYC-2 scores were compared by agreement between speech reception threshold (SRT) and pure tone average (PTA). Optimal DAYC-2 thresholds were also calculated for prediction of SRT-PTA agreement and assessed for sensitivity, specificity, and positive and negative predictive values. P < .05 was considered significant.
Results:
Complete data were obtained from 37 children. The mean age was 34.9 months (95% CI, 33.5-36.2), and 15 (41%) were female. Among the 37 children, 24 (65%) and 13 (35%) underwent visual reinforcement audiometry and conditioned play audiometry, respectively. SRT-PTA agreement was seen in 32 (87%) tests. Mean DAYC-2 raw score grouped by SRT-PTA agreement was 39.4 versus 33.4 for nonagreement (2.8-9.3, P < .001). The mean age-equivalent score grouped by SRT-PTA agreement was 29.6 versus 23.0 for nonagreement (2.7-10.6, P = .002). Optimal cut points based on DAYC-2 scores achieved moderate overall prediction performance (area under the curve, 0.73-0.77) with a positive predictive value of 100%.
Conclusion:
The DAYC-2 is a useful screen to identify children likely to complete an age-appropriate audiogram.
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