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Related Experiment Video

Updated: Dec 13, 2025

Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
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Peripheral Auditory Involvement in Childhood Listening Difficulty.

Lisa L Hunter1,2,3,4, Chelsea M Blankenship1,2,4, Li Lin2

  • 1Communication Sciences Research Center, Cincinnati, Ohio, USA.

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Summary

Children with listening difficulties (LiDs) do not show peripheral hearing impairment compared to typically developed peers. However, a history of pressure equalization (PE) tubes impacts extended high-frequency (EHF) hearing and middle ear function.

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Area of Science:

  • Audiology
  • Pediatric audiology
  • Hearing science

Background:

  • Idiopathic listening difficulties (LiDs) in children are often reported by caregivers.
  • The potential for undetected peripheral hearing impairment in children with LiDs requires investigation.

Purpose of the Study:

  • To test the hypothesis that children with idiopathic listening difficulties (LiDs) exhibit undetected peripheral hearing impairment.
  • To compare auditory function in children with LiDs to typically developed (TD) children using sensitive measures.

Main Methods:

  • Recruited 60 children with LiDs and 54 TD children (aged 6-14 years).
  • Conducted standard and extended high-frequency (EHF) pure-tone audiometry, tympanometry, middle ear muscle reflexes, and otoacoustic emissions.
  • Employed univariate/multivariate mixed models and regression analysis to assess group differences and influencing factors.

Main Results:

  • No significant differences in peripheral auditory measures were found between LiD and TD groups.
  • Extended high-frequency (EHF) hearing thresholds, tympanometry, middle ear reflexes, and otoacoustic emissions were related to a history of pressure equalization (PE) tube surgery across all children.
  • Physiologic measures were associated with EHF hearing loss, linked to PE tube history.

Conclusions:

  • Children with validated LiDs do not show significant peripheral auditory function differences compared to age- and sex-matched TD children.
  • History of PE tube surgery is significantly associated with EHF hearing and various physiologic auditory measures in children.
  • Peripheral auditory function appears intact in children with LiDs, but PE tube history is a relevant factor for auditory health.