Examining Audiometric Screening Outcomes in Non-Native English-Speaking Pediatric Patients

Early identification of hearing loss through screening, such as pure-tone audiometry, is a crucial aspect of preventive pediatric care that helps minimize negative developmental outcomes. However, non-native English-speaking (NNES) children, often immigrants or children of immigrant families, encounter systemic barriers in healthcare that limit their access to recommended screenings. This study is the first to investigate the differences in audiometric screening adherence and outcomes between NNES and native English-speaking (NES) children. Using a retrospective cohort analysis, demographic and audiometric screening data were collected from 176 patients (88 NNES and 88 NES) during well-child checks (WCC) at ages four, five, six, and eight at an academic outpatient pediatric clinic in the United States. Statistical analyses compared adherence to recommended hearing screenings between the two groups. Both NNES and NES groups had a mean age of 10.8 years (p = 0.83), shared similar insurance coverage, and had a balanced sex distribution. The non-English languages represented included Nepali (40%), Mai-Mai (11%), and Swahili (8%). Our findings showed that NNES children had lower audiometric screening rates at the four-year WCC (p = 0.04) and the six-year WCC (p = 0.04). No disparities were found in screening failure rates or referral rates to audiologists or pediatric otolaryngologists. Implementing targeted cultural competency interventions could help reduce implicit provider bias and improve hearing screening practices. The variability in adherence to hearing screening during attended WCC visits and test frequencies used underscores the necessity for more standardized and universally adopted guidelines for pediatric hearing screens at pediatric clinics.