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Updated: May 19, 2026
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Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
Published on: January 23, 2017
VALIDATION OF A BEHAVIOURAL, SPEECH SPECTRUM/SPEECH BASED mHEALTH HEARING SCREENER FOR CHILDREN
Deepashree Joshi1, Vidya Ramkumar2, Ramya Vaidyanath3
1Faculty of Audiology and Speech Language Pathology, Sree Balaji Medical College & Hospital, Chennai, Tamil Nadu, 600044, India.
Wellcome Open Research
|May 18, 2026
Summary
A new mHealth hearing screener (SRESHT) effectively identifies hearing loss in children in developing countries. Age-specific modules like BOA+HRR, SSAT, and SRT offer high accuracy for early detection.
Area of Science:
- Pediatric Audiology
- Public Health Technology
- Global Health
Background:
- Hearing impairment affects millions of children globally, particularly in developing nations.
- Early detection and intervention are crucial for child development.
- Existing screening methods are often inaccessible or unaffordable in low-resource settings.
Purpose of the Study:
- To develop and validate an affordable mobile health (mHealth)-based hearing screener for children.
- To support contextualized hearing screening in developing countries.
- To identify optimal screening modules for different age groups (0-6 years).
Main Methods:
- Development of the Subjective Hearing Screener (SRESHT) using calibrated headphones and speakers at 60 dB HL.
- Inclusion of age-specific modules: Behavioral Observation Audiometry (BOA), Speech Spectrum Awareness Task (SSAT), Speech Recognition Task (SRT), High Risk Register (HRR), and Parental Questionnaire (PQ).
- Evaluation of module suitability for detecting hearing loss ≥ 60 dB HL across age groups (0-1, 1-3, and 3-6 years).
Main Results:
- The combined BOA+HRR module showed high suitability for infants (0-1 year): Sensitivity 86%, Specificity 91%, Accuracy 90%.
- The SSAT module was suitable for toddlers (1-3 years): Sensitivity 98%, Specificity 85%, Accuracy 91.2%.
- The SRT module demonstrated suitability for preschoolers (3-6 years): Sensitivity 95%, Specificity 89%, Accuracy 91.43%.
Conclusions:
- SRESHT provides an effective and affordable solution for pediatric hearing screening in resource-limited settings.
- Age-specific modules (BOA+HRR, SSAT, SRT) offer tailored approaches for accurate hearing loss detection.
- Standalone HRR and PQ modules serve as viable alternatives when test-based screening is not feasible, meeting essential performance benchmarks.
