A study of the recommended pass/fail criteria for impedance audiometry in a school screening program

One hundred and nine children enrolled in kindergarten to grade 3 were studied audiologically and otologically over a three month period to examine pass/fail criteria that have been recommended for impedance audiometry in school screening programs. Results indicated that tympanogram type (flat or rounded) and puretones of 2,000 Hz (20 dB) and 4,000 Hz (25 dB) agreed most often with the ENT diagnosis of significant middle ear pathology. These pass/fail criteria also gave a reasonably acceptable over and under referral rate. A third screening is recommended one month following the first and second screenings, and if the child continues to "fail" a medical referral is suggested. There are at least two limitations of current automated impedance screening devices--pressure range, and acoustic reflex sensitivity, which will produce unnecessary failures due solely to instrumentation.