Evaluation of the E2L toy test as a screening procedure in clinical practice

Early identification of hearing loss in young children is essential in order to avoid the potentially disabling effects of deafness. This necessitates effective screening measures with proven positive predictive value (McCormick 1977, 1988; Mahon et al., 1993). Previous studies (Marcuson et al., 1988; Bellman and Marcuson, 1991) have indicated that the E2L Toy Test, designed as a word discrimination test for evaluating the hearing of children who have English as a second language (E2L), could be such a measure. The results of diagnostic audiological testing, including the E2L test, are reported in 264 children. Comparison of E2L results with audiometric testing shows the E2L test to have a sensitivity of 87% and specificity of 90% in identifying children with an average hearing threshold of greater than 25 dB HL (and 78% sensitivity: 94% specificity where the average hearing threshold level is above 20 dB HL). This is the case for both E2L children and for children whose first language is English, suggesting that the E2L Toy Test would be useful in hearing screening test batteries throughout the UK. The results of screening hearing using the E2L Toy Test in 500 children aged 2-7 years from a wide geographical area in the UK are also presented.