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10/25/2016  |   8:40 AM - 9:45 AM   |  BGPOP Building 402/403/404

What Would We Have Missed?

Introduction: The auditory system is a complex system. Oto-acoustic Emissions and screening Auditory Brainstem Responses are often used for infant screening. There is, however, no universally recommended hearing screening protocol for school-aged children. The purpose of this study was to examine the pass and referral rates of a combination of commonly used hearing tests when they were carried out in humanitarian environments. The goal was to examine a practical hearing screening protocol for testing school-aged children in the field. Methods: Children aged 3-18 years were tested using 1) otoscopy, 2) tympanometry, and 3) distortion-product Oto-acoustic Emissions (DPOAEs) in four different countries. If a 3-dB signal-to-noise ratio is not obtained at 4 of the 6 DPOAE test frequencies, the children were sent for a pure tone audiometry. The pass and referral rates were calculated when the results of different combinations of the tests were used to make clinical decisions. Results: Preliminary results from a total of 1682 ears tested in two countries indicated that: 1) DPOAE only: 96.4% pass rate and 3.5% referral rate 2) DPOAE and Otoscopy: 80.8% pass rate and 19.2% referral rate. The increase in failure rate was mainly due to 15.5% increase in the identification of ear wax accumulation 3) DPOAE, Otoscopy, and Tympanometry: 78.9% pass rate and 19.6% referral rate. Tympanometry identified an additional 0.4% of children with Type B tympanograms 4) DPOAE, Otoscopy, Tympanometry, and Pure Tone Audiometry: 79.3% pass rate and 18.8% referral rate. Forty-seven of the 59 children (80%) who failed the DPOAE test were found to have hearing sensitivity within normal limits, indicating that pure tone audiometry was a valuable test to reduce the false positive rate of the DPOAE tests. Conclusion: A 4-test battery is recommended to identify disorders in different parts of the auditory system and to avoid over-referral.

• Participants will be able to describe the pass and referral rates of school-aged children in Brazil, Cambodia, China, and the USA when different test batteries were used to make clinical decisions
• Participants will be able to describe which auditory conditions would be missed if a test battery is not used
• Participants will be able to use evidence-based data/research to advocate the use of multiple tests in humanitarian environments

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King Chung (POC,Author), Northern Illinois University, amplificationrocks@yahoo.com;
Dr. King Chung is a Professor of Audiology at Northern Illinois University. She has been leading students on humanitarian research and service trips to different countries every summer for several years. The long-term goal for these research and service trips is to facilitate better hearing services to all peoples around the world. A researcher at heart, Dr. Chung report the hearing systems in the visited countries/regions and the hearing status of people tested during these trips in professional publications so that more people are aware of the great demands for hearing services in different countries. The long-term goals of these humanitarian research and service trips are: 1. To facilitate academic and clinic exchanges, 2. To deliver hearing services to underprivileged populations, 3. To provide participants wit opportunities for cultural immersion 4. To advocate better hearing services for underserved and unserved populations around the the world