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10/28/2018  |   9:30 AM - 10:30 AM   |  Kramer Lecture Theater 2

Is WHO Underestimating the Number of Children with Hearing Loss in the World?

Children with mild, fluctuating or unilateral hearing loss are found to experience delays in speech, language, and cognitive development and lower quality of life. While the World Health Organization defines disabling hearing loss for children as an average hearing threshold at 500, 1000, 2000, and 4000 Hz >30 dB HL in the better ear, most professionals in high-income countries usually refer children for follow-up services with if their hearing thresholds are ?25 dB HL at 2 frequencies in either ear. The purposes of this study were 1) to compare the prevalence of hearing loss in 4 countries using these two definitions of hearing loss, and 2) to examine the need to include other hearing tests to meet children’s needs of ear and hearing care. A total of 1795 children from Brazil, Cambodia, China, and rural United States were tested using otoscopy, tympanometry, and distortion-product otoacoustic emissions. A pure tone audiometry was administered if they did not have otoacoustic emissions at 4 of the 6 test frequencies. The prevalence of hearing loss was calculated using the two methods. The percentages of children having different ear and hearing disorders identified by the addition of each hearing tests were calculated. The WHO hearing loss criterion significantly underestimated the prevalence of hearing loss (i.e., overall = 10 times lower; 3.84% vs. 0.39%). The referral rate increased to 21%, 17%, 11%, and 11% in Brazil, Cambodia, and China, and the US, respectively, when the results of all the tests were considered. Hearing professionals are encouraged to adopt stringent hearing loss criteria, include multiple tests to examine children’s outer, middle, and inner ear status, and provide immediate interventions following identification to minimize the negative effects of hearing loss in children.

• 1. Participants will be able to describe the effects of using different criteria to define “hearing loss” on the estimated prevalence of hearing loss
• 2. Participants will be able to describe the effects of including different tests in the hearing screening protocol on the identification of ear and hearing problems in children
• 3. Participants will be able to make an educated decision on which hearing tests to use for identifying ear and hearing disorders

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Deborah Ferrari (Author,Co-Author), University of Sao Paulo, Bauru, deborahferrari@usp.br;
Deborah Ferrari is professor in Audiology at the Speech Language Pathology and Audiology Department – University of Sao Paulo, Bauru Campus. She has more than 20 years of teaching and clinical experience in hearing aid selection and fitting process. She has been involved in audiology telehealth activities and research for over 12 years, mainly focusing on remote hearing aid fitting and patient centered care. She is also interested in innovative teaching methods and e-Learning. She is a member of the Brazilian Council of Telemedicine and Telehealth and of the Ida Institute advisory board.