The Hearing Scale Test for hearing screening of school-age children

Objectives

This study aimed to demonstrate a new modified hearing screening method that can rapidly screen hearing and provide stratified test values for each screened ear of children.

Methods

The proposed Hearing Scale Test (HST) and pure-tone screening (PTS) were applied to 384 school-age children. PTS involved applying four test tones to each tested ear: 500 Hz at 25 dB, and 1000, 2000, 4000 Hz at 20 dB; and classifying the results as “pass” (normal hearing in the ear) or “fail” (possible hearing impairment). The HST employs ten stratified hearing scales from S₁ to S₁₀, with each hearing scale containing four test tones and where adjacent scales differ from each other by 5 dB, ranging from 0 dB (S₁) to 45 dB (S₁₀). The four test tones of hearing scale S₅ are the same hearing criteria and the median reference standard of the stimulus level in the HST. Scales S₁-S₅ on the HST are equivalent to a PTS “pass” result, while S₆-S₁₀ and no response (NR) are equivalent to a PTS “fail” result.

Results

The two screening methods produced comparable “pass” and “fail” results. In the HST, the “pass” results were further stratified as S₁ in 4 ears, S₂ in 52 ears, S₃ in 226 ears, S₄ in 272 ears, and S₅ in 169 ears, while the “fail” results were stratified as S₆ in 23 ears, S₇ in 12 ears, S₈ in 1 ear, S₉ in 2 ears, S₁₀ in 5 ears, and no response (NR) in 2 ears. The hearing screening results of the HST are interpreted as follows: scales S₁-S₅ indicate normal hearing, scales S₆ and S₇ indicate possible hearing impairment, and scales S₈-S₁₀ and NR indicate confirmed hearing impairment.

Conclusions

Conventional PTS only gives a pass/fail result for each screened ear, lacks hearing status assessment, and lacks stratified test values to be recorded for follow-up. In contrast, the HST has stratified hearing scales for each screened ear, which reflects the current hearing status and provides test values that can be recorded for follow-up.