title: Preschool hearing screening: pass/refer rates for children enrolled in a head start program in eastern North Carolina.
abstract: This 4-year project investigated the pass/refer rates of preschool children in a hearing screening program. Three- and 4-year-old children who attended Head Start centers in rural, traditionally medically underserved, eastern North Carolina participated (n = 1,462). Screening procedures and pass/refer criteria were based on the Guidelines for Audiologic Screening (American Speech-Language-Hearing Association [ASHA], Panel on Audiologic Assessment, 1997). Only 54% (n = 787) of children passed the initial screening (i.e., passed all three of the screening components, which included pure-tone audiometry, tympanometry, and otoscopy), and an additional 22% (n = 323) passed the rescreening, for an overall pass rate of 76%. The initial pass rate was 90%, 71%, and 71% for otoscopy, tympanometry, and pure-tone audiometry, respectively. After the initial screening, 675 children were referred (i.e., 83%, 2%, and 15% for audiologic rescreening, medical evaluation, or both, respectively). About 71% (n = 478) received the recommended evaluation. Follow-up assessment compliance after the rescreening was poor. Slightly more than 10% of children were evaluated. The hearing status of 267 (i.e., 18.3%) children was never determined. Six (i.e., 0.5%) of the 1,195 children who completed the audiologic screening and/or received diagnostic audiologic assessment were confirmed to have hearing loss. Methodological factors that may have contributed to this high refer rate include the use of all screening techniques (pure tones, tympanometry, and otoscopy), procedural considerations in testing protocol and pass/refer criteria, and the demographic characteristics of the children screened.
authors.affiliation: East Carolina University, Greenville, NC 27858, USA. allenro@mail.ecu.edu
authors.forename: Rose L
authors.initials: RL
authors.lastname: Allen
authors.forename: Andrew
authors.initials: A
authors.lastname: Stuart
authors.forename: Deborah
authors.initials: D
authors.lastname: Everett
authors.forename: Saravanan
authors.initials: S
authors.lastname: Elangovan
mesh_terms: D000158:Acoustic Impedance Tests; D016235:American Speech-Language-Hearing Association; D001301:Audiometry, Pure-Tone; D002675:Child, Preschool; D015331:Cohort Studies; D018479:Early Intervention, Educational; D017408:Guidelines as Topic; D034381:Hearing Loss / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008403:Mass Screening / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D008507:Medically Underserved Area; D009657:North Carolina / Q000453:epidemiology; D038781:Otoscopy; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012424:Rural Population; D014481:United States