title: Automated hearing screening for preschool children.
abstract: OBJECTIVE
  To establish the reliability and validity of an automated hearing screening test system for preschoolers and to investigate the risk factors for hearing loss.
  
  
  METHODS
  The study used a cross-sectional design in a comparative study of subjects. The automated hearing screening test was performed in 6231 preschoolers (3-7 years old) from 41 kindergartens in Shanghai, China. Sensitivity and specificity of the automated test were investigated with subjects who failed the screening test and a group of control subjects.
  
  
  RESULTS
  Six hundred and forty-seven children were referred for diagnostic audiological assessment after the automated pure-tone screening test. Using the conventional pure-tone audiometry as the "gold standard," the sensitivity and specificity of the automated hearing screening test increased from 0.33 and 0.15 in the youngest age group to 0.95 and 1.00 in the oldest age group, respectively. There was no statistically significant gender effect, but there was an age effect (χ(2 )= 22.96, p < 0.01). In the univariate analysis of 104 cases and 201 controls, significantly elevated odds ratios (OR) for hearing loss were correlated with universal newborn hearing screening test results (OR = 28.15, p < 0.01), parental suspicion of hearing loss (OR = 10.10, p < 0.05), and attendance at preschool before the age of five (OR = 0.51, p < 0.05).
  
  
  CONCLUSIONS
  The results suggest that the automated hearing screening test system can be used in screening programmes for preschoolers aged older than five years.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Chinese University of Hong Kong Institute of Human Communicative Research, Chinese University of Hong Kong.
authors.forename: Anna Chi Shan
authors.initials: AC
authors.lastname: Kam
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Chinese University of Hong Kong.
authors.forename: Lawrence Kwok Chang
authors.initials: LK
authors.lastname: Li
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Chinese University of Hong Kong.
authors.forename: Kammy Ngan Kam
authors.initials: KN
authors.lastname: Yeung
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai Jiaotong University School of Medicine.
authors.forename: Wenjin
authors.initials: W
authors.lastname: Wu
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai Jiaotong University School of Medicine.
authors.forename: Zhiwu
authors.initials: Z
authors.lastname: Huang
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai Jiaotong University School of Medicine.
authors.forename: Hao
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Chinese University of Hong Kong Institute of Human Communicative Research, Chinese University of Hong Kong mtong@ent.cuhk.edu.hk.
authors.forename: Michael Chi Fai
authors.initials: MC
authors.lastname: Tong
mesh_terms: D001301:Audiometry, Pure-Tone / Q000592:standards*; D016022:Case-Control Studies; D002648:Child; D002662:Child Health Services; D002675:Child, Preschool; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D034381:Hearing Loss / Q000175:diagnosis*; D006801:Humans; D008297:Male; D012572:School Health Services; D012574:Schools; D012680:Sensitivity and Specificity
keywords: automated; hearing screening; preschool children