title: Olfactory testing in children using objective tools: comparison of Sniffin' Sticks and University of Pennsylvania Smell Identification Test (UPSIT).
abstract: BACKGROUND
  Detection of olfactory dysfunction is important for fire and food safety. Clinical tests of olfaction have been developed for adults but their use in children has been limited because they were felt to be unreliable in children under six years of age. We therefore administered two olfactory tests to children and compared results across tests.
  
  
  METHODS
  Two olfactory tests (Sniffin' Sticks and University of Pennsylvania Smell Identification Test (UPSIT)) were administered to 78 healthy children ages 3 to 12 years. Children were randomized to one of two groups: Group 1 performed the UPSIT first and Sniffin' Sticks second, and Group 2 performed Sniffin' Sticks first and UPSIT second.
  
  
  RESULTS
  All children were able to complete both olfactory tests. Performance on both tests was similar for children 5 and 6 years of age. There was an age-dependent increase in score on both tests (p < .01). Children performed better on the Sniffin' Sticks than the UPSIT (65.3% versus 59.7%, p < .01). There was no difference in performance due to order of test presentation.
  
  
  CONCLUSIONS
  The Sniffin' Sticks and UPSIT olfactory tests can both be completed by children as young as 5 years of age. Performance on both tests increased with increasing age. Better performance on the Sniffin' Sticks than the UPSIT may be due to a decreased number of test items, better ability to maintain attention, or decreased olfactory fatigue. The ability to reuse Sniffin' Sticks on multiple children may make it more practical for clinical use.
authors.affiliation: Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, ON, Canada. sarah.hugh@mail.utoronto.ca.
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Hugh
authors.affiliation: School of Medicine, Queen's University, Kingston, ON, Canada. jsiu@qmed.ca.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Siu
authors.affiliation: Department of Otorhinolaryngology, Interdisciplinary Center Smell & Taste, Technische Universitat Dresden, Dresden, Germany. thummel@mail.zih.tu-dresden.de.
authors.forename: Thomas
authors.initials: T
authors.lastname: Hummel
authors.affiliation: Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, ON, Canada. vito.forte@sickkids.ca.|The Hospital for Sick Children, Toronto, ON, Canada. vito.forte@sickkids.ca.
authors.forename: Vito
authors.initials: V
authors.lastname: Forte
authors.affiliation: Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, ON, Canada. paolo.campisi@sickkids.ca.|The Hospital for Sick Children, Toronto, ON, Canada. paolo.campisi@sickkids.ca.
authors.forename: Paolo
authors.initials: P
authors.lastname: Campisi
authors.affiliation: Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, ON, Canada. blake.papsin@sickkids.ca.|The Hospital for Sick Children, Toronto, ON, Canada. blake.papsin@sickkids.ca.
authors.forename: Blake C
authors.initials: BC
authors.lastname: Papsin
authors.affiliation: Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, ON, Canada. evan.propst@utoronto.ca.|The Hospital for Sick Children, Toronto, ON, Canada. evan.propst@utoronto.ca.
authors.forename: Evan J
authors.initials: EJ
authors.lastname: Propst
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D009812:Odorants; D000857:Olfaction Disorders / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012684:Sensory Thresholds