A tablet-based language-independent self-test involving the recognition of
ecological sounds in background noise, the Sound Ear Check (SEC), was adapted to
make it feasible for young children. Two experiments were conducted. The first
experiment investigated the SEC‘s feasibility, as well as its sensitivity and
specificity for detecting childhood hearing loss with a monaural adaptive test
procedure. In the second experiment, the SEC sounds, noise, and test format were
adapted based on the findings of the first experiment. The adaptations were
combined with three test procedures, one similar to the one used in Experiment
1, one presenting the sounds dichotically in diotic noise, and one presenting
all the sounds with a fixed signal-to-noise ratio and a stopping rule. Results
in young children show high sensitivity and specificity to detect different
grades of conductive and sensorineural hearing loss (70–90%). When using an
adaptive, monaural procedure, the test duration was approximately 6 min, and 17%
of the results obtained were unreliable. Adaptive staircase analyses showed that
the unreliable results probably occur due to attention/motivation loss. The test
duration could be reduced to 3-4 min with adapted test formats without
decreasing the test-retest reliability. The unreliable test results could be
reduced from 17% to as low as 5%. However, dichotic presentation requires longer
training, reducing the dichotic test format‘s feasibility.