The Incidence and Significance of High-Frequency Deafness in Children

Abstract

THE SOUND frequencies to be tested in school hearing screening programs have been and continue to be the subject of discussion. Within the past few years, new concepts of screening have developed in which the single frequency of 4,000 cycles per second, or a combination of 4,000 and 1,000 cps, or 4,000 and 2,000 cps have been used in place of the standard five-and six-frequency sweep tests. Differences of opinion exist as to the effectiveness of this technique. Glorig and House1 developed oto-check, as two\x=req-\ frequency (4,000 and 2,000 cps) screening audiometer which they stated was 99.5% as accurate in detecting hearing impairments as the standard sweep test. In a study de-signed to check the validity of oto-check, Lightfoot et al2 concluded that the t wo\ x=req-\ frequency screening procedure was inadequate for use in school programs and physicians' offices. They based their conclusions on the fact that of 552 ears capable of passing the oto check, 381 (69%) were found by otological examination to be defective. By use of the six-frequency sweep check only 78 out of the 381 defective ears would have been missed, an 80% reduction in false negatives.Siegenthaler and Sommers3 in an evalua¬ tion of sweep check procedures found that a single-frequency hearing test procedure was not appropriate for school hearing screening purposes. They found a two-frequency screening to have a greater potential but concluded that it too would fail to detect an appreciable proportion of children with hearing loss. On the other hand, Lawrence and Rubin4 found the combined 4,000 cps and 1,000 cps frequencies adequate for de¬ tecting hearing losses with medical sig¬ nificance. In order to determine if limited frequency tests would be effective in detect¬ ing those hearing losses concomitant with ear pathology, Maxwell and Davidson5 ana¬ lyzed the audiograms and otological findings of 161 ears (of 90 children) with losses in one or more of the frequencies 250, 500, 1,000, 2,000, 4,000 and 8,000 cps. They inves¬ tigated the effectiveness of screening tests using 4,000 cps, 4,000 and 1,000 cps, and 4,000 and 2,000 cps in detecting these pre¬ viously-known losses. Their results indicat¬ ed that none of the limited-frequency tests studied would detect all ear pathologies ac¬ companied by hearing loss. Norton and Lux6 evaluated the rapidity and reliability of a two-frequency (4,000 and 2,000) check as compared with the standard five-frequen¬ cy, pure-tone method. They found that the two-frequency check was simple and fast to administer but was less reliable in detecting children with hearing loss than the fivefrequency, pure-tone method.The idea of limited frequency testing orig¬ inated, no doubt, out of a desire to screen the greatest number of children with often limited available time and personnel. Most of the studies conducted to assess limited frequency methods have shown that they are inadequate for finding all children with audiogram losses. Furthermore, Siegentha-ler7 in a critical appraisal of the findings of Norton and Lux poi...

Minimal Hearing Impairment

“…In fact, Niskar and colleagues (2001) estimated that 12.5% of children in the United States between the ages of 6 and 19 years have NIHL in at least one ear, and 77% to 97% of American third-grade students report exposure to hazardous noise levels (Bess et al, 1998;Blair, Hardegree, & Benson, 1996). Even 36 years ago, Anderson (1967) reported NIHL in school-age children and found that these children had more learning difficulties and behavioral problems than their peers with normal hearing. NIHL at this young age (6-19 years) typically results from exposure to noisy leisure activities, such as concerts, fireworks, lawn equipment, personal and stationary stereos, toys, firearms, referee whistles, school "shop" and band classes (Lass, Woodford, Lundeen, Lundeen, & Everly-Myers, 1986;Lipscomb, 1972Lipscomb, , 1974Niskar et al, 2001).…”

The Importance of Hearing Conservation Instruction

“…Children with high-frequency hearing loss in Anderson’s (1967) study had more learning difficulties and behavioral problems than their classmates who had normal hearing. Bess, Dodd-Murphy, and Parker (1998) reported that children with minimal sensorineural hearing loss (MSHL) scored significantly lower on the Comprehensive Test of Basic Skills compared with their classmates with normal hearing; they also exhibited more behavioral problems and lower self-esteem.…”

“…Several studies have demonstrated that the prevalence of NIHL among children is increasing (Chermak & Peters-McCarthy, 1991; Montgomery & Fujikawa, 1992; Woodford & O’Farrell, 1983). Anderson (1967) reported a surprisingly high prevalence of NIHL in school-age children more than 30 years ago. Blair and colleagues (1996) claimed that 1% of the school age population has some degree of NIHL.…”

Hearing-Loss Prevention Practices Should Be Taught in Schools

“…Children with high-frequency hearing loss in Anderson's study 11 had more learning difficulties and behavioral problems than did their classmates who had normal hearing. Bess et al 20 reported that, compared with their classmates with normal hearing, children with minimal sensorineural hearing loss (MSHL) scored significantly lower on the Comprehensive Test of Basic Skills; they also exhibited more behavioral problems and lower self-esteem.…”

“…Several studies demonstrated that the prevalence of NIHL among children is increasing. 2,9,10 Anderson 11 reported a surprisingly high prevalence of NIHL in school-age children more than 30 years ago. Blair et al 1 claimed that 1% of the school-age population has some degree of NIHL.…”