Current office-based hearing screening questions fail to identify adolescents at risk for hearing loss

Objective: There is a rising prevalence of hearing loss among adolescents in the United States. Current paediatric preventive care recommendations by the Bright Futures guidelines and the American Academy of Pediatrics suggest that clinicians should ask adolescents ten hearing screening questions to identify those who are at high risk of hearing loss for further objective hearing testing. We assessed the utility of these subjective risk assessment questions to distinguish those adolescents with objectively documented hearing loss. Setting: A single public high school in Pennsylvania. Methods: We compared results from a prospective study evaluating objective hearing assessments with the use of the ten Bright Futures hearing screening questions plus additional adolescent-specific questions to predict adolescent hearing loss. Results: In relation to the questions used in this study, adolescents who were referred following objective hearing screens were more likely to report ‘‘trouble following the conversation when two or more people are talking at the same time’’ and a ‘‘past experience of slight hearing loss’’. Referrals from sound treated booth testing were more likely to report ‘‘trouble hearing over the phone’’ and have a diagnosis or history of hearing loss. Conclusions: Most Bright Futures questions were not associated with adolescent hearing loss. An objective adolescent hearing screen should be considered in the recommended schedule of preventive care, instead of the current risk-based subjective assessment.