Improving detection of adolescent hearing loss

Objectives: To compare a protocol for pure-tone threshold testing, capable of detecting high-frequency hearing loss as indicated by notched audiometric configurations, with the current school rapid hearing screen and to determine typical adolescent noise exposures associated with notched audiometric configurations. Design: In conjunction with required school rapid hearing screening, a pure-tone threshold testing protocol was administered, specifically to test hearing at high frequencies. A single audiologist reviewed the results. Students completed a survey assessing their noise exposures. Setting: A public high school in Pennsylvania. Participants: Eleventh-grade students. Main Outcome Measure: Notched audiometric configurations on the pure-tone threshold test. Results: Among 296 participants, 78 (26.4%) failed puretone threshold testing compared with 15 (5.1%) failing rapid hearing screening. Among those failing the puretone threshold testing, 67 (85.9%) failed due to notched audiometric configurations. Self-reported headphone use with an MP3 player was significantly associated with notched audiometric configurations compared with use of earbuds or stereo connection/docking systems. Conclusions: Pure-tone threshold testing incorporating high frequencies detects adolescent hearing loss more often than rapid hearing screens. Most state hearing screens omit high-frequency testing, potentially missing high-frequency losses, such as noise-induced hearing loss. Because noise-induced hearing loss in particular is preventable and hazardous noise exposures have increased, a reliable school hearing screen to detect high-frequency hearing loss in adolescents is warranted.