The Sensitivity of Adolescent Hearing Screens Significantly Improves by Adding High Frequencies

Purpose One in 6 US adolescents has high-frequency hearing loss, often related to hazardous noise. Yet, the American Academy of Pediatrics (AAP) hearing screen (500, 1,000, 2,000, 4,000 Hertz) primarily includes low frequencies (<3,000 Hertz). Study objectives were to determine (1) sensitivity and specificity of the AAP hearing screen for adolescent hearing loss and (2) if adding high frequencies increases sensitivity, while repeat screening of initial referrals reduces false positive results (maintaining acceptable specificity). Methods Eleventh graders (n = 134) participated in hearing screening (2013–2014) including “gold-standard” sound-treated booth testing to calculate sensitivity and specificity. Results Of the 43 referrals, 27 (63%) had high-frequency hearing loss. AAP screen sensitivity and specificity were 58.1% (95% confidence interval 42.1%–73.0%) and 91.2% (95% confidence interval 83.4–96.1), respectively. Adding high frequencies (6,000, 8,000 Hertz) significantly increased sensitivity to 79.1% (64.0%–90.0%; p = .003). Specificity with repeat screening was 81.3% (71.8%–88.7%; p = .003). Conclusions Adolescent hearing screen sensitivity improves with high frequencies. Repeat testing maintains acceptable specificity.