Comparison of pure tone and transient otoacoustic emissions screening in a grade school population

Otoacoustic emissions provide an alternative to traditional pure tone hearing screening in a diverse grade school population. Mandated pure tone hearing screening programs for grade school children have several significant limitations. Otoacoustic emissions have been shown to be a reliable screening test in newborns, but there are no data on screening a diverse grade school population. Five hundred eighty-three grade school children in four separate school populations were screened for hearing loss using the standard pure tone four-frequency protocol and transient evoked otoacoustic emissions. Students failing either test received a comprehensive audiogram by an audiologist that served as the "gold standard." Sensitivity and specificity of both tests were compared. The sensitivity and specificity of pure tone screening was 87% and 80%, respectively, compared with 65% and 91% for transient evoked otoacoustic emissions. Pure tone screening was a statistically significant better screening test for detecting hearing loss in this population of grade school children.