Comparison of Pure-Tone and Distortion Product Otoacoustic Emission Screenings in School-Age Children

The purpose of this study was to compare the outcome of a distortion product otoacoustic emission (DPOAE) screening to the outcome of a pure-tone hearing screening for school-age children. Participants included 565 children in kindergarten through second grade in central Arkansas. Data were analyzed on a total of 547 participants. A McNemar Chi-square test [χ2 (1, N=547) =2.06; p=.151)] revealed there was not a statistically significant difference between the rates of identification for the DPOAE and pure-tone screenings. Four hundred and seven (74%) participants had the same outcome on both screening measures, either pass (N=369) or refer (N=38). However, 140 (26%) of the participants were classified as “pass” or “refer” by one of the screening measures, but not both. Although the majority of these children (74%) obtained the same results on both screening measures, a relatively large percentage (26%) had differing results. Therefore, it was unclear whether those children had hearing sensitivity that was of concern, or whether one or both of those screening measures would have indicated a large over-referral rate. The analyses revealed these screening measures are not interchangeable, and the two may offer unique contributions to the identification of individuals who should be referred for further diagnostic testing. Without a follow-up diagnostic test, the exact relationship between the two screening measures could not be determined. Further testing using a complete diagnostic evaluation (i.e., otoscopy, immittance measures, airand bone-conduction thresholds, and speech recognition thresholds) should be conducted to identify cases that are false positives and false negatives, something a screening measure cannot do.