Subscribe to RSS
Hearing Screening in the Community
26 May 2020 (online)
Adults typically wait 7–10 yr after noticing hearing problems before seeking help, possibly because they are unaware of the extent of their impairment. Hearing screenings, frequently conducted at health fairs, community events, and retirement centers can increase this awareness. To our knowledge, there are no published studies in which testing conditions and outcomes have been examined for multiple “typical screening events.”
The purpose of this article is to report hearing screening outcomes for pure tones and self-report screening tests and to examine their relationship with ambient noise levels in various screening environments.
One thousand nine hundred fifty-four individuals who completed a hearing screening at one of 191 community-based screening events that took place in the Portland, OR, and Tampa, FL, metro areas.
Data Collection and Analysis:
The data were collected during the recruitment phase of a large multisite study. All participants received a hearing screening that consisted of otoscopy, pure-tone screening, and completion of the Hearing Handicap Inventory–Screening Version (HHI-S). In addition, ambient sound pressure levels were measured just before pure-tone testing.
Many more individuals failed the pure-tone screening (n = 1,238) and then failed the HHI-S (n = 796). The percentage of individuals who failed the pure-tone screening increased linearly with age from <20% for ages <45 yr to almost 100% for individuals aged ≥85 yr. On the other hand, the percentage of individuals who failed the HHI-S remained unchanged at approximately 40% for individuals aged ≥55 yr. Ambient noise levels varied considerably across the hearing screening locations. They impacted the pure-tone screen failure rate but not the HHI-S failure rate.
It is important to select screening locations with a quiet space for pure-tone screening, use headphones with good passive attenuation, measure sound levels regularly during hearing screening events, halt testing if ambient noise levels are high, and/or alert individuals to the possibility of a false-positive screening failure. The data substantiate prior findings that the relationship between pure-tone sensitivity and reported hearing loss changes with age. Although it might be possible to develop age-specific HHI-S failure criteria to adjust for this, such an endeavor is not recommended because perceived difficulties are the best predictor of hearing health behaviors. Instead, it is proposed that a public health focus on education about hearing and hearing loss would be more effective.
This study was supported by funding by NIH NIDCD R01 DC013761 and Department of Veterans Affairs (VA), Veterans Health Administration, VA Office of Research and Development award #C9230C. The views are those of the authors and do not necessarily represent the position or policy of the United States Department of Veterans Affairs or the United States Government.
Aspects of this work were presented at the American Auditory Society meeting in Scottsdale, AZ, March 2–4, 2017.
- American Speech-Language-Hearing Association (ASHA). (n.d.) Adult Hearing Screening (Practice Portal). www.asha.org/Practice-Portal/Professional-Issues/Adult-Hearing-Screening/ . Accessed June 5, 2017.
- American Speech-Language-Hearing Association (ASHA) 2004 Scope of practice in audiology [Scope of Practice]. www.asha.org/policy . Accessed August 8, 2017
- Contrera KJ, Wallhagen MI, Mamo SK, Oh ES, Lin FR. 2016; Hearing loss health care for older adults. J Am Board Fam Med 29 (03) 394-403 https://doi.org/10.3122/jabfm.2016.03.150235
- Davis A, Smith P, Ferguson M, Stephens D, Gianopoulos I. 2007; Acceptability, benefit and costs of early screening for hearing disability: a study of potential screening tests and models. Health Technol Assess 11 (42) 1-294 https://doi.org/10.3310/hta11420
- Fischer ME, Cruickshanks KJ, Wiley TL, Klein BE, Klein R, Tweed TS. 2011; Determinants of hearing aid acquisition in older adults. Am J Public Health 101 (08) 1449-1455 https://doi.org/10.2105/AJPH.2010.300078
- Frank T, Williams DL. 1993; Effects of background noise on earphone thresholds. J Am Acad Audiol 4 (03) 201-212
- Hétu R. 1996; The stigma attached to hearing impairment. Scand Audiol Suppl 43: 12-24
- Hickson L, Meyer C, Lovelock K, Lampert M, Khan A. 2014; Factors associated with success with hearing aids in older adults. Int J Audiol 53 (Suppl 1) S18-S27 https://doi.org/10.3109/14992027.2013.860488
- Kamil RJ, Genther DJ, Lin FR. 2015; Factors associated with the accuracy of subjective assessments of hearing impairment. Ear Hear 36 (01) 164-167
- Knudsen LV, Oberg M, Nielsen C, Naylor G, Kramer SE. 2010; Factors influencing help seeking, hearing aid uptake, hearing aid use and satisfaction with hearing aids: a review of the literature. Trends Amplif 14 (03) 127-154
- Lo AH, McPherson B. 2013; Hearing screening for school children: utility of noise-cancelling headphones. BMC Ear Nose Throat Disord 13 (01) 6 https://doi.org/10.1186/1472-6815-13-6
- Merluzzi F, Hinchcliffe R. 1973; Threshold of subjective auditory handicap. Audiology 12: 65-69
- Meyer C, Hickson L, Lovelock K, Lampert M, Khan A. 2014; An investigation of factors that influence help-seeking for hearing impairment in older adults. Int J Audiol 53 (Suppl 1) S3-S17 https://doi.org/10.3109/14992027.2013.839888
- Moyer VA. U.S. Preventive Services Task Force Screening for hearing loss in older adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 157 (09) 655-661 https://doi.org/10.7326/0003-4819-157-9-201211060-00526
- Newman CW, Jacobson GP, Hug GA, Weinstein BE, Malinoff RL. 1991; Practical method for quantifying hearing aid benefit in older adults. J Am Acad Audiol 2 (02) 70-75
- Nondahl DM, Cruickshanks KJ, Wiley TL, Tweed TS, Klein R, Klein BE. 1998; Accuracy of self-reported hearing loss. Audiology 37 (05) 295-301 https://doi.org/10.3109/00206099809072983
- Pronk M, Kramer SE, Davis AC, Stephens D, Smith PA, Thodi C, Anteunis LJ, Parazzini M, Grandori F. 2011; Interventions following hearing screening in adults: a systematic descriptive review. Int J Audiol 50 (09) 594-609 https://doi.org/10.3109/14992027.2011.582165
- Saunders GH, Field DL, Haggard MP. 1992; A clinical test battery for obscure auditory dysfunction (OAD): development, selection and use of tests. Br J Audiol 26 (01) 33-42 https://doi.org/10.3109/03005369209077869
- Saunders GH, Forsline A, Fausti SA. 2004; The performance-perceptual test and its relationship to unaided reported handicap. Ear Hear 25 (02) 117-126 https://doi.org/10.1097/01.AUD.0000120360.05510.E5
- Schow RL, Nerbonne MA. 1982; Communication screening profile: use with elderly clients. Ear Hear 3 (03) 135-147 https://doi.org/10.1097/00003446-198205000-00007
- Sindhusake D, Mitchell P, Smith W, Golding M, Newall P, Hartley D, Rubin G. 2001; Validation of self-reported hearing loss. The Blue Mountains Hearing Study. Int J Epidemiol 30 (06) 1371-1378 https://doi.org/10.1093/ije/30.6.1371
- Smith PA, Davis AC, Pronk M, Stephens D, Kramer SE, Thodi C, Anteunis LJ, Parazzini M, Grandori F. 2011; Adult hearing screening: what comes next?. Int J Audiol 50 (09) 610-612 https://doi.org/10.3109/14992027.2011.585668
- Uchida Y, Nakashima T, Ando F, Niino N, Shimokata H. 2003; Prevalence of self-perceived auditory problems and their relation to audiometric thresholds in a middle-aged to elderly population. Acta Otolaryngol 123 (05) 618-626 https://doi.org/10.1080/00016480310001448
- Ventry IM, Weinstein BE. 1983; Identification of elderly people with hearing problems. ASHA 25 (07) 37-42
- Wallhagen MI. 2010; The stigma of hearing loss. Gerontologist 50 (01) 66-75 https://doi.org/10.1093/geront/gnp107
- Wiley TL, Cruickshanks KJ, Nondahl DM, Tweed TS. 2000; Self-reported hearing handicap and audiometric measures in older adults. J Am Acad Audiol 11 (02) 67-75