The role of hearing capability test as a screening test for the possibility of hearing disorder in children with speech delay

Abstract

Background Hearing disorder may cause speech delay so that every child with speech delay should undergo hearing test. The gold standard for audiometric test is otoacustic emission (OAE) and brainstem evoked response audiometry (BERA). They have high sensitivity and specificity, but the availability is limited and expensive. Hence, both tests are not available at the primary health care centers. In 1997, the Department of Health, Republic of Indo- nesia, established a simple subjective test instrument, i.e. the hear- ing capability test (HCT). Objective To asses the accuracy of HCT compared to the gold standard hearing tests (OAE and/or BERA). Methods This study was a cross sectional study on 89 children aged less than 5 years who had speech delay and came to the Growth and Development Outpatient Clinic or the General Outpa- tient Clinic, Pediatric Neurology Clinic of the Department of Child Health, Cipto Mangunkusumo (CM) Hospital; and Center for Ear Care and Communicative Disorders (CECCD), Department of ENT, CM Hospital, during March to August 2005. Results HCT sensitivity and specificity were 92.9% and 27.7%, respectively. Positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likehood ratio (NLR) were 84%, 50%, 1.9, and 0.7, respectively. Conclusion The sensitivity and specificity of HCT as a screening test of hearing disorder in children with speech delay were 93% and 28%, respectively. Based on this result, HCT should only be used as screening test and not as a diagnostic test

Keywords

• hearing capability test
• otoacustic emission
• brainstem evoked response audiometry