Children with mild hearing loss are more likely to repeat a grade in school and will lose, on average, between $220,000 and $440,000 in lost wages as they get older. A recent study conducted at the Penn State College of Medicine has revealed that standard screening tests administered by the state and schools fail to identify hearing loss in teenagers due to their inability to test objectively.

"We found that you can't rely on the Bright Futures questions to select out teenagers at high risk for hearing loss who would warrant an objective screen," Dr. Deepa Sekhar, assistant professor of pediatrics, said in a statement. "Although our test had more false positives, we caught 100 percent of the students with hearing loss.”

Sekhar and her colleagues asked 11th-grade students at a nearby high school to answer 10 Bright Futures hearing screening questions along with the Pennsylvania state-mandated hearing test, where children are asked to raise their hand after hearing a tone. Researchers also administered a hearing test they developed to detect high-frequency noise-related hearing loss. A smaller sample of children underwent additional testing in a soundproof booth.

While the screening tests developed by the research team had 100 percent sensitivity for adolescent hearing loss, the Pennsylvania state-mandated screening only had a sensitivity of 13 percent. Bright Futures questions, Pennsylvania state screening, and additional questions were not specific toward adolescent hearing loss. The American Academy of Pediatrics recommends subjectively screening adolescents at risk for hearing loss before administering objective screening tests.

Standard hearing tests administered by school or the state generally screen for low-frequency hearing loss, which is often associated with ear infections and fluid in the ear of younger children. These tests tend to miss signs of high-frequency hearing loss. Researchers from Penn States are looking to develop an objective hearing screening test for teens with high-frequency tones over 3,000 Hertz, the standard unit of measurement for frequency.

"The onset of high-frequency hearing loss is often very insidious and the symptoms are often very subtle," Sekhar added. "It's important to identify hearing problems at any age because of the impact it can have on all different areas of life, including academic success, workplace advancement, and social relationships."

According to the American Speech-Language-Hearing Association, children with mild hearing loss often struggle with learning vocabulary, grammar, word order, idiomatic expressions, and other aspects of verbal communication. Data from the National Health and Nutrition Examination Survey has shown that one out of every five Americans between the ages of 12 and 19 suffers from some kind of hearing loss.

Source: Paul I, King T, Zalewski T, Sekhar D. Current office-based hearing screening questions fail to identify adolescents at risk for hearing loss. Journal of Medical Screening. 2014.