Hearing tests are just child’s play: the sound scouts game for children entering school

Objective: To create a hearing test useable without the involvement of a clinician or calibrated equipment, suitable for children aged 5 or older. Design: The tablet-based app (Sound Scouts) includes tests of speech in quiet, speech in noise and tones in noise, all embedded in game designed to maintain attention. Data were collected to intelligibility-equalize the stimuli, establish normative performance, and evaluate the sensitivity with which Sound Scouts detected known hearing problems and identified their type. Study sample: Participants were children from age 5 to 14 (394 with normal hearing, 97 with previously identified hearing loss) and 50 adults with normal hearing. Results: With pass-fail criteria set such that 98% of children with normal hearing passed Sound Scouts, 85% of children with hearing loss failed Sound Scouts (after exclusion of children in either group who received an inconclusive result or had incomplete results). No child with four-frequency average hearing thresholds of 30 dB HL or greater in their poorer ear passed Sound Scouts. Hearing loss type was correctly identified in only two-thirds of those cases where the algorithm attempted to identify a single type of loss. Conclusions: Sound Scouts has specificity and sensitivity sufficiently high to provide hearing screening around the time children typically enter school.