Reliability of parental assessment of auditory skills in young children: a cross-sectional study in Italian language

Abstract

Objective: Hearing impairments (HIs) that progress or have later onset may have specific effects on language and cognitive development, but are difficult to suspect during routine primary care visits. Family concern regarding hearing is thought to represent an important risk factor requiring audiological examination. Yet it is not clear how successful parents are in recognising the consequences or specific suspect elements of HI in young children. The aim of this study is to verify whether parents of at-risk children recognise the presence of HI through a parental questionnaire that draws attention to auditory skills development and compares them with language and communication skills.

Design: Observational study.

Setting: From 2013 to 2019, parents were administered the Questionnaire on Hearing and Communication Abilities before audiological evaluation of their children at a secondary care institute.

Participants: 309 Italian children (1-36 months old) at risk of HI.

Primary and secondary outcome measures: Questionnaire sensitivity in predicting the presence and type of HI.

Results: Parents report a decrease in auditory skills for children with sensorineural HI (Χ²(2)=14.4, p=0.003), with an increased concern expressed in 59% compared with 24% in normally hearing children. Both auditory (r=-0.18, p=0.002) and comprehension (r=-0.13, p=0.057) skills weakly but negatively correlated with a diagnosis of HI. On discriminant analysis, the positive predictive value of the questionnaire was 0.78, but with low sensitivity (0.39).

Conclusions: Parents of children with a verified risk of HI have some capacity to recognise non-typical auditory behaviour. Thus, it is important to assess parental concerns during primary care health visits, and a targeted questionnaire on auditory abilities can complement existing screening procedures. However, given the low sensitivity of the questionnaire, we conclude that for a reliable detection of HIs that progress or have later onset an objective screening tool is always required.

Keywords: audiology; paediatric otolaryngology; primary care.