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August 19, 1998

Hearing Loss Among Children—Reply

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;280(7):602. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-7-jbk0819

In Reply.—Dr Dobie contrasts the ASHA's current recommended screening guidelines (20 dB HL at 1, 2, and 4 kHz with inclusion of immittance testing) with our findings.1 The current ASHA-recommended screening guidelines could miss many children with slight or high-frequency hearing losses. The ASHA does recommend screening at 0.5 kHz, when immittance testing is not included, provided ambient noise levels are acceptable, in order not to miss some of the children with possible conductive losses.1 The ASHA guidelines for screening for hearing losses evolve from consideration of research findings and resources and allow for professional leeway. Our study findings showed that high-frequency hearing loss is more prevalent than low-frequency hearing loss among children. In addition, recent studies have demonstrated the need to screen adolescents and to include 3 and 6 kHz as screening frequencies in order to detect high-frequency hearing loss, including noise-induced hearing loss.2

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