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Niskar AS, Kieszak SM, Holmes A, Esteban E, Rubin C, Brody DJ. Prevalence of Hearing Loss Among Children 6 to 19 Years of Age: The Third National Health and Nutrition Examination Survey. JAMA. 1998;279(14):1071–1075. doi:10.1001/jama.279.14.1071
From the Epidemic Intelligence Service, Epidemiology Program Office (Ms Niskar), and National Center for Environmental Health (Ms Kieszak and Drs Esteban and Rubin), Centers for Disease Control and Prevention, Atlanta, Ga; the University of Florida, Gainesville (Dr Holmes); and the National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Md (Ms Brody).
Context.— Hearing loss in children influences the development of communication
and behavioral skills, but few studies in the United States have used pure-tone
audiometry to derive hearing loss prevalence estimates for children.
Objective.— To describe the prevalence of hearing loss among US children by sociodemographic
characteristics, reported hearing loss, and audiometric screening factors.
Design.— National population-based cross-sectional survey with an in-person interview
and audiometric testing at 0.5 to 8 kHz.
Setting/Participants.— A total of 6166 children aged 6 to 19 years completed audiometry in
the mobile examination center of the Third National Health and Nutrition Examination
Survey conducted between 1988 and 1994.
Main Outcome Measure.— Hearing loss, defined as audiometric threshold values of at least 16-dB
hearing level based on a low or high pure-tone average.
Results.— A total of 14.9% of children had low-frequency or high-frequency hearing
loss of at least 16-dB hearing level, 7.1% had low-frequency hearing loss
of at least 16-dB hearing level, and 12.7% had high-frequency hearing loss
of at least 16-dB hearing level. Most hearing loss was unilateral and slight
in severity (16- to 25-dB hearing level). Of those with measured hearing loss,
10.8% were reported to have current hearing loss during the interview.
Conclusions.— This analysis indicates that 14.9% of US children have low-frequency
or high-frequency hearing loss of at least 16-dB hearing level in 1 or both
ears. Among children in elementary, middle, and high school, audiometric screening
should include low-frequency and high-frequency testing to detect hearing
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