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.
