The role of hearing capability test as a screening test for the possibility of hearing disorder in children with speech delay
AbstractBackground Hearing disorder may cause speech delay so that
every child with speech delay should undergo hearing test. The
gold standard for audiometric test is otoacustic emission (OAE)
and brainstem evoked response audiometry (BERA). They have
high sensitivity and specificity, but the availability is limited and
expensive. Hence, both tests are not available at the primary health
care centers. In 1997, the Department of Health, Republic of Indo-
nesia, established a simple subjective test instrument, i.e. the hear-
ing capability test (HCT).
Objective To asses the accuracy of HCT compared to the gold
standard hearing tests (OAE and/or BERA).
Methods This study was a cross sectional study on 89 children
aged less than 5 years who had speech delay and came to the
Growth and Development Outpatient Clinic or the General Outpa-
tient Clinic, Pediatric Neurology Clinic of the Department of Child
Health, Cipto Mangunkusumo (CM) Hospital; and Center for Ear
Care and Communicative Disorders (CECCD), Department of ENT,
CM Hospital, during March to August 2005.
Results HCT sensitivity and specificity were 92.9% and 27.7%,
respectively. Positive predictive value (PPV), negative predictive
value (NPV), positive likelihood ratio (PLR), and negative likehood
ratio (NLR) were 84%, 50%, 1.9, and 0.7, respectively.
Conclusion The sensitivity and specificity of HCT as a screening
test of hearing disorder in children with speech delay were 93%
and 28%, respectively. Based on this result, HCT should only be
used as screening test and not as a diagnostic test
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