Hearing Threshold Estimation With Distortion Product Otoacoustic Emission Growth Functions in People With Intellectual Disabilities in an Outreach Setting.

The study sample included only adults with mild intellectual disability or normal-range IQ; results cannot be generalized to those with moderate or severe intellectual disabilities. Testing was conducted in a quiet room within a workshop, not a soundproof booth, which may have affected ambient noise levels and measurement precision. DPOAEgf showed poor specificity at the 20 dB HL cutoff, leading to a high rate of false positives and potential over-referral. The test does not estimate thresholds accurately for hearing losses greater than 50 dB HL. Participants with abnormal tympanograms (middle ear issues) showed significant discrepancies between DPOAEgf and reference thresholds, suggesting DPOAEgf alone is insufficient without middle ear status evaluation.

The authors declared no conflicts of interest. The study was part of the larger HEID project, and the equipment (Sentiero device) was provided by PATH MEDICAL GmbH, though the funding source for the broader project is not explicitly detailed in the provided text beyond the general description of the HEID study.

Do not interpret a DPOAEgf threshold above 20 dB HL as definitive evidence of hearing loss requiring intervention. At this cutoff, the test has only 62% specificity, meaning nearly 40% of people flagged as having hearing loss may actually have normal hearing by behavioral standards. Use a higher cutoff (30 dB HL) for more reliable screening or confirm findings with behavioral audiometry or other objective measures where possible.