Prevalence of Hearing Loss Among a Representative Sample of Canadian Children and Adolescents, 3 to 19 Years of Age.

The study is a cross-sectional survey, so it provides a snapshot of hearing acuity and cannot show whether hearing loss prevalence is changing over time. Audiometry was not conducted in 3- to 5-year-olds, so their hearing status was based only on DPOAE and tympanometry results. Response rates were 50.7% for ages 3 to 5 and 53.5% for ages 6 to 19, and people who refused the physical measures portion were not analysed, so selection bias is possible. Some subgroup estimates had high sampling variability and were flagged as marginal, including DPOAE estimates for 3- to 5-year-olds and 6- to 19-year-olds. Bone conduction testing was not done, so conductive hearing loss may have been missed and the true prevalence of permanent hearing loss is uncertain. The hearing loss threshold was above 20 dB for ages 6 to 18 and at least 26 dB for age 19; using a lower threshold, such as above 15 dB for younger children, may identify more hearing loss, so the 7.7% estimate may be an underestimate. Otoscopy recorded excessive or impacted wax or pus but did not separate pus from wax. The survey excluded residents of the three territories, First Nations Reserves and other Aboriginal settlements, certain remote regions, institutional residents, and full-time members of the Canadian Forces. Self-reported hearing difficulty was measured with the HUI3 hearing attribute, which has not been validated against objective audiometric hearing loss.

Do not apply the 7.7% hearing loss estimate to children aged 3 to 5, because audiometry was not conducted in that age group. For 3- to 5-year-olds, the hearing findings were based only on DPOAE and tympanometry.