Peripheral Auditory Involvement in Childhood Listening Difficulty

OBJECTIVES: This study tested the hypothesis that undetected peripheral hearing impairment occurs in children with idiopathic listening difficulties (LiD), as reported by caregivers using the Evaluation of Children’s Listening and Processing Skills (ECLiPS) validated questionnaire, compared to children with typically developed (TD) listening abilities. DESIGN: Children with LiD aged 6–14 y.o. (n = 60, mean age = 9.9 yr.) and 54 typical age matched children were recruited from audiology clinical records and from IRB-approved advertisements at hospital locations and in the local and regional area. Both groups completed standard and extended high frequency pure tone audiometry, wideband absorbance tympanometry and middle ear muscle reflexes, distortion product and chirp transient evoked otoacoustic emissions. Univariate and multivariate mixed models and multiple regression analysis were used to examine group differences and continuous performance, as well as the influence of demographic factors and pressure equalization (PE) tube history. RESULTS: There were no significant group differences between the LiD and TD groups for any of the auditory measures tested. However, analyses across all children showed that extended high frequency hearing thresholds, wideband tympanometry, contralateral middle ear muscle reflexes, distortion product and transient evoked otoacoustic emissions were related to a history of PE tube surgery. The physiologic measures were also associated with extended high frequency hearing loss, secondary to PE tube history. CONCLUSIONS: Overall, the results of this study in a sample of children with validated LiD compared to a TD group matched for age and sex showed no significant differences in peripheral function using highly sensitive auditory measures. Histories of PE tube surgery were significantly related to EHF hearing and to a range of physiologic measures in the combined sample.