Parents cannot detect mild hearing loss in children

Otitis media with effusion is among the most common illnesses of childhood and is often associated with chronic or persistent middle ear effusion (MEE ). Our goal was to develop and validate a self-administered parent survey t hat would identify children at high risk for mild hearing loss caused by ME E. We evaluated 115 children. Parents rated their child's hearing using the HL-7, a 7-item self-administered survey, and a global visual-analog scale. Static admittance and gradient were recorded. Test-retest reliability, int ernal consistency, and validity of the HL-7 were compared with the 4-freque ncy pure-tone average (PTA) hearing level (HL) for the better hearing ear. The HL-7 had good test-retest reliability and internal consistency. Survey scores correlated well with the global hearing rating (R = 0.67, P < 0.001) but did not correlate with PTA (R = 0.10, P = 0.29). Tympanometric gradien t was unrelated to ear-specific PTA, but not abnormal static admittance (<0 .2 cc), which produced a mean 7-dB HL decrease in hearing (ANOVA, P = 0.02) . The HL-7 is a reliable and internally consistent measure of parent percep tion of child hearing, but unfortunately these perceptions are inaccurate f or mild hearing loss. Abnormal static admittance is a risk factor for heari ng loss.