Screening methods for childhood hearing impairment in rural Bangladesh Abbey L. Berg a,b, * , Hemayetunnesa Papri c , Shamim Ferdous d , Naila Z. Khan d,e , Maureen S. Durkin f a Department of Communication Studies/Communication Sciences & Disorders, 1 Pace Plaza, Pace University, New York, NY 10038, USA b Department of Otolaryngology/Head & Neck Surgery, College of Physicians & Surgeons, Columbia University, New York, NY, USA c HICARE (Society for Education & Care of Hearing Impaired Children of Bangladesh), Dhaka, Bangladesh d Bangladesh Protibondhi Foundation, Dhaka, Bangladesh e Child Development and Neurology Unit, Dhaka Shishu Hospital, Dhaka, Bangladesh f Waisman Center and Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin Received 25 January 2005; accepted 22 May 2005 International Journal of Pediatric Otorhinolaryngology (2006) 70, 107—114 www.elsevier.com/locate/ijporl KEYWORDS Hearing screening; Children; Play audiometry; Otoacoustic emissions; Tympanometry; Developing countries; Bangladesh Summary Objective: The purpose of this study was to determine a feasible strategy for screening young children in rural Bangladesh for hearing impairments. Methods: Trained community health workers (CHWs) screened 4003 children between the ages of 2 and 9 years using conditioned play audiometry (CPA) and a subset of 569 of these children (ages 2—5 years), using physiologic (otoacoustic emissions [OAEs] and tympanometry). Measures of frequency and cross-tabulations are presented to describe results. Results: Hearing screening using CPA was feasible for most children in the 6—9 years age range, but not for the younger children due to shyness and lack of cooperation. More than two thirds of the younger children were untestable on CPA. In response to this limitation, OAEs and tympanometry, requiring less cooperation on the part of the child, was implemented for a sample of younger children. Of the 569 children who received both CPA and OAE/tympanometry, 69% were untestable using CPA and 8.9% were untestable using OAE and tympanometry. Conclusions: These results suggest that hearing screening using CPA for older (6—9 years) and OAE/tympanometry for younger (2—5 years) children is feasible. Using the physiologic measures of OAE/tympanometry significantly reduced the number of * Corresponding author. Tel.: +1 212 346 1792; fax: +1 212 346 1511. E-mail address: aberg@pace.edu (A.L. Berg). 0165-5876/$ — see front matter # 2005 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijporl.2005.05.029