{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T16:28:05Z","timestamp":1787588885486,"version":"build-2736575974"},"reference-count":19,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Preschool hearing screening is critical for early identification of hearing loss, yet factors associated with screening completion are not well described.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate completion rates of pure-tone audiometry (PTA) and otoacoustic emission (OAE) screening among preschool children in the community and identify factors, including child characteristics and screener-child language concordance, associated with completion.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This multicenter prospective cohort study across 204 preschools in 15 California counties included a population-based sample of 7035 children who underwent screening from November 7, 2023, to December 3, 2025.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Child age (\u226448 months vs &amp;gt;48 months), preferred home language, teacher-reported communication concerns (eg, speech, language, or hearing), and screener Spanish proficiency (low vs high).<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Completion of PTA and OAE screening in both ears. Odds of completion were estimated using logistic regression, adjusted for age, screener experience, and teacher-reported concerns. Ratios of estimated probabilities were used to compare Spanish- and English-speaking children across screener proficiency levels.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among 7035 children screened (median age, 47 [IQR, 39-54] months; 3583 [50.9%] male; 4780 [67.9%] preference for English and 2683 [38.1%] preference for Spanish), OAE was completed in 6745 children (95.9%), whereas PTA was completed in 4601 (65.4%). Teacher-reported concerns included speech (1039 children [14.8%]), language (577 children [8.2%]), and hearing (298 children [4.2%]). Children 48 months or younger (odds ratio [OR], 0.17; 95% CI, 0.15-0.19), those with speech concerns (OR, 0.44; 95% CI, 0.36-0.53), and those with non-English home language preference (OR, 0.84; 95% CI, 0.74-0.94) had lower odds of PTA completion. For OAE, younger age (OR, 0.38; 95% CI, 0.29-0.50) and speech concerns (OR, 0.39; 95% CI, 0.28-0.55) had lower odds of completion; non-English home language preference was not associated with OAE completion (OR, 1.04; 95% CI, 0.80-1.35). Spanish-speaking children whose screeners had high Spanish proficiency had higher estimated PTA completion than those with low-proficiency screeners, achieving parity with English-speaking children in the high-proficiency group (ratio of estimated probabilities, 0.96; 95% CI, 0.91-1.02), while Spanish-speaking children had lower estimated probability of completion than English-speaking children when evaluated by low-proficiency screeners (ratio of estimated probabilities, 0.87; 95% CI, 0.80-0.94). Screener language proficiency was not associated with OAE completion.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this prospective cohort study of 7035 preschoolers, PTA completion rate was significantly lower than that for OAE and varied by age, speech concerns, and home language, whereas OAE completion was consistently high. High Spanish proficiency by the screener was associated with higher PTA estimated probability of completion among Spanish-speaking children, supporting the importance of language-concordant screening in early childhood hearing assessment.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.30641","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T15:43:04Z","timestamp":1787586184000},"page":"e2630641","source":"Crossref","is-referenced-by-count":0,"title":["Completion Rates of Screening Examinations for Hearing Among Preschool-Aged Children"],"prefix":"10.1001","volume":"9","author":[{"given":"Lourdes","family":"Kaufman","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihyun","family":"Stephans","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mimoh","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julianna B.","family":"Giammona","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dylan K.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"issue":"20","key":"zoi260836r1","doi-asserted-by":"publisher","first-page":"2151","DOI":"10.1056\/NEJMra050700","article-title":"Newborn hearing screening\u2014a silent revolution.","volume":"354","author":"Morton","year":"2006","journal-title":"N Engl J Med"},{"issue":"7312","key":"zoi260836r2","doi-asserted-by":"publisher","first-page":"536","DOI":"10.1136\/bmj.323.7312.536","article-title":"Prevalence of permanent childhood hearing impairment in the United Kingdom and implications for universal neonatal hearing screening: questionnaire based ascertainment study.","volume":"323","author":"Fortnum","year":"2001","journal-title":"BMJ"},{"issue":"1","key":"zoi260836r3","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1177\/0194599815623467","article-title":"Clinical practice guideline: otitis media with effusion (update).","volume":"154","author":"Rosenfeld","year":"2016","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"5","key":"zoi260836r5","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1542\/pir.2020-000901","article-title":"Hearing screening in pediatric primary care.","volume":"42","author":"Yoeli","year":"2021","journal-title":"Pediatr Rev"},{"issue":"4","key":"zoi260836r6","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1007\/s11065-012-9208-z","article-title":"Language development and assessment in the preschool period.","volume":"22","author":"Conti-Ramsden","year":"2012","journal-title":"Neuropsychol Rev"},{"issue":"3","key":"zoi260836r8","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2023-063288","article-title":"Hearing assessment in infants, children, and adolescents: recommendations beyond neonatal screening.","volume":"152","author":"Bower","year":"2023","journal-title":"Pediatrics"},{"issue":"2","key":"zoi260836r9","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1044\/2015_AJA-14-0065","article-title":"An Evidence-based systematic review on the diagnostic accuracy of hearing screening instruments for preschool- and school-age children.","volume":"24","author":"Prieve","year":"2015","journal-title":"Am J Audiol"},{"issue":"12","key":"zoi260836r10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0208050","article-title":"Use of otoacoustic emissions to improve outcomes and reduce disparities in a community preschool hearing screening program.","volume":"13","author":"Cedars","year":"2018","journal-title":"PLoS One"},{"issue":"4","key":"zoi260836r11","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1001\/jamaoto.2021.4430","article-title":"Outcomes of an early childhood hearing screening program in a low-income setting.","volume":"148","author":"Brodie","year":"2022","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"issue":"4","key":"zoi260836r12","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1111\/j.1746-1561.2009.00383.x","article-title":"Otoacoustic emissions: a valid, efficient first-line hearing screen for preschool children.","volume":"79","author":"Yin","year":"2009","journal-title":"J Sch Health"},{"issue":"6","key":"zoi260836r13","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1016\/j.jcomdis.2005.11.006","article-title":"A comparison of two methods of hearing screening in the preschool population.","volume":"39","author":"Sideris","year":"2006","journal-title":"J Commun Disord"},{"issue":"10146","key":"zoi260836r15","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1016\/S0140-6736(18)31129-2","article-title":"Autism spectrum disorder.","volume":"392","author":"Lord","year":"2018","journal-title":"Lancet"},{"issue":"12","key":"zoi260836r16","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.1016\/j.ijporl.2010.08.023","article-title":"Comparison of two hearing screening programs in the same population: oto-acoustic emissions (OAE) screening in newborns and behavioral screening when infants.","volume":"74","author":"Geal-Dor","year":"2010","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"6","key":"zoi260836r17","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1067\/mhn.2002.129734","article-title":"A comparison of screening methods in school-aged children.","volume":"127","author":"Krueger","year":"2002","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"2","key":"zoi260836r18","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1001\/jamaoto.2013.1229","article-title":"Children with sensorineural hearing loss after passing the newborn hearing screen.","volume":"139","author":"Dedhia","year":"2013","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"issue":"1","key":"zoi260836r19","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1121\/1.4973618","article-title":"Compensating for ear-canal acoustics when measuring otoacoustic emissions.","volume":"141","author":"Charaziak","year":"2017","journal-title":"J Acoust Soc Am"},{"key":"zoi260836r4","unstructured":"2022 Annual data early hearing detection and intervention program. Centers for Disease Control and Prevention. October 7, 2024. Accessed May 28, 2025. https:\/\/archive.cdc.gov\/www_cdc_gov\/ncbddd\/hearingloss\/ehdi-data2022.html"},{"key":"zoi260836r7","unstructured":"Clinical practice guidelines. Childhood hearing screening. American Academy of Audiology. Accessed June 2, 2026. https:\/\/www.audiology.org\/practice-guideline\/clinical-practice-guidelines-childhood-hearing-screening\/"},{"key":"zoi260836r14","unstructured":"Preschool hearing screening. ClinicalTrials.gov identifier: NCT06058767. Updated February 2, 2026. Accessed February 4, 2026. https:\/\/clinicaltrials.gov\/study\/NCT06058767"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2853206\/kaufman_2026_oi_260836_1786974528.08995.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T15:43:06Z","timestamp":1787586186000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2853206"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,24]]},"references-count":19,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8,3]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2026.30641","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,24]]}}}