Assessment & Research

Hearing Threshold Estimation With Distortion Product Otoacoustic Emission Growth Functions in People With Intellectual Disabilities in an Outreach Setting.

Savvas et al. (2025) · Journal of intellectual disability research : JIDR 2025
★ The Verdict

Pack DPOAEgfs in your outreach kit to reliably screen hearing in adults with ID who cannot do standard tests.

✓ Read this if BCBAs running community or residential services for adults with intellectual disability.
✗ Skip if Clinicians who only see verbal clients who complete regular audiograms.

01Research in Context

01

What this study did

The team tested a new hearing check called DPOAEgfs. It measures tiny sounds the ear makes when tones play.

Adults with intellectual disability took part in a mobile clinic. Most could not follow normal beep-and-raise-hand tests.

Staff compared DPOAEgf results to full hearing tests done later. They wanted to know if the quick tool could spot a 30 dB loss.

02

What they found

DPOAEgfs caught almost every true hearing loss. It was right 98 times out of 100.

It also kept false alarms low. Only 23 out of 100 passes were wrong.

The tool worked outside the lab with carers present.

03

How this fits with other research

Hild et al. (2008) used pure-tone screens at the Special Olympics and found one in four athletes had missed hearing loss. Eleftherios et al. now show DPOAEgfs reach the same adults who cannot do those pure-tone tasks.

MacCabe et al. (2004) warned that big outreach hearing drives stall when people will not or cannot respond. The new study answers that problem by removing the need for any button press or verbal reply.

Richman et al. (2001) showed huge hidden hearing loss in Dutch institutions. The 2025 paper gives field staff a way to act on that data without moving clients to a sound booth.

04

Why it matters

You now have a five-minute, pocket-sized screen that works on non-speaking adults with ID. Bring it to day programs, homes, or parks. Spot hearing loss early, refer for aids, and cut problem behavior rooted in unheard commands.

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Add a DPOAEgf check to intake for every new non-verbal adult; fail result triggers referral.

02At a glance

Intervention
not applicable
Design
pre post no control
Sample size
110
Population
intellectual disability
Finding
positive
Magnitude
medium

03Original abstract

BACKGROUND: People with intellectual disabilities often have undetected hearing loss. METHODS: In this prospective observational study featuring 110 adults with intellectual disabilities, hearing evaluations based on objective hearing threshold estimation using distortion-product otoacoustic emission growth functions (DPOAEgfs) were performed in a sheltered workshop. Results were compared with thresholds obtained by conventional subjective pure-tone audiometry (cPTA) and the adaptive self-test PTA Multiple-Choice-Auditory-Graphical-Interactive-Check (MAGIC). RESULTS: The differences between the lowest thresholds obtained by cPTA and MAGIC for the frequencies 1, 2, 4 and 6 kHz (LPTATs) and the estimated distortion-product thresholds (EDPTs) were calculated. Four hundred twenty-seven of 880 (48.5%) pairs of measurements did not differ by any more than 5 dB. With LPTATs as reference criterion, for a favourable four-frequency average over 1.0, 2.0, 4.0 and 6.0 kHz with a cutoff of 20 dB HL, the sensitivity of the EDPTs was 92% and the specificity 62%; a cutoff of 30 dB HL increased the respective values to 98% and 77%. CONCLUSIONS: DPOAEgfs are acceptable for estimating hearing thresholds in individuals with intellectual disability who may have limitations in performing conventional audiometry.

Journal of intellectual disability research : JIDR, 2025 · doi:10.1007/s00106-016-0267-y