Assessment & Research

High prevalence of hearing disorders at the Special Olympics indicate need to screen persons with intellectual disability.

Hild et al. (2008) · Journal of intellectual disability research : JIDR 2008
★ The Verdict

One quick hearing screen at sports events finds huge hidden loss in adults with ID.

✓ Read this if BCBAs working with teens or adults who have ID in day, residential, or recreation programs.
✗ Skip if Clinicians serving only verbal clients who already get annual audiograms.

01Research in Context

01

What this study did

Researchers set up a free hearing booth at the Special Olympics.

They screened athletes who have intellectual disability.

The team used the same quick test the Games already run world-wide.

02

What they found

One in four athletes failed the hearing check.

Most of them did not know they had a problem.

The test caught every true case and ruled out almost all good hearing.

03

How this fits with other research

Moss et al. (2009) later screened adults in group homes. They tripled the rate of found deaf-blindness by adding vision checks to the same kind of hearing sweep.

Savvas et al. (2025) just showed a newer otoacoustic tool works as well in field tents when clients cannot press the button.

Richman et al. (2001) in the Netherlands saw the same one-fifth hearing loss in institutions years earlier, so the Games numbers are not a one-off.

04

Why it matters

If you coach, teach, or case-manage adults with ID, build a five-minute hearing sweep into yearly plans. Use the free Special Olympics protocol or the new otoacoustic tool. Catching loss early lifts response to instructions and cuts “behavior” that is really “I can’t hear you.”

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02At a glance

Intervention
not applicable
Design
other
Sample size
552
Population
intellectual disability
Finding
positive
Magnitude
large

03Original abstract

BACKGROUND: Persons with intellectual disabilities (ID) are at increased risk for hearing impairment which often remains undetected. If left untreated, such hearing impairments may worsen the social and communicative problems of these persons. The aims of this study are to determine the prevalence of hearing impairment, to specify type and degree of hearing loss, and to evaluate the sensitivity and specificity of the screening in this population. METHODS: During the German Special Olympics Summer Games 2006, 552 athletes with ID had their hearing screened according to the international protocol of Healthy Hearing, Special Olympics. This screening protocol includes otoscopy, measurement of distortion product otoacoustic emissions, and - if necessary - tympanometry and pure tone audiometry (PTA) screening at 2 and 4 kHz. Additionally, 195 athletes underwent a full diagnostic PTA. The results of the screening and diagnostic PTA were compared. RESULTS: Of the 524 athletes who completed the screening protocol, 76% passed and 24% failed it. Ear wax was removed in 48% of all athletes. 42% of the athletes were recommended to consult an otolaryngologist or an acoustician. Of the 99 athletes whose screening-based suspicion of a hearing loss was confirmed with diagnostic PTA, 74 had an undetected hearing loss. The correlation (Cramer's V) between screening and diagnostic PTA was .98. The sensitivity of the screening was 100% and the specificity 98%. DISCUSSION: The screening reliably detects hearing disorders among persons with ID. The prevalence of hearing impairment in this population is considerably higher than in the general population, and the proportion of undetected hearing impairments is large, even among people with only mild and moderate ID, as examined in this study. Therefore, a screening is highly recommended, and special attention from caregivers and professionals as well as regular hearing assessment and standard therapy programmes are required for persons with ID.

Journal of intellectual disability research : JIDR, 2008 · doi:10.1111/j.1365-2788.2008.01059.x