An evaluation of the 'voice test' as a method for assessing hearing in children with particular reference to the situation in developing countries.

In developing countries with limited no or access to standard audiometric methods a 'voice test' is a potential non-technological alternative method of assessing hearing. A three level 'voice test' was developed, refined and standardised-accurate response to a whispered voice equating with normal hearing, to a conversational voice with mild hearing loss and to a loud voice to moderate/severe hearing loss. In a hospital based study 177 children were voice tested in sound treated rooms and then tested using standard audiometric procedures to determine precise hearing thresholds. In this situation the voice test had a specificity of 95.9% and a sensitivity of 80%. When the test was evaluated on 201 children aged 3-8 years, first voice tested and then tested with standard audiometry in the classrooms of their pre-primary schools it was found to have a specificity of 97.8% and a sensitivity of 83.3%. With this degree of accuracy in detecting hearing impairment and given the simplicity required to administer the test, it is felt that such a test could be recommended for use by primary health care workers in developing countries where access to standard audiometric methods for assessing hearing are not available.