Audiograms and Prevalence of Hearing Loss in U.S. Children and Adolescents 6-19 Years of Age.

Purpose: The aim of this study was to determine median audiograms and prevalence of hearing loss for U.S. 6- to 19-year-olds.

Method: U.S. national audiometric data for 2,709 six- to 19-year-olds from the National Health and Nutrition Examination Survey 2017-2020 were analyzed. Analyses were primarily descriptive and relied on distribution-free medians, cumulative distribution functions (CDFs), and population-weighted prevalence estimates. Differences between CDFs were examined using Cohen's effect size. Results are presented for the age range of 6-19 years. Main effects of sex, age, and race/ethnicity were examined.

Results: Differences in the audiograms between the sexes and among the various race/ethnicity groups were minor, but age group differences were notable. Pure-tone thresholds at 500 and 8000 Hz for the 6- to 9-year age group were 3-5 dB higher (worse) than those of the other age groups. The overall prevalence of hearing loss among 6- to 19-year-olds, defined as either of the pure-tone averages (PTAs) for 500, 1000, and 2000 Hz (PTA512) or 3000, 4000, 6000, and 8000 Hz (PTA3468k) exceeding 15 dB HL in either ear, was 11.24% (95% confidence interval [10.00%, 12.48%]). Binary logistic regression analyses found the odds of hearing loss to be significantly higher for individuals from families with a low income as well as for those with abnormal otoscopy or abnormal tympanometry.

Conclusions: For children and adolescents in the United States, hearing was unaffected by differences in sex and race/ethnicity, with only age impacting pure-tone thresholds and only at the lowest (500 Hz) and highest (8000 Hz) frequencies examined. The overall prevalence of hearing loss was about 11%.