Abstract
Background: Hearing screening in preschool children aged 4–5 years is essential for the
early detection of hearing loss, which can prevent long-term auditory impairment.
Objective: To evaluate the effectiveness of the PASS PRO application for school-based
hearing screening compared with hospital-based screening and the gold standard diagnostic
test, conditioned play audiometry.
Methods: A prospective experimental study was conducted among preschool children aged
4–5 years from 37 schools across northern, northeastern, eastern, southern regions, and
Bangkok, Thailand. A total of 1,479 children participated, of whom 1,431 provided complete
data for analysis (716 boys and 715 girls; mean age 60.1 ± 6.82 months).
Results: Normal hearing was identified in 1,299 children (90.8%), while 116 children (8.1%)
had hearing impairment. For PASS PRO screening, sensitivity was 82.4% (right ear) and
73.8% (left ear), with specificity of 88.0% and 90.1%, respectively. When screening for
disabling hearing loss (PTA at 0.5, 1, 2, 4 kHz > 35 dB), sensitivity was 87.0% (right ear)
and 89.2% (left ear). Screening time using PASS PRO was comparable between teachers and
non-audiologist healthcare staff, averaging 81.45 seconds and 77.11 seconds, respectively,
and was significantly shorter than conventional play audiometry (391.38 seconds,
approximately 6 minutes).
Conclusion: The PASS PRO application is feasible for hearing screening in children aged 4–
6 years in hospital settings without requiring specialized audiologists. For school-based
implementation, additional user training and software refinement are recommended to
improve sensitivity and specificity.
