School Screening

iHEAR: School Aged Hearing Screening with an iPad Audiometer


Although newborn hearing screening is performed in many Canadian provinces, few offer universal hearing testing of school-aged children. The American Academy of Audiology recommends hearing screening in preschool, kindergarten, grades 1, 3, 5, and either 7 or 9. [1]

Unfortunately, newborn testing won’t detect hearing loss that develops or progresses over time. Research shows that if not caught early, hearing loss can significantly impact social, emotional, and even cognitive development, often leading to poor academic performance, low self-esteem, and behavioral issues.

In an effort to address this issue, a group of medical students from the University of Ottawa organized an interest group they call iHEAR. Under the guidance of Dr. Matthew Bromwich, an Otolaryngologist at the Children’s Hospital of Eastern Ontario (CHEO), approximately 30 members of the team – which included students and several audiologists – traveled to local primary schools to test the hearing of children in Grades 1 and 2

Over three months in early 2015, 251 students were screened for hearing loss. To facilitate the mobile nature of this screening project and to test as many students as possible in a short time, the iHEAR team was equipped with SHOEBOX. SHOEBOX is a clinically validated digital audiometer. Testing is presented on the device as a game that the students interact with directly. By sorting objects based on whether or not they heard a sound produced, audiograms could be produced for each student in as little as five minutes. SHOEBOX proved to be a “simple to use, self-directed, accurate, reliable, inexpensive, and an engaging method of hearing loss detection,” as stated by David Chan Chun Kong, 4th-year medical student and creator/co-ordinator of the iHear program.

By getting out and into the schools, Dr. Chan and his team detected 12 students with hearing-related concerns who were then scheduled for traditional audiology follow-up appointments. Take a moment and read the article Dr. Chan published on this initiative in Scrub In.

Dr. Chan’s efforts continue locally, and he challenges medical students across North America to take up the cause and provide children with the hearing health care they deserve.

[1] Craemer R; Econtext Pty Ltd. A social cost-benefit analysis: Early intervention programs to assist children with hearing loss develop spoken language. Blackburn, Victoria, Australia: First Voice; 2011 Jul. Available at:  Accessed 2015 Jun 15.