Article Text

other Versions

Download PDFPDF
Cross-sectional epidemiology of hearing loss in Australian children aged 11–12 years old and 25-year secular trends
  1. Jing Wang1,2,
  2. Carlijn M P le Clercq1,3,
  3. Valerie Sung1,2,
  4. Peter Carew1,4,
  5. Richard S Liu1,2,
  6. Fiona K Mensah1,2,
  7. Rachel A Burt1,5,
  8. Lisa Gold1,6,
  9. Melissa Wake1,7
  1. 1Murdoch Children’s Research Institute, The Royal Children’s Hospital, Melbourne, Victoria, Australia
  2. 2Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
  3. 3Department of Otolaryngology, Erasmus University Medical Center, Rotterdam, The Netherlands
  4. 4Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, Victoria, Australia
  5. 5The HEARing Cooperative Research Centre, The University of Melbourne, Melbourne, Victoria, Australia
  6. 6School of Health and Social Development, Deakin University, Geelong, Australia
  7. 7Department of Paediatrics, The Liggins Institute, The University of Auckland, Auckland, New Zealand
  1. Correspondence to Melissa Wake, Murdoch Children’s Research Institute, The Royal Children’s Hospital, Melbourne VIC 3052, Australia; melissa.wake{at}


Objective In a national study of Australian children aged 11–12 years old, we examined the (1) prevalence and characteristics of hearing loss, (2) its demographic risk factors and (3) evidence for secular increases since 1990.

Methods This is a cross-sectional CheckPoint wave within the Longitudinal Study of Australian Children. 1485 children (49.8% retention; 49.7% boys) underwent air-conduction audiometry. Aim 1: hearing loss (≥16 decibels hearing level (dB HL)) was defined in four ways to enable prior/future comparisons: high Fletcher Index (mean of 1, 2 and 4 kHz; primary outcome relevant to speech perception), four-frequency (1, 2, 4 and 8 kHz), lower frequency (1 and 2 kHz) and higher frequency (4 and 8 kHz); aim 2: logistic regression of hearing loss by age, gender and disadvantage index; and aim 3: P for trend examining CheckPoint and reported prevalence in studies arranged by date since 1990.

Results For high Fletcher Index, the prevalence of bilateral and unilateral hearing loss ≥16 dB HL was 9.3% and 13.3%, respectively. Slight losses (16–25 dB HL) were more prevalent than mild or greater (≥26 dB HL) losses (bilateral 8.5% vs 0.8%; unilateral 12.5% vs 0.9%), and lower frequency more prevalent than higher frequency losses (bilateral 11.0% vs 6.9%; unilateral 15.4% vs 11.5%). Demographic characteristics did not convincingly predict hearing loss. Prevalence of bilateral/unilateral lower and higher frequency losses ≥16 dB HL has risen since 1990 (all P for trend <0.001).

Conclusions and relevance Childhood hearing loss is prevalent and has risen since 1990. Future research should investigate the causes, course and impact of these changes.

  • hearing loss
  • prevalence
  • risk factors
  • secular trend
  • children

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors MW conceived the CheckPoint study with the CheckPoint team. MW was the primary student supervisor, along with RAB and VS, and oversaw all aspects of the study and the manuscript preparation. RSL contributed to hearing data collection and, under the guidance of PC, designed the hearing protocols. JW and CMPC conducted data extraction, cleaning and handling. JW performed data analysis and wrote the main paper. MW, PC, FKM and LG advised on statistical issues and interpretation. All authors critically reviewed the manuscript and had final approval of the submitted and published version of this paper. MW and JW had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

  • Funding This work was supported by the National Health and Medical Research Council (NHMRC) of Australia (1041352, 1109355), The Royal Children’s Hospital Foundation (2014-241), the Murdoch Children’s Research Institute, The University of Melbourne, the National Heart Foundation of Australia (100660) and Financial Markets Foundation for Children (2014-055, 2016-310). The funding bodies did not play any role in the study. The following authors were supported by the NHMRC: VS (Early Career Fellowship 1125687), PC (Centre of Research Excellence in Child Language 1023493), RSL (Postgraduate Scholarship 1114567), FKM (Career Development Fellowship 1111160), LG (Early Career Fellowship 1035100) and MW (Senior Research Fellowship 1046518). VS was additionally supported by a Cottrell Research Fellowship from the Royal Australasian College of Physicians; CMPC by a Ter Meulen Grant from the Royal Netherlands Academy of Arts and Sciences; RAB by the HEARing Cooperative Research Centre, established and supported under the Cooperative Research Centres Program, an Australian Government Initiative; and MW by Cure Kids New Zealand.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The Royal Children’s Hospital Human Research Ethics Committee (HREC33225) and The Australian Institute of Family Studies Ethics Committee (AIFS14-26) approved the study.

  • Provenance and peer review Not commissioned; externally peer reviewed.