A longitudinal study of the validity of parental reporting in the detection of otitis media and related hearing impairment in infancy.

A total of 150 full-term and 66 pre-term infants were selected at birth and prospectively examined at three-monthly intervals from birth until the age of 27 months. Parental reports of middle ear infection and/or hearing impairment were obtained prior to otoscopic and audiometric evaluation. The relationships between parental reports and the diagnoses acute otitis media (AOM), otitis media with effusion (OME) and hearing impairment (HI), were assessed in terms of sensitivity, specificity and positive and negative predictive values, using the data obtained during the follow-up period. AOM and OME were diagnosed using otoscopy and tympanometry. Hearing was assessed by conditioned orientation reflex audiometry. HI was defined as averaged thresholds > or = 20 dB compared with age-appropriate response levels. Despite the repeated feedback which parents received on the middle ear condition and hearing of their infants, the majority fail to recognize the presence of AOM, OME and HI. The limited sensitivity of parental reporting should discourage both researchers and clinicians from using it as a diagnostic or monitoring instrument, but they should not disregard parental concern when confronted with it.