The Cross-Check Principle Revisited

In a classic 1976 article, James Jerger and Deborah Hayes (for a little more background on Dr. Hayes, see Audiology Genealogy in Personal Pages) articulated a logical strategy for pediatric hearing assessment: No single audiologic procedures is infallible. Reliance on a single audiological procedure will sometimes lead to serious errors in diagnosis of hearing loss in children, and subsequent mismanagement of children. The prudent approach is to evaluate auditory function with a battery of independent test procedures, some behavioral (e.g., pure tone audiometry) and some objective (e.g., acoustic immittance or auditory brainstem response (ABR). Jerger and Hayes went on to document their thesis with actual case studies illustrating the problems arising from total dependence on, for example, behavioral audiometry for assessment of hearing in children. Over the past 35+ years, the "cross-check principle" has been consistently confirmed by clinical research and in clinical practice. I encourage you to read the original paper by Jerger and Hayes (The Cross-Check Principle in Pediatric Audiometry. Arch Otolaryngol. 1976;102(10):614-620). It's easily accessed nowadays by an internet search.

I emphasize the cross-check principle in a number of PPT presentations on pediatric hearing assessment and objective test procedures (e.g., acoustic immittance and OAES). You might also want to read this article.

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James W. Hall III       |