Audiometric Thresholds and Hearing Health Knowledge in Spanish-Speaking English Learner Students: A School-Based Comparative Study

PURPOSE: This study examined audiometric threshold sensitivity and hearing health knowledge, attitudes, and behaviors (KAB) in Spanish-speaking English learner (EL) students and monolingual English-speaking peers across three central Illinois school districts. METHOD: Participants included 142 children aged 5-17 years (71 non-EL, 71 EL) from elementary, middle, and high schools. Pure-tone air-conduction thresholds were obtained at frequencies from 250 to 8000 Hz following American Speech-Language-Hearing Association-recommended procedures. Middle and high school students completed an adapted KAB survey; all participants completed an open-ended word association task. Linear mixed-effects models examined associations between EL status and thresholds across the frequency range and within the noise-induced hearing loss (NIHL) range. Multiple linear regression examined whether KAB scores predicted low-frequency thresholds after controlling for EL status and age. RESULTS: EL students had significantly elevated thresholds relative to non-EL peers, with differences concentrated in the low frequencies (250-500 Hz) and diminishing across higher frequencies, converging by 6000-8000 Hz. Mean thresholds in both groups fell within clinically normal limits. EL status was not associated with thresholds in the NIHL range (3000-6000 Hz), and KAB scores did not predict thresholds. CONCLUSIONS: Spanish-speaking EL students showed systematic low-frequency threshold elevation not attributable to noise exposure or to self-reported hearing health factors. Although differences generally fell within clinically normal limits, even subclinical elevations have been associated with increased listening effort and poorer academic performance, which may be compounded for children simultaneously acquiring English. Findings highlight the need to examine the functional significance of low-frequency threshold differences in linguistically diverse pediatric populations.