Development of an International Odor Identification Test for Children: The Universal Sniff Test

Objective: The measurement of olfactory function in children is challenging and at present, there is no test that is commonly used. Our objective was to assess olfactory function in children and to create and validate an odor identification test to diagnose olfactory dysfunction in children, which we called the “Universal-Sniff (U-Sniff)” test. Study design: This is a multicenter study involving 19 countries. The “U-Sniff” was developed in three phases including 1760 children age 5-7 years. Phase 1: Identification of potentially recognizable odors; Phase 2: Selection of odorants for the odor identification test; and Phase 3: Evaluation of the test and acquisition of normative data. Test—retest reliability was evaluated in a subgroup of children (n=27) and the test was validated using children with congenital anosmia (n=14). Results: Twelve odors were familiar to children and therefore included in the “U-Sniff”. Children scored a mean±SD of 9.88±1.80 points out of 12. Normative data was obtained and reported for each country. The “U-Sniff” demonstrated a high test—retest reliability (r27=0.83, p<0.001) and enabled discrimination between normosmia and children with congenital anosmia with a sensitivity of 100% and specificity of 86%. Conclusion: The “U-Sniff” is a valid and reliable method of testing olfaction in children and can be used internationally.