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The Pediatric Otophoniatric Department of U.S.L.75II, the Multicenter of Preventive Medicine in Via Cherasco, 5, Milan, carried out two otophoniatric screenings on about 70 four-year-old nursery school children. While this screening was considered experimental in four schools, the ultimate goal is to extend it to all the nursery schools in the same area. The primary aim of the screening was to individualize several pathologies of the upper respiratory tract in this age range. The second aim was to identify language pathologies in children under the age of six in order to treat them as soon as possible with adequate and preventive therapy and appropriate language re-education before their entrance into primary school. The materials and methods employed were as follows: O.R.L. examination: otoscopy, rhinoscopy, oropharyngoscopy, indirect laryngoscopy (after individualization of dysphonia); Audiometric test: peep show in free field with a 250 Hz-4000 Hz frequency range at 30 dB; Language evaluation through examination and interpretation of questionnaires formulated in order to evaluate language development filled in by the children's teachers. Two modifications in the method used in the 1989 study were made in the 1990 screening: The preventive use of an auditory duct cleaner and the distribution of the above-mentioned questionnaires at the very beginning of the study. These two changes improved screening planning as well as development. The results of the two screenings were compared and an increase in the percentage of children examined and subjected to the audiometric test was noted. In fact, in the 1989 study, only 77% of the children underwent the audiometric test (23% had ear wax), while in the 1990 study 100% underwent the test (ear cleaner had been used). With regard to the questionnaires, the data were gathered four months after screening in the 1989 study, whereas in the 1990 study this phase was carried out on the same day of the screening. The new methodology saved time in the screening.