Development of an international odor identification test for children: The Universal Sniff Test

Valentin A. Schriever, Eduardo Agosin, Aytug Altundag, Hadas Avni, Helene Cao Van, Carlos Cornejo, Gonzalo de los Santos, Gad Fishman, Claudio Fragola, Marco Guarneros, Neelima Gupta, Robyn Hudson, Reda Kamel, Antti Knaapila, Iordanis Konstantinidis, Basile N. Landis, Maria Larsson, Johan N. Lundström, Alberto Macchi, Franklin Mariño-SánchezLenka Martinec Nováková, Eri Mori, Joaquim Mullol, Marie Nord, Valentina Parma, Carl Philpott, Evan J. Propst, Ahmed Rawan, Mari Sandell, Agnieszka Sorokowska, Piotr Sorokowski, Lisa-Marie Sparing-Paschke, Carolin Stetzler, Claudia Valder, Jan Vodicka, Thomas Hummel

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Objective: 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 test was developed in 3 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 test. 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 test demonstrated a high test—retest reliability (r27 = 0.83, P < .001) and enabled discrimination between normosmia and children with congenital anosmia with a sensitivity of 100% and specificity of 86%. 
Conclusions: The U-Sniff is a valid and reliable method of testing olfaction in children and can be used internationally.
Original languageEnglish
Pages (from-to)265-272.e3
Number of pages8
JournalJournal of Pediatrics
Early online date2 May 2018
Publication statusPublished - Jul 2018


  • olfaction
  • children
  • smell testing
  • Sniffin' Sticks
  • olfactory dysfunction

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