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.

Departamento de Biología Celular y Fisiología Instituto de Investigaciones Biomédicas Universidad Nacional Autónoma de México Mexico

Department of Anthropology Faculty of Humanities Charles University Czech Republic; National Institute of Mental Health Klecany Czech Republic

Department of Otolaryngology Head and Neck Surgery Hospital for Sick Children University of Toronto Canada

Department of Otorhinolaryngology and Head and Neck Surgery Pardubice Hospital Faculty of Health Studies University of Pardubice Czech Republic

Department of Otorhinolaryngology Head and Neck Surgery Cairo University Cairo Egypt

Department of Otorhinolaryngology The Jikei University School of Medicine Tokyo Japan

Department of Otorhinolaryngology University College of Medical Sciences and GTB Hospital Delhi India

Escuela de Ingeniería Pontificia Universidad Católica de Chile Santiago Chile

Escuela de Psicología Pontificia Universidad Católica de Chile Santiago Chile

Food Chemistry and Food Development Department of Biochemistry University of Turku Turku Finland; Department of Food and Environmental Sciences University of Helsinki Helsinki Finland

Frey and Lau Henstedt Ulzburg Germany

Functional Foods Forum University of Turku Turku Finland

Gösta Ekman Laboratory Department of Psychology Stockholm University Stockholm Sweden

INGENIO Immunoal lèrgia Respiratòria Clínica i Experimental Hospital Clínic CIBERES Barcelona Catalonia Spain

Istanbul Smell and Taste Center Istanbul Turkey

Monell Chemical Senses Center Philadelphia PA; Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden

Monell Chemical Senses Center Philadelphia PA; International School for Advanced Studies Neuroscience Area Trieste Italy

ORL Clinica Università of Insubriae Varese ASST Settelaghi Varese Italy

Otorhinolaryngology Department Aristotle University Thessaloniki Greece

Pediatric Feeding Disorders clinic Dana Children's Hospital Tel Aviv Medical Center Tel Aviv Israel

Pediatric Otolaryngology Dana Children's Hospital Tel Aviv Medical Center Sackler School of Medicine Tel Aviv Israel

Pediatric Otolaryngology Unit Department of Otorhinolaryngology Head and Neck Surgery University Hospitals of Geneva Geneva Switzerland

Rhinology Olfactology Unit Department of Otorhinolaryngology Head and Neck Surgery University Hospital of Geneva Switzerland

Smell and Taste Clinic Department of Otorhinolaryngology Medizinische Fakultät Carl Gustav Carus Technische Universität Dresden Germany

Smell and Taste Clinic Department of Otorhinolaryngology Medizinische Fakultät Carl Gustav Carus Technische Universität Dresden Germany; Abteilung Neuropädiatrie Medizinische Fakultät Carl Gustav Carus Technische Universität Dresden Germany

Smell and Taste Clinic James Paget University Hospital Gorleston United Kingdom; Norwich Medical School University of East Anglia Norwich United Kingdom

Smell and Taste Research Lab Institute of Psychology University of Wroclaw Poland

Smell and Taste Research Lab Institute of Psychology University of Wroclaw Poland; Department of Psychotherapy and Psychosomatic Medicine TU Dresden Dresden Germany

Unidad de Rinología y Cirugía de Base de Cráneo Servicio de Otorrinolaringología Hospital Universitario Ramón y Cajal Madrid Spain

Unidad de Rinología y Cirugía de Base de Cráneo Servicio de Otorrinolaringología Hospital Universitario Ramón y Cajal Madrid Spain; INGENIO Immunoal lèrgia Respiratòria Clínica i Experimental Hospital Clínic CIBERES Barcelona Catalonia Spain

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