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Otitis media with effusion in children: Binaural hearing before and after corrective surgery
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identification of common phrases with and without visual cues. The performance of the subjects using 3M/House and Tactaid II devices was similar on all tests except those requiring integration of auditory or tactile cues and visual cues, on which the 3M/House device users achieved significantly higher scores than did the Tactaid II device users. Otitis media with effusion in children: Binaural bearing before and after corrective Pillsbury H.C.; Grose J.H.; Hall J.W. III ARCH. OTOLARYNGOL. HEAD NECK SURG. (1991) 117/l (718-723)
surgery
The masking-level difference (MLD) was investigated in a group of children having no known history of ear disease, and a group of children having a history of otitis media with effusion and hearing loss. The MLD is a psychoacoustic measure of the sensitivity of the auditory system to subtle interaural difference cues of time and amplitude and relates to the ability of the listener to detect and to recognize signals in noisy backgrounds. In the otitis media with effusion group, MLDs were measured both before and 1 and 3 months after the placement of pressure equalization tubes. The MLDs were often abnormally small in the otitis media with effusion group before surgery, when hearing loss was present. Significantly, MLDs sometimes remained abnormally small after surgery (after normal hearing had returned). The postsurgery MLD was particularly likely to be abnormally reduced in subjects who had experienced asymmetric losses of hearing. Audit from preschool developmental surveillance of vision, hearing, and language referrals Rona R.J.; Reynolds A.; Allsop M.; Morris R,W.; Morgan M.; Mandalia S. ARCH. DIS. CHILD. (1991) 66/S (921-926)
Referrals from preschool medical examinations were followed up for two years to assess attendance rate, waiting time for appointment, appropriateness of the referral, the diagnosis and management of the condition. Altogether 184 children were referrals for ophthalmology, 285 for audiology, and 195 for speech therapy. The median waiting time for an appointment was 46 days in ophthalmology, 175 days in audiology, and 83 days in speech therapy. The poorest attendance rate was identified in speech therapy (75%). Approximately 60% of examined children had a justified referral to ophthalmology and 20% had a clear defect. Over half the children in audiology (55%) had an altered impedance or hearing impairment. Of those with a hearing problem kept under review only half improved spontaneously. In speech therapy 80% of those assessed had a language problem. Many health problems were detected for which parents were unaware or did not use the service. Parental awareness alone will not uncover the sizable level of lingual and sensorial problems in inner city areas. This audit identified specific deficiencies in the provision of services and a number of organisational changes are suggested to improve their effectiveness. Effectiveness and efficacy of early detection of hearing impairment Ruben RJ. ACTA OTO-LARYNGOL. SUPPL. (1991) -/482 (127-135)
in children
Throughout the industrial world, technology and techniques are now available so that any child, no matter how young or how impaired, can have an accurate and precise assessment of middle ear function, auditory reactivity, and physiological processing of auditory stimuli. Yet, a major problem exists in the lack of timely identification of many children with hearing impairments. Presently, identification systems are primarily proactive and are based on technology. These consist of testing of infants with biological risk factors and the use of hearing screening programs at various times during the first decade of life. The reactive sources of referral appear to be inadequate, an impression that is supported by the data on the delay of diagnosis. These inadequacies appear to be due to a lack of awareness on the part of health providers as to the potential hearing losses; ignorance concerning the ability to diagnose them; and a lack of awareness of the potential of effective intervention. Two additional approaches are suggested which would be added to those already existing for improving the number of children who will have their diagnoses made in a timely fashion. The first of these is educational: health providers should have required and continuing education concerning the effects of hearing loss, the ability to diagnose, and to intervene effectively. A parallel educational program should be provided for the public. The second is the periodic assessment of speech and language from early infancy through the first few years of life for all children. This would enable children with suspected
identification of common phrases with and without visual cues. The performance of the subjects using 3M/House and Tactaid II devices was similar on all tests except those requiring integration of auditory or tactile cues and visual cues, on which the 3M/House device users achieved significantly higher scores than did the Tactaid II device users. Otitis media with effusion in children: Binaural bearing before and after corrective Pillsbury H.C.; Grose J.H.; Hall J.W. III ARCH. OTOLARYNGOL. HEAD NECK SURG. (1991) 117/l (718-723)
surgery
The masking-level difference (MLD) was investigated in a group of children having no known history of ear disease, and a group of children having a history of otitis media with effusion and hearing loss. The MLD is a psychoacoustic measure of the sensitivity of the auditory system to subtle interaural difference cues of time and amplitude and relates to the ability of the listener to detect and to recognize signals in noisy backgrounds. In the otitis media with effusion group, MLDs were measured both before and 1 and 3 months after the placement of pressure equalization tubes. The MLDs were often abnormally small in the otitis media with effusion group before surgery, when hearing loss was present. Significantly, MLDs sometimes remained abnormally small after surgery (after normal hearing had returned). The postsurgery MLD was particularly likely to be abnormally reduced in subjects who had experienced asymmetric losses of hearing. Audit from preschool developmental surveillance of vision, hearing, and language referrals Rona R.J.; Reynolds A.; Allsop M.; Morris R,W.; Morgan M.; Mandalia S. ARCH. DIS. CHILD. (1991) 66/S (921-926)
Referrals from preschool medical examinations were followed up for two years to assess attendance rate, waiting time for appointment, appropriateness of the referral, the diagnosis and management of the condition. Altogether 184 children were referrals for ophthalmology, 285 for audiology, and 195 for speech therapy. The median waiting time for an appointment was 46 days in ophthalmology, 175 days in audiology, and 83 days in speech therapy. The poorest attendance rate was identified in speech therapy (75%). Approximately 60% of examined children had a justified referral to ophthalmology and 20% had a clear defect. Over half the children in audiology (55%) had an altered impedance or hearing impairment. Of those with a hearing problem kept under review only half improved spontaneously. In speech therapy 80% of those assessed had a language problem. Many health problems were detected for which parents were unaware or did not use the service. Parental awareness alone will not uncover the sizable level of lingual and sensorial problems in inner city areas. This audit identified specific deficiencies in the provision of services and a number of organisational changes are suggested to improve their effectiveness. Effectiveness and efficacy of early detection of hearing impairment Ruben RJ. ACTA OTO-LARYNGOL. SUPPL. (1991) -/482 (127-135)
in children
Throughout the industrial world, technology and techniques are now available so that any child, no matter how young or how impaired, can have an accurate and precise assessment of middle ear function, auditory reactivity, and physiological processing of auditory stimuli. Yet, a major problem exists in the lack of timely identification of many children with hearing impairments. Presently, identification systems are primarily proactive and are based on technology. These consist of testing of infants with biological risk factors and the use of hearing screening programs at various times during the first decade of life. The reactive sources of referral appear to be inadequate, an impression that is supported by the data on the delay of diagnosis. These inadequacies appear to be due to a lack of awareness on the part of health providers as to the potential hearing losses; ignorance concerning the ability to diagnose them; and a lack of awareness of the potential of effective intervention. Two additional approaches are suggested which would be added to those already existing for improving the number of children who will have their diagnoses made in a timely fashion. The first of these is educational: health providers should have required and continuing education concerning the effects of hearing loss, the ability to diagnose, and to intervene effectively. A parallel educational program should be provided for the public. The second is the periodic assessment of speech and language from early infancy through the first few years of life for all children. This would enable children with suspected