Using otoacoustic emissions to screen for hearing loss in early childhood care settings

OBJECTIVE: Until recently, no objective tool has been available to help health and early childhood education providers screen young children for hearing loss. The aim of this study was to screen underserved children 相似文献   

Hearing loss in infancy. Who first suspects it? A descriptive analysis?

BACKGROUND: The aim of this study was to analyze the sensitivity of suspicion preceding the diagnosis of a child's hearing impairment (HI).METHODS: Parents of children with confirmed HI were questioned in order to evaluate the age and the initiators of the suspicion of congenital or early HI. A total of 185/199 parents provided information on their children aged from 1 to 120 months.RESULTS: Parents showed more frequent correct suspicion/detection of HI than professionals. In 46% of all cases, the parents were the first to suspect HI (in 20% of all children with conductive losses and 52% of all sensorineural HIs). The first suspicion was raised by pediatricians in 25%, by otorhinolaryngologists and by school entrance examination each with 7%, and by obstetricians in 6% of cases. There was an average delay of 13.2 months from parental suspicion to a valid diagnosis of bilateral sensorineural HI (mean diagnosis age 50.9 months+/-30.3SD). Individual hearing aids were accordingly fitted late (mean aiding age 51.5 months+/-30.7).CONCLUSIONS: These findings support the use of parental observation as part of the early detection of HI until universal newborn hearing screening can be implemented.     

Parental decision-making in considering cochlear implant technology for a deaf child

OBJECTIVES: Advances in cochlear implant (CI) technology have increased the complexity of treating childhood deafness. We compare parental decision-making, values, beliefs, and preferences between parents of eligible and ineligible children in considering cochlear implants. METHODS: Surveys were obtained from 83 hearing parents of deaf children. A subset of 50 parents also underwent semi-structured interviews. Nine hypothetical outcomes, ranging from mainstream success to poor mainstream outcome were created to measure parents' overall preferences and preference for specific outcomes for their child who is deaf. RESULTS: Among parents of eligible children (n = 50), approximately 2/3 considered implantation (n = 33). The other 1/3 did not consider implantation. Parents who were eligible but did not consider implantation placed significantly lower priority on mainstream success over bilingual success (P < 0.03), and on the child's ability to speak versus sign (P < 0.02). They also showed significantly higher concerns on the cost of services in general and on the availability of resources offered at the local school district (both P > 0.05). Parents of ineligible children (n = 30) rarely considered implantation, even if they showed similar aspirations in mainstream outcomes (P = 0.003). Semi-structured interview data supported these findings. CONCLUSIONS: The decision to consider cochlear implantation is strongly influenced by the eligibility and by professionals' recommendations. However, for some parents, the decision goes beyond eligibility and is determined by parental preferences, goals, values, and beliefs. This highlights the importance of careful audiologic evaluation and professionals' awareness of and sensitivity to parental goals, values, and beliefs in evaluating the child's candidacy.     

The age of diagnosis of sensorineural hearing impairment in children

Objective: To identify factors responsible for delays in diagnosis and treatment of pediatric sensorineural hearing impairment (SNHI), and to assess the thoroughness of medical evaluation in these children. Design: Retrospective analysis. Setting: State-supported school for the deaf. Patients and other participants: 291 children with SNHI, the vast majority of whom are profoundly hearing impaired. Data were collected from the school's database, individual student records, and a parental questionnaire. Main outcome measures: (1) The age of diagnosis and treatment of SNHI; (2) factors leading to a delay in diagnosis; (3) current medical evaluations used to determine the etiology of SNHI; and (4) the level of parental satisfaction with the evaluation process. Results: Many children with SNHI experience delays in diagnosis from the time of first suspicion of hearing loss. Children with a risk factor for SNHI are diagnosed no earlier than children without a risk factor. Caucasian children are diagnosed significantly earlier than either Black or Hispanic children, regardless of socioeconomic status. Inconsistent medical evaluation ensues following the diagnosis of SNHI, and parental satisfaction with this process is low. Conclusions: The average age of diagnosis of SNHI remains unacceptably high. There exists a need to enhance physician awareness of childhood deafness and to develop guidelines for the medical evaluation in cases of pediatric SNHI. Lastly, the importance of parental concern regarding a child's hearing or language development must be re-emphasized.     

Hearing-impaired children in the United Kingdom, IV: cost-effectiveness of pediatric cochlear implantation

OBJECTIVE: To estimate the cost-effectiveness of pediatric cochlear implantation by conducting a cost-utility analysis from a societal perspective. DESIGN: In a cross-sectional survey, the parents of a representative sample of hearing-impaired children assessed the health utility of their child using a revised version of the Health Utilities Index Mark III questionnaire. Linear regression was used to estimate the gain in health utility associated with implantation while controlling for eight potentially confounding variables: average (4-frequency, unaided, preoperative) hearing level (AHL), age at onset of hearing-impairment, age, gender, number of additional disabilities, parental occupational skill level, ethnicity, and parental hearing status. The gain in health utility was accumulated to estimate the number of quality-adjusted life years (QALYs) that would be gained from implantation over 15 yr and over a child's lifetime. The incremental societal cost of implantation, calculated in euros at 2001/2 levels, was estimated by summing the incremental costs of implantation that are incurred in the health sector, in the education sector, and by the child's family. The cost-effectiveness of cochlear implantation was estimated by calculating the incremental societal cost per QALY gained and was compared with an upper limit of acceptability of 50,000 euros per QALY. RESULTS: The parents of 403 implanted children, and 1863 nonimplanted children, completed the health utility questionnaire. Higher health utility was associated with a more favorable AHL, an older age at onset of hearing impairment, female gender, having fewer additional disabilities, having parents with a greater occupational skill level, white ethnicity, and implantation. The gain in health utility associated with implantation was estimated to be higher for children with a worse preoperative AHL and who were implanted when younger. Over 15 yr, for a child implanted at age 6 with a preoperative loss of 115 dB, 2.23 QALYs were estimated to be gained, compared with a mean incremental societal cost of 57,359 euros, yielding a mean cost per QALY of 25,629 euros. Cost-effectiveness was more favorable: (1) when estimated over a child's lifetime rather than 15 yr, (2) for children with a worse preoperative AHL, and (3) for children who were implanted when younger. CONCLUSIONS: The mean cost of gaining a QALY for the children in the present sample falls within acceptable limits. The strategy of giving highest priority for implantation to children with the greatest loss of hearing, and who are younger, maximizes benefit for a given cost.     

Hearing screening--aspects of epidemiology and identification of hearing impaired children

Mass screening of hearing in children is based on the concept of secondary prevention. In recognition of the importance of an early identification and intervention in children with congenital or early-acquired (i.e. neonatal period) hearing disability, numerous hearing screening programs have been introduced throughout the world. The devastating consequences of a congenital/early acquired hearing disability upon the speech, language, and social development of a child, and the estimated prevalence rates of at least 1-1.5/1000 live births of congenital permanent hearing impairment, represent an important health problem. The increase in the estimated prevalence of permanent hearing impairment in childhood, reaching at least 3.6-8.2% of live births at 5-9 years of age further emphasizes the importance of the problem. The delayed identification of children with congenital/early acquired hearing disability should result in the implementation of universal neonatal hearing screening, and the negative impact on the learning processes during school age from hearing impairment acquired throughout childhood seems to justify the introduction or maintenance of a hearing screening at school entrance. Implementation of efficient hearing screening programs throughout the neonatal period, infancy, or childhood should result in secondary prevention of this important health problem.     

A questionnaire-based analysis of parental perspectives on pediatric cochlear implant (CI) re/habilitation services: a pilot study from a developing CI service in India

Objective: To study parental perspectives on re/habilitation services offered for pediatric cochlear implant (CI) users at a non-profit organization in India.

Methodology: A non-standardized questionnaire comprising 46 items was created to understand perspectives of parents of pediatric CI users. Questions were designed to examine re/habilitation services from the angles of service delivery, parental stress levels, reasons for delay in obtaining services, sources of emotional support, concerns, and fears during each stage starting from diagnosis of hearing loss to CI surgery, re/habilitation services and parents’ views of their children post-CI. The questionnaire was posed to 30 parents and responses were recorded and coded.

Results and discussion: Qualitative and quantitative analyses based on parents’ responses identified several factors that significantly influenced parental perspectives during each stage. The major factors delaying the decision to go for CI included a fear of surgery, lack of funds for CI and the subsequent re/habilitation process, and limited knowledge. Key concerns were the child’s academic performance and social acceptance. Familial support played an important role during each stage. A significant reduction in the parental stress levels was observed following CI surgery. Parents indicated that local support for therapy, financial assistance and better guidance at each stage would substantially help in lowering stress levels.

Conclusions: The parental perspectives analyzed in this study can be utilized towards improving the quality of service delivery in terms of parental satisfaction and outcomes post-CI. Efforts should be taken to improve parental awareness, funding options, and access to re/habilitation services and social networks connecting similar parents.     

Ten-year outcome of newborn hearing screening in Austria

OBJECTIVE: Current health care standards recommend that congenital hearing loss be confirmed before age three months and intervened for before age six months. This study evaluated to what extent the Austrian universal neonatal hearing screening (UNHS) program achieves this goal. The Austrian UNHS program is a hospital-based, two-stage screen based on transient oto-acoustic emissions, as promoted in 1995 in a position paper of the Austrian ENT Society. METHODS: Retrospective chart review and data analysis. All Austrian institutions engaged in the diagnosis and treatment of childhood hearing loss were requested to provide their data on children with permanent congenital sensorineural hearing impairment registered since 1990. Children who had undergone hearing screening, were compared to those who had not. Main outcome measures were age at confirmation of and age at intervention for the hearing loss. In each group, the percentage of children, whose hearing loss was confirmed by age three months, and intervened for by age six months, was determined. RESULTS: Data from 321 hearing-impaired children were useable. Of these children, 167 were screened and 154 were not. At age three months, a hearing loss was diagnosed in 35% of screened children, but in only 2% of unscreened. These percentages rose to 69% and 6%, respectively, at age six months and to 81% and 12%, respectively, at age one year. Intervention mostly started within less than one month after diagnosis. At age six months, 61% of screened children, but only 4% of unscreened children, had undergone intervention. CONCLUSIONS: Hearing screening enormously increases the number of early-detected children. However, in quite a few screened children hearing loss is neither confirmed within three months after birth, nor intervened for within six months after birth. Reasons for the delay must be paid attention in order to warrant that UNHS can be as effective as possible.     

A study of knowledge,attitude and practices about otitis media in parents in Navi-Mumbai

Although otitis media poses a serious health risk in developing countries,being a frequent occurrence in children below five years of age,parental awareness and practices about otitis media have not been adequately researched.Present cross-sectional study was undertaken in Navi Mumbai schools,from October 2019 to December 2019,wherein parents with children<5 years of age answered a questionnaire which gathered data on their knowledge,attitude and practices about otitis media in their wards.Chi-square tests,Cramer’s V were used to study association between gender,age-group and education of parents with their knowledge,practice and attitude about otitis media.Out of 425 valid responses,overall most parents displayed adequate knowledge(77%),positive attitude(61%)and good care-seeking practices(70%).There was a positive correlation of knowledge and practice with level of education.This study shows acceptable levels of knowledge,attitude and practices in parents about otitis media.Parents who did not seek treatment from health centre attributed the behaviour to poverty,ignorance and lack of health insurance.The positive correlation of knowledge and practices with level of education highlights the importance of role of education in modifying parental awareness and care seeking behaviour.Our findings call for a need to further strengthen community-based healthcare and improve parental confidence in healthcare services for early detection and adequate treatment of otitis media.     

The needs of hearing impaired children's parents who attend to auditory verbal therapy-counseling program

OBJECTIVE: Exploring the information and support needs of parents with hearing impairment in habilitation process. The effects of variables such as duration of hearing aid use and habilitation (duration of intervention) and the number of hearing impaired individuals in family are also considered during the evaluation. METHODS: Sixty-five parents of children between 24 and 348 months of age (median: 80) participated in this study by returning the completed in The Family Needs Survey. Age at diagnosis of deafness varied from 1 to 84 months of age (median: 16). The duration of hearing aid use was 8-252 months (median: 24) and the duration of intervention was 2-176 months (median: 36). In view of the fact that the family dynamics might have effects on the type and amount of the needs of parents, the number of siblings (none, two or more siblings) and the presence of hearing impaired individuals apart from their child was also explored. RESULTS: The parental needs with regard to different topics such as general information, hearing loss, communication-services and educational resources, family and social support, childcare and community services, financial were evaluated separately. The needs of parents participating in a multi-dimensional Auditory-Verbal intervention program differed by their preferential demands. The duration of intervention was found significantly correlated with the amount of information needs related with other conditions their children may have, explaining their children's hearing problem to others, locating good baby-sitters and day-care programs for their children and transportation (p< or =0.05). It was also found that the long-termed continuing intervention generates additional psychotherapeutic, social and financial needs for the parents. No significant correlation was found between hearing impaired individuals existence with the type and amount of family needs (p>0.05). CONCLUSION: These findings support the positive effect of persistent and long-term Auditory-Verbal therapy and Counseling approach which incorporates parents as inalienable members in all rehabilitation process. Creating an adequate and appropriate educational environment by considering individualized needs and family dynamics in a long term and persistent Auditory-Verbal therapy and Counseling approach are all equally important. In addition to a team approach to management, with parents taking a major role in the habilitation process, and all these will lead to a much better outcome.     

Parents' needs following identification of childhood hearing loss

PURPOSE: Appropriate support for families of children diagnosed with hearing impairment may have a direct impact on the success of early hearing detection and intervention programs in reducing the negative effects of permanent hearing loss. We conducted a qualitative study to explore parents' needs after learning of their child's hearing loss to better understand the important components of service delivery from families' perspectives. METHOD: Semistructured interviews were conducted with 17 families (21 parents) of preschool children in 4 centers in Ontario, Canada. Parents of children identified by neonatal screening as well as those identified through traditional referral routes participated. We asked parents to share their perceptions of the strengths and gaps in the care system. RESULTS: Although the majority of parents were satisfied with the range and quality of audiology and therapy services available, they identified gaps in the areas of service coordination, availability of information, and the integration of social service and parent support into the system. Access to audiology services appears to have been facilitated for children who were systematically screened. CONCLUSIONS: The findings provide insights into the services most valued by families. These findings highlight the importance of eliciting parents' perspectives in designing optimal care models for children and families.     

Hörstörung im Kindesalter

Background

The aim of this study was to analyze the sensitivity of suspicion preceding the diagnosis of a child’s hearing impairment (HI).

Methods

Parents of children with confirmed HI were questioned in order to evaluate the age and the initiators of the suspicion of congenital or early HI. A total of 185/199 parents provided information on their children aged from 1 to 120 months.

Results

Parents showed more frequent correct suspicion/detection of HI than professionals. In 46% of all cases, the parents were the first to suspect HI (in 20% of all children with conductive losses and 52% of all sensorineural HIs). The first suspicion was raised by pediatricians in 25%, by otorhinolaryngologists and by school entrance examination each with 7%, and by obstetricians in 6% of cases. There was an average delay of 13.2 months from parental suspicion to a valid diagnosis of bilateral sensorineural HI (mean diagnosis age 50.9 months±30.3SD). Individual hearing aids were accordingly fitted late (mean aiding age 51.5 months±30.7).

Conclusions

These findings support the use of parental observation as part of the early detection of HI until universal newborn hearing screening can be implemented.     

Evaluation of the use of a questionnaire to detect hearing loss in Kenyan pre-school children

In developing countries, there is a lack of trained personnel and testing equipment to facilitate the early detection of hearing impairment in children. A questionnaire offers a low cost option and the value of this for detecting hearing impairment in pre-school children was determined in several districts in Kenya. The questionnaire was completed by either teachers, parents/carers or community nurses. The children were subsequently tested using pure tone audiometry and visual examination of the ear by ENT Clinical Officers, who were not given prior access to the results of the questionnaire. A total of 757 (88%) questionnaires were completed. Of the 735 children, who could be tested using pure tone audiometry, four were found to have a unilateral hearing impairment and one was detected by the questionnaire. A total of 13 children had a bilateral hearing impairment >40 dB HL. All were detected using the questionnaire. There were eight males and five females with ages ranging from 4.2 to 6.9 years, mean age 5.7 years and median age 5.8 years. Eight had a sensorineural hearing impairment and two a mixed hearing impairment. Three of the children with a sensorineural hearing loss had a family history of hearing impairment. No question detected all children with a hearing impairment and some questions were more discerning than others. There was 100% sensitivity for the questionnaire when a hearing loss of >40 dB was considered, but specificity was lower at 75%. Negative predictive value was 100%, but the positive predictive value was low, 6.75%. It was concluded that a questionnaire of this nature could be usefully applied at Primary Health Care level for detecting hearing impairment at the pre-school stage. There would be need for services available for diagnosis, treatment and habilitation before a screening programme was introduced.     

Etiological diagnosis of bilateral, sensorineural hearing impairment in a pediatric Greek population

Early diagnosis, evaluation and treatment of childhood deafness are essential for a child's normal growth. Etiological diagnosis of hearing loss makes prevention, family scheduling and more effective therapy feasible goals. Etiological assessment of sensorineural deafness still remains difficult although recently with the progress of genetics it has become more efficient. In this retrospective study, the etiology of bilateral, sensorineural hearing loss with indication for hearing aids has been studied in 153 hearing impaired children. Etiological diagnosis was based on family and patient record, physical, audiological and laboratory examinations. Among the 94 children who completed the diagnostic protocol etiological groups revealed the following distribution: non-hereditary acquired hearing impairment was present in 36 children (38%) and hereditary was present in 44 (47%) children. The etiology remained unknown in 14 (15%) children. Non-syndromic autosomal dominant type accounted for 13 (29% of hereditary hearing loss) children, non-syndromic autosomal recessive type for 21 (48%) children and syndromic deafness for 10 (23%) children. Modern diagnostic methods, such as genetic testing, help diminish the number of cases with hearing impairment of unknown etiology, for the benefit of children who receive early and appropriate medical, audiologic, genetic and educational counseling based on the etiology of their hearing loss.     

婴幼儿有意义听觉整合量表对人工耳蜗植入幼儿康复效果的评估

目的研究婴幼儿有意义听觉整合量表(infant-toddler meaningful auditory integration scale,IT-MAIS)对早期植入人工耳蜗(cochlear implant,CI)幼儿康复效果评估的价值。方法使用ITMAIS对开机年龄在18个月以内的12名人工耳蜗植入幼儿(CI组)于开机时及开机后3、6、12个月分别进行评估,并将其得分与同龄健听幼儿(健听组)得分比较。结果开机时CI组的听觉发育总体能力、声音察觉能力和声音识别能力得分分别为10.8%±7.6%、16.6%±12.6%、1.1%±2.4%,开机后1年时分别为78.0%±11.2%、76.6%±16.1%、80.0%±19.8%。从开机时到开机后1年内,CI组ITMAIS得分(即其对言语声的察觉和识别能力)值升高迅速且发展速度超过同龄健听幼儿,在开机1年时ITMAIS得分已达健听儿童水平。结论早期植入CI幼儿随着年龄增长,其听觉发育能力可接近同龄健听幼儿,ITMAIS可简单、有效地评估其初期康复效果。     

Universal newborn hearing screening program in Bulgaria

The design of a Universal Newborn Hearing Screening Program (UNHSP) depends on many factors unique to each hospital. The goal of any UNHSP is to perform a valid hearing screening on all newborn infants prior to hospital discharge. Ultimately hearing screening of all infants should decrease the age at which intervention is initiated in these who require it. It is clear that there is no "one" model for UNHSPs. Each program must carefully consider what type and severity of hearing loss it wishes to identify. Then, based on available screening tools, program philosophy, prior experience, personnel, typical maternity length of stay, etc., an appropriate protocol must be developed. We present our protocol for detection and confirmation of hearing loss, and for habilitation of deaf children. For detection the hearing loss we used the automated auditory brainstem response (ABR) delivery system (A-ABR), and we confirm this with conventional non-automated ABR delivery system (BERA). The healthy babies we screen after 6h of age using a simultaneous 35-dB nHL screening option available on the Newborn Hearing Screener ALGO-2. The neonatal intensive care unit (NICU) babies we screen prior to discharge using all options of the ALGO-2. The "refer" ALGO-2 results are immediately retested. Infants in need of an outpatient screen are recalled at age 3-4 weeks. The diagnosis "hearing loss" is determinate only by BERA and the neonatal hearing screening is the first part of program of habilitation of hearing-impaired children. The cost for UNHSP in Bulgaria is 1407 euro per case identified.     

Effects of childhood hearing loss on organization of semantic memory: typicality and relatedness

OBJECTIVE: The purpose of this research was to study how early childhood hearing loss affects development of concepts and categories, aspects of semantic knowledge that allow us to group and make inferences about objects with common properties, such as dogs versus cats. We assessed category typicality and out-of-category relatedness effects. The typicality effect refers to performance advantage (faster reaction times, fewer errors) for objects with a higher number of a category's characteristic properties; the out-of-category relatedness effect refers to performance disadvantage (slower reaction times and more errors) for out-of-category objects that share some properties with category members. DESIGN: We applied a new children's speeded category-verification task (vote "yes" if the pictured object is clothing). Stimuli were pictures of typical and atypical category objects (e.g., pants, glove) and related and unrelated out-of-category objects (e.g., necklace, soup). Participants were 30 children with hearing impairment (HI) who were considered successful hearing aid users and who attended regular classes (mainstreamed) with some support services. Ages ranged from 5 to 15 yr (mean = 10 yr 8 mo). Results were related to normative data from . RESULTS: Typical objects consistently showed preferential processing (faster reaction times, fewer errors), and related out-of-category objects consistently showed the converse. Overall, results between HI and normative groups exhibited striking similarity. Variation in speed of classification was influenced primarily by age and age-related competencies, such as vocabulary skill. Audiological status, however, independently influenced performance to a lesser extent, with positive responses becoming faster as degree of hearing loss decreased and negative responses becoming faster as age of identification/amplification/education decreased. There were few errors overall. CONCLUSIONS: The presence of a typicality effect indicates that 1) the structure of conceptual representations for at least one category in the HI group was based on characteristic properties with an uneven distribution among members, and 2) typical objects with a higher number of characteristic properties were more easily accessed and/or retrieved. The presence of a relatedness effect indicates that the structure of representational knowledge in the HI group allowed them to appreciate semantic properties and understand that properties may be shared between categories. Speculations linked the association 1) between positive responses and degree of hearing loss to an increase in the quality, accessibility, and retrievability of conceptual representations with better hearing; and 2) between negative responses and age of identification/amplification/education to an improvement in effortful, postretrieval decision-making proficiencies with more schooling and amplified auditory experience. This research establishes the value of our new approach to assessing the organization of semantic memory in children with HI.     

The effectiveness of screening programs based on high-risk characteristics in early identification of hearing impairment.

Prompt identification of educationally significant hearing loss is yet an unattained goal. However, there is some evidence that the ability to identify and diagnose hearing loss at an early age has been significantly improved through the use of carefully designed screening protocols such as birth certificate-based high-risk registries. To evaluate the efficiency of birth certificate-based screening programs, 70 parents and guardians of 6- to 9-yr-old children with significant sensorineural losses were surveyed regarding their child's identification history. Each of these children was born in the state during the time a birth certificate-based screening program was in full operation. Results indicate that children with at least one risk factor for hearing impairment were identified an average of 7.7 mo earlier than children with no risk history. However, only 50% of the children with sensorineural hearing losses exhibited any of the risk factors and a significant number of children with risk factors were missed by the system. Had admission to a neonatal intensive care unit been considered a risk factor, 63% of the children would have exhibited at least one risk factor. More extensive implementation of high-risk registries in conjunction with more widespread education of parents and primary care providers regarding early behavioral indicators of hearing loss, procedures for referral, and appropriate intervention and management services needs to be considered.     

Perception of hearing impairment and the willingness to use hearing aids in an elderly population in southern Taiwan: A community-based study

Objectives: To estimate the prevalence and severity of hearing impairment (HI), the self-perception of HI, and the willingness to use a hearing aid (HA) in the elderly population in southern Taiwan. Design: This community-based study was performed in a metropolitan hospital. A questionnaire about the perception of HI and the willingness to use a HA was used. The severity of HI in speech-frequency pure-tone average (PTA) was evaluated. The associations between sex, age, severity of HI, self-perception of HI, and the willingness to use a HA were analysed. Study sample: A total of 599 volunteers were recruited from the health management center; 324 (54.1%) males and 275 (45.9%) females, who were 65 years of age or older. Results: The prevalence of HI?>25 dBHL in the elderly was 78%. The predicted levels for elderly persons to perceive HI and hearing difficulties were 34.38 dBHL and 54.38 dBHL, respectively. Males and younger participants were more willing to use HA. The primary reasons for refusing HA use were discomfort (25.1%) and a self-perception that the HA was unnecessary (19.7%). Conclusions: The prevalence of HI was high among the elderly population in southern Taiwan. Age and sex were the determinants of HA use.     

Unilateral sensorineural hearing impairment in childhood: analysis of 31 consecutive cases

This report presents the selected variables of a consecutive series of 1-10-year-old children with unilateral sensorineural hearing impairment (USNHI; defined as four-frequency pure-tone audiometry (PTA) 0.5, 1, 2, 4 kHz > or = 30 dB HL): severity, presumptive aetiologies, age at ascertainment, hearing aid acceptance, non-verbal intelligence, time of occurrence of first words and two-word utterances, size of vocabulary, and linguistic achievements. During a 4-year-period in a defined geographical area of Germany (Lower Saxony), 31 children were carefully audiologically and psychologically examined at the Department of Phoniatrics/Pedaudiology, University of G?ttingen. All children were fitted unilaterally with a hearing aid. The HI was mild in 3%, moderate in 23%, severe in 29% and profound in 45% of the cases. The hearing defect was congenital in 23%, postnatally acquired in 16%, and of unknown onset in 61% of the cases. The affected side was the right in 17 cases, and the left in 14. The mean age at ascertainment was 65.5 months (SD 25.5; median 70). According to parental judgement, nearly 81% of the children had accepted their hearing aid (based on the daily/weekly time for which the child was using the hearing aid). On average, the children scored in the normal range in standardized non-verbal intelligence tests. They were delayed in using two-word phrases (on average for 5 months), but not in using their first words. However, children with USNHI experienced no more difficulty on standardized linguistic tasks than normally hearing subjects of the same age and gender.