Distortion product otoacoustic emissions in children at school entry: A comparison with pure tone screening and tympanometry results

This study examined the test performance of distortion product otoacoustic emissions (DPOAEs) when used as a screening tool in the school setting. A total of 1003 children (mean age 6.2 years, SD = 0.4) were tested with pure-tone screening, tympanometry, and DPOAE assessment. Optimal DPOAE test performance was determined in comparison with pure-tone screening results using clinical decision analysis. The results showed hit rates of 0.86, 0.89, and 0.90, and false alarm rates of 0.52, 0.19, and 0.22 for criterion signal-to-noise ratio (SNR) values of 4, 5, and 11 dB at 1.1, 1.9, and 3.8 kHz respectively. DPOAE test performance was compromised at 1.1 kHz. In view of the different test performance characteristics across the frequencies, the use of a fixed SNR as a pass criterion for all frequencies in DPOAE assessments is not recommended. When compared to pure tone plus tympanometry results, the DPOAEs showed deterioration in test performance, suggesting that the use of DPOAEs alone might miss children with subtle middle ear dysfunction. However, when the results of a test protocol, which incorporates both DPOAEs and tympanometry, were used in comparison with the gold standard of pure-tone screening plus tympanometry, test performance was enhanced. In view of its high performance, the use of a protocol that includes both DPOAEs and tympanometry holds promise as a useful tool in the hearing screening of schoolchildren, including difficult-to-test children

Measuring parent satisfaction with a neonatal hearing screening program

The primary aim of the present study was to investigate parent satisfaction with a neonatal hearing screening program through use of a valid and reliable questionnaire developed for this purpose (Parent Satisfaction Questionnaire with Neonatal Hearing Screening Program; PSQ-NHSP). Eighty parents whose children had received hearing screening participated in this study. High levels of satisfaction were reported with more than 90% of parents satisfied with all aspects of the program. The PSQ-NHSP was analyzed for validity and reliability and demonstrated excellent internal consistency reliability (sigma = 0.94) and excellent test-retest reliability (rho = 0.97). Content validity of the PSQ-NHSP was partially established by reviewing available literature on parent satisfaction studies in other pediatric health-care service programs. Construct validity of the PSQ-NHSP was indicated by a significant positive relationship between overall satisfaction and the three specific dimensions in the questionnaire. The satisfaction questionnaire was found to be a useful instrument for identifying service shortfalls, and routine use of the PSQ-NHSP in other neonatal hearing screening programs is recommended

Follow-up in newborn hearing screening – a systematic review

Introduction The quality and efficiency of newborn hearing screening programs (NHS) rely heavily on appropriate follow-up. The Joint Committee on Infant Hearing recommends a follow-up rate of more than 95% of infants who fail the initial hearing screening. However, a 70% benchmark is considered to be more feasible. This high loss to follow-up (LTF) rate acts as a threat to the overall success of NHS programs. The objective of the study was to identify and examine the reported rates of LTF, attributed reasons for LTF and strategies undertaken to reduce LTF. Methods Using a systematic search, articles published between 2005 to December 2015 were identified from PubMed/Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Educational Resources Information Center (ERIC), Scopus, Ovid, ProQuest, and Cochrane Library. To be included in the review, the study should be exploring the loss to follow-up or drop-out rate in newborn hearing screening programs and be published in an indexed peer-reviewed journal in the English language. The main outcome measures were overall rate of LTF, factors leading to LTF and measures adopted to overcome LTF. Results 53 articles were short-listed for data extraction. Out of these, 27 were single-centre studies, 19 were multi-centre, 3 compared multiple databases, and 4 used survey-based methods. Overall LTF rates of 20% in single-centre and 21% in multiple-centre studies were observed. Educational disparity and lack of adequate knowledge among parents were associated with LTF. The most commonly used strategy to overcome LTF suggested by studies was the use of an adequate data management system. Conclusion This review is a novel attempt to explore the LTF among NHS studies, reasons for LTF and strategies to reduce LTF. This review can act as a basis for planning and execution of effective NHS programs

Early Detection and Intervention in Audiology

"Early hearing detection and intervention (EHDI) is the gold standard for any practising audiologist, and for families of infants and children with hearing impairment. Yet EHDI remains a significant challenge for Africa, and various initiatives are in place to address this gap in transferring policy into practice within the southern African context. Early Detection and Intervention in Audiology: An African Perspective aims to address the diversity of factors in southern Africa that presents unique challenges to teaching and research in this field. The South African government’s heightened focus on increasing access to health care, which includes ongoing Early Childhood Development (ECD) programmes, makes this an opportune time for establishing and documenting evidence-based research for current undergraduate and postgraduate students. Detailed case studies pay careful attention to contextual relevance and responsiveness to both identification and intervention in hearing impairment. With diverse contributions from local and international experts, but always with an African perspective, this textbook will be an essential resource for students, researchers and practitioners.

Early Detection and Intervention in Audiology

"Early hearing detection and intervention (EHDI) is the gold standard for any practising audiologist, and for families of infants and children with hearing impairment. Yet EHDI remains a significant challenge for Africa, and various initiatives are in place to address this gap in transferring policy into practice within the southern African context. Early Detection and Intervention in Audiology: An African Perspective aims to address the diversity of factors in southern Africa that presents unique challenges to teaching and research in this field. The South African government’s heightened focus on increasing access to health care, which includes ongoing Early Childhood Development (ECD) programmes, makes this an opportune time for establishing and documenting evidence-based research for current undergraduate and postgraduate students. Detailed case studies pay careful attention to contextual relevance and responsiveness to both identification and intervention in hearing impairment. With diverse contributions from local and international experts, but always with an African perspective, this textbook will be an essential resource for students, researchers and practitioners.

Counseling of families and children with hearing loss

In the case of permanent childhood hearing impairment, it is often assumed that the fitting of hearing aids along with commencement of early intervention will facilitate optimal language development. However, as noted by Kurtzer-White and Luterman (2003), the resolution of grief associated with the diagnosis, parent-child bonding, parental stress, parental emotional availability, and the child's sense of self have equally important roles to play. Although such should be essential considerations in all services for children with hearing loss, often it is found that little attention and resources are invested in these factors. Counseling may assist parents in dealing with their grief and promote the development of coping and problem-solving skills, thus affecting outcomes for children with hearing loss (Calderon & Greenburg, 1999; Kurtzer-White & Luterman, 2003; Yoshinaga-Itano & de Uzcategui, 2001). In fact, the literature indicates parental coping to be determined largely by how well they are able to deal with their feelings that are generated by the initial diagnosis and the overwhelming amount of information that usually accompanies it (Kurtzer-White & Luterman, 2003). This chapter will deal with both personal adjustment and informational counseling. Specifically, it will address the importance of self-awareness growth, the listening process, and the development of empathetic understanding. It will also explore the concept of nonfinite grief, discuss information priorities for families of children with hearing loss and provide useful suggestions for counseling of the children themselves. Ultimately, this chapter will assist and encourage pediatric audiologists to enhance their counseling skills