The purpose of this presentation is to describe the application of The International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY) (WHO, 2007) as a framework for international collaboration with the aim of translating an outcomes measure and to field test the clinical applicability and cultural validity thereof.

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Abstract is available through the XX IERASG Biennial Symposium.

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The incidence of DM is 9.6% in the USA with its prevalence increasing globally (NIDDKD, 2005). A common, but under-recognized complication of DM is hearing difficulty (~ 93%). However, the nature of this often sub-clinical dysfunction is still poorly understood. The aim of this study is to better understand DM-related hearing loss.

Self-assessment forms and diagnostic tests were used to assess benefits of a treatment program that addressed tinnitus and hyperacusis severity in a population of 30 veterans (29 males, 1female) between the ages of 43 and 79. Patients were enrolled in the treatment program for an average of 20.8 months (range=12-31 months). For the purposes of this study, tinnitus was defined as the subjective perception of a sound lacking an environmental correlate. Hyperacusis was defined as the over-sensitivity to an environmental sound present at a level that would not produce excessive loudness for individuals with normal hearing sensitivity. Treatment strategies included guided counseling regarding auditory and neurological mechanisms of tinnitus coupled with sound therapy designed to reduce the tinnitus disruption. Sound therapy instruments utilized by the subjects included hearing aids, cochlear implants, bedside noise generators, and near-level tinnitus maskers. The tinnitus handicap inventory (THI), self-assessment forms, and loudness discomfort level (LDL) testing were administered to assess benefit of the treatment program. Subjects were first interviewed using an interview form adapted from Jastreboff and Jastreboff, 1999. The THI was then administered in interview format to all patients. Initial sessions were approximately two hours in length. Follow-up sessions lasted approximately one hour. Most patients returned for at least three follow-up visits over the course of their treatment. The correlation between the patients hearing thresholds and the tinnitus handicap inventory (THI) score were poor, consistent with previous reports. Pre and post-testing with the THI indicated that 36.7% of the test subjects experienced significant improvement in tinnitus handicap. The total scores and all sub-scale scores on the THI showed statistically significant improvements. An analysis of the self-assessment forms revealed that 27% of the subjects experienced improvement with concentration, 27% experienced improvement with sleep, 36.7% experienced improvement with quiet recreational activities, and 23.3% experienced improvement with social activities. LDL testing was administered at the initial and post treatment sessions with twenty-two of the thirty subjects. LDL testing indicated that hyperacusis severity was reduced by 13.6% in the right ear and 4.6% in the left ear from the initial evaluation to the post treatment evaluation. Regarding test subject satisfaction with the treatment program, 93.3% expressed satisfaction, and 90% indicated they would be unhappy if asked to return their sound generating devices. Test subjects appeared to be satisfied with their overall experiences with the tinnitus treatment program. The clinical implications of these findings will be discussed.

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Purpose: Children with specific language impairment (SLI) lag behind children with typical language (TL) in their grammatical development, despite equivalent early exposure to recasts in conversation (M. E. Fey, T. E. Krulik, D. F. Loeb, & K. Proctor-Williams, 1999) and the ability to learn from recasts in intervention as quickly as do children with TL (K. E. Nelson, S. Camarata, J. Welsh, L. Butovsky, & M. Camarata, 1996). This experiment tested whether this apparent paradox could be attributed to variations in the density of recasts in conversation versus intervention. Method: Thirteen children (7–8 years of age) with SLI and 13 language-similar children (5–6 years of age) with TL were exposed to 3 recast densities of novel irregular past tense verbs (none, conversation-like, intervention-like) over 5 sessions. Outcomes were based on spontaneous conversational productions and a post-test probe. Results: As predicted, at conversation-like densities, children with TL more accurately produced the target verbs they heard in recasts than in nonrecast models (d = 0.58), children with SLI showed no differences, and children with TL produced the verbs more accurately than did children with SLI (d = 0.54). Contrary to expectations, at higher intervention-like recast densities, the SLI group did not improve their accuracy, and the TL group performances were significantly poorer (d = 0.47). Conclusion: At conversational levels, recasts facilitated greater verb learning than models alone but only in the TL group. Increasing recast density to the modest levels in this brief intervention experiment did not benefit children with SLI and led to poorer learning for children with TL. To optimize learning, efficiency of recast distribution as well as rate must be considered.