Although the need for intact hearing to develop communication, and for early detection of hearing loss to minimize its adverse effects, is well documented and is addressed by school screening programs in the United States, in Mexico hearing screening programs are practically nonexistent and the prevalence of hearing loss among schoolage children is unknown. This study was primarily conducted to determine the prevalence of middle ear pathology and to assess the hearing status of 590 first grade public school children in school zone 34 in Queretaro, Mexico. A secondary purpose was to develop a hearing conservation model for public school-age children in Mexico. The children screened included 298 females and 292 males of middle low, and low socioeconomic status, with an average age of 6.5 years (range 5 - 12). ASHA's 1985/1990 guidelines for hearing screening were followed to implement the screening process that included visual inspection, acoustic immittance measures and identification audiometry. A Type A tympanogram with measures within a +50 and -200 daPa range for middle ear pressure, 0.4 to 1.4 ml range for static admittance, 0.4 to 1.5 ml range for equivalent ear canal volume and acoustic reflex present was considered normal for immittance screening. The cutoff criterion for responses to pure-tone stimuli at 1,000, 2,000 and 4,000 Hz was set at 20 dB HL. Results indicate that on visual inspection excessive dark colored cerumen was observed in 108 (9.2%) screened ears affecting 86 (14.6%) screened children in at least one ear. On immittance and pure tone screening 349 (59.2%) children had all measures within normal limits; 139 (23.6%) children failed one immittance measure only; 52 (8.8%) failed immittance screening; 9 (1.5%) failed pure-tone screening and 41 (6.9%) failed both immittance and pure-tone screening. A description of the hearing conservation program that was developed is included. Most findings are consistent with data reported in other studies, however the number of children with mild to moderate sensorineural hearing losses is below that expected from the literature. Replication of this study in other Mexican populations, follow up research on the impact of early detection, and the short and long term impact of the hearing conservation program implemented for school-age children from zone 34 is recommended.

Background: Fourteen million new cancer cases are reported annually and up to 10% of those involve children below 15 years. Cisplatin, a commonly used anti-cancer drug for its high success rate, is associated with ototoxicity. Cisplatin-induced ototoxicity is characterised by permanent bilateral severe-to-profound hearing loss and hearing loss, when occurring during childhood, can impact negatively on communication development, scholastic performance and quality-of-life. Aims: To determine the prevalence of cisplatin-induced ototoxicity in paediatric oncology patients as well as determining the best paediatric ototoxicity grading scale with regards to early identification and making treatment recommendations in line with the set standards. Study Design: Retrospective records review of paediatric oncology patients who underwent cisplatin-based chemotherapy from January 2016 to December 2017. Data collected included demographic, cisplatin treatment, audiometric and distortion products otoacoustic emissions [DPOAEs] information. The IBM SPSS was used for data analysis. Results: A total of 58 records were reviewed. Ototoxic hearing loss was found in 39 (80%) of the patients whose records were reviewed and majority (65%) presented with a bilateral moderate-to-severe sensorineural hearing loss. DPOAEs were absent in 32 (67%) patients. Younger age (200mg/m2 ) were associated with higher incidences of ototoxicity (p< 10 years), black ethnicity, female gender and higher cumulative dose (<200mg/m2 ) were associated with higher incidences of ototoxicity (p< 0.05). The SIOP scale identified more subjects with hearing loss early (at 1 month testing) and made recommendations about hearing amplification more consistent with the American Academy of Audiology (AAA) Protocol. Conclusion(s): This study found a high prevalence (80%) of cisplatin-induced ototoxicity, which may leave long-term negative impacts on development and quality-of-life. The SIOP scale performed better in early identification of ototoxicity and making treatment recommendations more consistent with the AAA Protocol. Consequently, this study recommends the development of paediatric-specific monitoring protocols including the use of extended high-frequency audiometry. Additionally, these findings highlight the need for experimental studies in oto-protection; to prevent the negative impacts of hearing loss in this vulnerable population group.

Thesis (PH.D.) -- Syracuse University, 2007. / "Publication number AAT 3266286"

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 5 uppsatser.

Thesis (PH.D.) -- Syracuse University, 2006 / "Publication number AAT 3251788."

A model of the human peripheral auditory system is presented which is based on the anatomical and physiological data and mathematical presentations of the principal workers in the field. The physiological data come from human cadavers and cats in vivo. Since not all sections of the ear are understood with equal certainty, not all sections of the model are presented with the same degree of confidence. The model is used as a tool in carrying out experiments relating psychological performance with the underlying mechanisms. One interesting example is the localization of the mechanism producing combination tones within the human ear. Since the model is also capable of producing combination tones with all but one nonlinearity within the model eliminated, the primary auditory neuron is shown to be the nonlinearity causing the formation of combination tones. A plausible theory for this effect is presented and compared to psychological data. The model was programmed in Fortran IV and run on the IBM 360/67. Because of better I/O and display facilities for acoustic input, it is desirable to implement the model on a smaller computer such as the PDP-12. The large amount of storage for the present model prohibits this but simplifications are suggested so as to enable the implementation. The major discrepancy between the data produced by the model and physiological data results because the neural frequency selectivity of the model is inadequate. An inhibitory scheme to sharpen the selectivity is proposed. / Applied Science, Faculty of / Electrical and Computer Engineering, Department of / Graduate

Includes abstract. / Includes bibliographical references. / A descriptive survey research design was used to describe the auditory function of children with tuberculosis (TB) receiving ototoxic medication at Brooklyn Chest Hospital. A battery of audiologic tests (otoscopy, immittance, audiometry or OAE and AABR) were conducted on 29 children, aged 0 to 18 years, and the results were analysed using descriptive statistics and Generalized Linear Models. The results suggest that 55% of children had middle ear abnormality and 48% had hearing loss. The degree of hearing loss ranged from mild to profound in 41 % of the cases while 59% had hearing within the normal range with their loss restricted to high frequencies. No statistically significant associations were found between sex, duration of hospitalization, comorbid presentation of HIV and TB and middle ear abnormality.

Knowledge of the impact of a diagnosis of hearing loss in children on their caregivers and the nature of their relationships with professionals during this process is inadequate in South Africa. The purpose of this study was to understand the experiences and perceptions of caregivers of diagnosis of hearing loss in their children. A qualitative, retrospective, narrative inquiry research design was used. Participants who were purposefully selected included one couple and 12 caregivers in the Tshwane Metropolitan area. They were interviewed using an in-depth interview method. The narrative data was subjected to in-depth thematic analysis. Three themes emerged from the data: 1) The catastrophic emotional impact of diagnosis, 2) The good and the bad of professional interaction, 3) Imbalanced relationships, strained resources and resulting identity threats. The discussion focused on the deeply emotional nature of the participants' experiences and the changes that ensued during and following the diagnosis of hearing loss in their relationship with their child and the wider community and how this impacted on their sense of identity. The study concluded that diagnosis has extensive, pervasive and disruptive effects on caregivers and that the professional plays an important role in shaping that experience. It thus makes recommendations for a humanistic, family-centred, paediatric audiology practice.

Aims and Objectives. This study aimed to describe auditory characteristics and balance function in patients with diabetes between 18-55 years of age as well as determine the association between patients' auditory and balance function with diabetes characteristics (type, duration and control). Background. Diabetes is one of the most prevalent non-communicable diseases worldwide with approximately 422 million people diagnosed globally. This number is projected to rise to 642 million by 2040 if no appropriate interventions are implemented to reverse the rise in the number of people with diabetes. South Africa has the second highest diabetes prevalence in Africa (after Nigeria) with 2.6 million cases. A rise in diabetes prevalence should be a concern for audiologists with increasing literature linking diabetes with the risk of acquiring hearing and balance disorders. However, there is currently a lack of research done in South Africa to investigate auditory and balance disorders in patients with diabetes. Therefore, the current study sought to investigate auditory characteristics and balance function in South African patients diagnosed with diabetes. It is anticipated that the study findings will yield evidence that will highlight the role of an audiologist in the clinical management of patients with diabetes. Research Design. The study utilised an observational cross-sectional matched groups design with a cohort (patients with diabetes) and control (volunteers without diabetes) group of participants. Participants were recruited from a Primary Health Care clinic in Polokwane, Limpopo using purposive and convenience sampling for the cohort and control group respectively. Methodology. Several methods were used to collect data pertinent to this study. These included case history interview and a medical folder review to obtain information related to participants' diabetes status. Furthermore, all participants underwent the following assessments: otoscopy, pure tone audiometry, diagnostic distortion product otoacoustic emissions (DPOAE), vision screening, peripheral neuropathy screening, Dynamic Gait Index test (DGI) and the Modified Clinical Test of Sensory Integration (MCTSIB). Data were analyzed using both descriptive and inferential statistical tests. Results. A total of 192 participants took part in this study; 110 in the cohort and 82 in the control group. There were similar distributions of gender in both groups with the following age distributions (in years) for each group; cohort; median =46, range =20-55, control; median =43, range =21-55. Pure tone audiometry assessments showed a significantly higher prevalence of hearing loss in the cohort (55%) when compared to the control (20%) group (p < .001). Participant age, gender and diabetes duration were associated with the likelihood of having hearing loss (age: odds ratio=2.90, 95% CI: 1.19-7.08, p=0.019; gender (male): odds ratio=.266, 95% CI: .104-.677, p=0.005; diabetes duration: odds ratio=1.12, 95% CI: 1.02-1.22, p=0.013). DPOAE assessments showed significantly higher percentages of abnormalities with signal to noise ratio (p < 0.01) and DPOAE level (p < 0.01) in the cohort compared to the control group. A significantly higher proportion (38%) of participants in the cohort group reported tinnitus when compared to 15% in the control (p < .001). Balance screening assessments with the DGI and the MCTSIB, showed significantly poorer performance in the cohort group than the control (DGI:, p < .001; MCTSIB: p < .001). Conclusion. Overall findings of this study showed that participants who were diagnosed with diabetes had a higher proportion of auditory and balance abnormalities when compared to those in the control group. Older age, male gender and longer duration since diabetes diagnosis were associated with a higher likelihood of having hearing loss. The findings of this study therefore suggest that auditory and balance dysfunction should be considered as comorbidities associated with diabetes. This study also highlighted the role of an audiologist in the managment of patients with diabetes with respect to early identification and management of auditory and balance dysfunctions amongst these patients.

Hearing and vision loss in children pose significant academic, social, and developmental challenges. Currently, there are limited studies on dual sensory screening programmes. This study aimed to describe a dual sensory screening programme for school-aged children using mHealth technology facilitated by lay health workers (LHWs). During the duration of the programme, six LHWs (but only three LHWs were employed at any given time) were trained to provide hearing and vision screening using validated smartphone applications (apps) for hearing screening (hearScreen™), air conduction threshold audiometry (hearTest™) and vision screening (PEEK™ acuity) which was conducted between September 2017 to April 2019. LHWs evaluated children with a mean age of 6.0 years (0.9 SD) and 5.8 years (0.9 SD), for hearing and vision screening, respectively. Programme performance was evaluated, and logistic regression analysis was used to determine the effect of age, gender, and noise levels on hearing screening outcomes. Logistic regression analysis was also used to identify the effects of gender and age on vision acuity screening outcomes. A total of 4888 participants underwent the hearing screening (49.7% female) and 4933 underwent the vision screening (50.2% female). The duration of screenings was 105.1 seconds (+/-102.5 SD) for hearing screening and 111.0 seconds (+/- 60.5 SD) for vision screening. Overall, 1.6% of participants referred the hearing screening and 3.6% referred vision screening. Logistic regression showed that females were more likely to pass hearing screening (OR:1.61; 95% CI: 1.11-2.54) while older children were less likely to pass visual acuity screening [OR: (0.87, 95% CI:0.79-0.96). A third (32.5%) of referred cases followed up for air conduction threshold audiometry and one in four (25.1%) followed up for diagnostic vision testing. A high proportion of these cases were confirmed to have hearing (73.1%; 19/26) or vision loss (57.8%; 26/45). The logistic regression analysis showed that gender was a significant predictor for hearing screening outcomes and age was a significant predictor for vision screening outcomes. Exceeded permissible noise levels during hearing screening were minimal and did not significantly influence outcomes. Community-based smartphone sensory screening facilitated by LHWs provided hearing and vision services to schools in a low-income community. Those children who attended follow-up services and were identified with potential sensory deficits were referred to a secondary hospital or private facility for diagnostic testing. Follow-up rates were low but the screening programme was cost-effective. / Dissertation (MA)--University of Pretoria, 2020. / Speech-Language Pathology and Audiology / MA / Unrestricted