En 2010, plus de 200 000 personnes dans le monde en étaient équipées, dont plus de 10 000 en France (adultes et enfants). La technologie utilisée pour les premiers implants commercialisés au milieu des années 1980 a beaucoup évolué et l’implant cochléaire permet désormais à son utilisateur d’avoir accès à des caractéristiques acoustiques de plus en plus précises des sons de son environnement et notamment des sons de parole. Cependant, l’information auditive fournie par l’implant reste limitée, ce qui a pour conséquence des difficultés persistantes de production de certains sons de parole par l’utilisateur d’implant cochléaire, même après plusieurs années d’utilisation. Ces difficultés de production peuvent se traduire également par une intelligibilité moindre, et peuvent avoir des répercussions sur les relations familiales et sociales, en particulier chez l’enfant.Les études disponibles dans la littérature se concentrent sur les effets et les bénéfices à court-terme de l’implant cochléaire chez l’enfant, et il existe relativement peu d’études de production de parole chez l’enfant en âge scolaire, en particulier chez l’enfant francophone. L’objectif de ce travail est donc de proposer une évaluation des difficultés de production de plusieurs contrastes phonologiques chez l’enfant sourd, porteur d’implant cochléaire, plusieurs années après l’implantation cochléaire, et des facteurs qui influencent son intelligibilité.Dans le cadre de notre thèse, nous avons constitué un corpus de productions de parole de 13 enfants âgés de 6;6 à 10;7 ans, atteints de surdité pré- ou périlinguistique, ayant reçu un implant cochléaire entre 1;1 et 6;6 ans, et l’utilisant depuis plus d’un an et de 20 enfants normo-entendants appariés en âge chronologique (de 5;7 à 10;6 ans).Dans un premier temps, nous avons comparé les caractéristiques acoustiques des voyelles orales, des occlusives et des fricatives du français, ainsi que la réalisation de la coarticulation dans des séquences occlusive-voyelle par ces deux groupes d’enfants. Les résultats montrent une grande proximité entre les productions des enfants typiques et implantés, et certaines différences, par exemple sur les voyelles antérieures arrondies, les fricatives alvéolaires et les occlusives vélaires. Ces différences peuvent s’expliquer par les caractéristiques technologiques de l’implant et son usage par l’enfant, et révèlent également le poids des différents facteurs du développement phonologique : contraintes articulatoires, contraintes perceptives, caractéristiques de l’input langagier et de la langue maternelle.Dans un deuxième temps, nous avons élaboré une méthode d’évaluation perceptive de l’intelligibilité de la parole, que nous avons soumise à 9 auditeurs experts en parole pathologique et à 17 auditeurs naïfs, tous francophones. Notre étude perceptive d’intelligibilité met en évidence 1) une absence d’effet d’expertise sur le jugement d’intelligibilité puisque les notes données par les auditeurs experts et naïfs sont corrélées, 2) un effet de l’audition sur l’intelligibilité, puisque les enfants sourds porteurs d’implant cochléaire sont jugés moins intelligibles que les enfants normo-entendants, et 3) une meilleure intelligibilité chez les enfants implantés précocement (avant 20 mois) mais pas d’effet de la durée d’utilisation de l’implant cochléaire sur l’intelligibilité.Ce travail montre donc le bénéfice apporté par l’implant pour la communication orale, mais aussi l’existence de difficultés persistantes, qui doivent être prises en compte dans la rééducation et l’accompagnement familial, scolaire et social des enfants.Notre étude fournit en outre un ensemble de données de référence sur le développement phonologique tardif des enfants francophones, et un corpus de parole utilisable pour d’autres travaux de recherche sur le développement typique et pathologique. / As of 2010, cochlear implant has been used by over 200 000 persons (adults and children) worldwide and by 10 000 persons in France. Technology has largely improved since the first devices were put on the market in the 1980’s, and it now provides its user with more and more detailed acoustical information about the sounds of their environment in general, and about speech sounds in particular. However, perception with a cochlear implant remains limited, which leads to persisting difficulties in producing some speech sounds, even after several years of implant use. These difficulties in speech production can translate into a lower intelligibility, with effects on interactions with family and community members for its users, especially for children.A large body of studies in the literature focusses on short-term effects and gains of cochlear implant for young children and infants, but fewer studies in speech production in school-age children are available, especially in French-speaking children. The goal of this project is to assess the difficulties in the production of selected phonological contrasts in cochlear-implanted children, several years after cochlear implantation, and the factors influencing their intelligibility.For this thesis, we recorded thirteen 6;6-to-10;7 year old, pre- or perilinguistically deaf children wearing cochlear implants since they were 1;1 to 6;6 years old, with more than a year of use, and twenty normal-hearing age-matched children (chronological age ranging from 5;7 to 10;6 years).In a first experiment, we compared the acoustical characteristics of ten oral vowels, six stops and three fricatives of French. We also studied the realization of coarticulation in plosive-vowel sequences in these two groups of children.Our results show a high degree of similarity in typical and implant using children, and several differences, for example, for front rounded vowels, alveolar fricatives and velar stops. These differences can be explained by the implant’s technology and its use by the child. They also show the importance of several factors in phonological development: articulatory constraints, perceptual constraints, characteristics of language input and mother tongue.In a second experiment, we designed a method to perceptually assess the intelligibility of speech: 9 expert and 17 naïve French-speaking listeners participated in this experiment.Our perceptual assessment of intelligibility shows 1) no effect of expertise since grades given by expert and naïve listeners are correlated, 2) an effect of hearing level on intelligibility since cochlear-implanted children are less intelligible than their normal-hearing peers, and 3) a better intelligibility in early implanted children (before 20 months) but no effect of duration of implant use on intelligibility.This work emphasizes the benefits for oral communication provided by cochlear implants, but also the remaining difficulties, that need to be taken into acount for rehabilitation and support from the child’s family, school and society.Our study also provides both reference data on late stages of phonological development in French-speaking children, and a corpus of speech production which can be used for further research on typical and pathological speech development.

Bakgrund: Goda sociala relationer är i viss mån grundläggande för ungdomars identitetsutveckling. Utveckling av deras sociala förmågor har även positiva effekter på deras psykiska hälsa. För ungdomar med hörselnedsättning kan sociala relationer bli svåra eftersom de lever i ett samhälle där hörande kommunicerar med talad svenska och döva kommunicerar med svenskt teckenspråk. Ungdomar med hörselnedsättning har inte samma förutsättningar som hörande och det kan därför vara svårt för dem att hänga med i sociala samspel och skapa sociala relationer till andra. Om ungdomar med hörselnedsättning inte kan teckenspråk har de inte heller förutsättningar för att hänga med i det sociala samspelet som finns i dövsamhället. Den teoretiska inramningen för studien är James Marcias teori om identitetsutveckling och socialkonstruktionistisk teori. Syfte: Studiens syfte är att undersöka hur ungdomar med hörselnedsättning upplever sin psykosociala hälsa utifrån sina sociala relationer och hur de påverkar deras möjligheter till identitetsutveckling. Metod: Kvalitativ metod användes i studien och data samlades in med nio semistrukturerade intervjuer med ungdomar med hörselnedsättning i åldrarna 12–16 år. Resultatet har analyserats med kvalitativ innehållsanalys. Resultat och slutsatser: Under analysen framkom två kategorier; kompisar är viktiga men det är svårt och kommunikation är bra men den fungerar inte alltid. Ungdomarna upplevde att de hade kompisar men att de fanns i skolan och att de inte umgicks med dem på fritiden. De berättade också om hur kommunikationen påverkade deras möjligheter att kunna hänga med i det sociala samspelet. Ungdomarna undvek vissa situationer och höll sig tillbaka på grund av att de inte hörde allt som sades vilket de upplevde som pinsamt, jobbigt eller att de såg dumma ut. På grund av olika kommunikationssätt kan ungdomar med hörselnedsättning bli begränsade och få mindre möjligheter till sociala relationer och på så sätt kan de ges mindre utrymme till utveckling av sin identitet, sina sociala förmågor och att få en bra psykisk hälsa. Resultatet visar att samhällets strukturer begränsar vilka möjligheter till utveckling av identitet och sociala relationer som ungdomar med hörselnedsättning får. / Background: Good social relationships are a fundamental part of adolescents identity development, development of their social skills and have positive effects on their mental health. For adolescents with hearing impairment, social relationships can be difficult because they live in a society where hearing people communicates with spoken Swedish and deaf people communicates with sign language. Adolescents with hearing impairment don´t have the same ability as hearing people and it can for that reason be difficult to keep up in social interaction and create social relationships with others. If adolescents with hearing impairment don´t know sign language they also have no prerequisites for the social interaction that exists in the deaf community. The theoretical framework for the study is James Marcia's theory of identity development and social construction theory. Aim: The aim of the study is to investigate how adolescents with hearing impairment experience their psychosocial health based on their social relationships and how they affect their opportunities for identity development. Method: Qualitative methodology was used in the study and data was collected with nine semi structured interviews with adolescents with hearing impairment aged 12-16 years. The result has been analyzed with qualitative content analysis. Results and conclusions: During the analysis two categories emerged; friends are important, but it is difficult, and communication is good, but it does not always work. The adolescents experienced that they had friends but that they were at school and did not spend time with them in their spare time. They also talked about how communication affected their opportunities to be able to keep up with social interaction. The adolescents avoided certain situations and retreated because they did not hear everything that was said which they felt as embarrassing, difficult or that they looked dumb. Due to different communication needs, adolescents with hearing impairment can be limited and have less opportunities for social relationships, thus providing less space for the development of their identity, social skills and good mental health. The results show that society´s structures limit what opportunities for development of identity and social relationships that adolescents with hearing impairment may have.

This diploma dissertation is focused on integration of hearing handicapped people in the society. The objective of the diploma dissertation is the analysis of possibilities to integrate the hearing handicapped people in socio-cultural milieu of the majority society. The diploma dissertation is an investigation work and it is divided into two parts, namely to theoretical and practical ones. In the first theoretical part, I am dealing with a brief division of hearing defects, communication and personality types of hearing handicapped individuals and further with areas of education, employment and culture. Methods and techniques of the qualitative research are described in the practical part. The research method is used in the diploma dissertation and data collection technique is represented by the semi-controlled conversation with hearing handicapped people. The research was implemented on the territory of the capital city of Prague. The research set is made up of 10 respondents altogether having different types of hearing handicap. The cardinal question set within the framework of the research is What are the chances of integration of the hearing handicapped people in the socio-cultural milieu of the majority society? Further, other secondary investigative questions were set. It resulted from the research that chances for education of hearing handicapped persons are not sufficient and further that the hearing handicapped people have a limited access to labour market due to their hearing defects. In addition, the investigation showed that the highest barriers in relation to the hearing society consist in communication and information barriers and further in persistent prejudices of the society and that the hearing handicapped people do not have an adequate access to cultural enjoyment equally over the entire Czech Republic territory. One of the outcomes of the dissertation thesis for practical utilization is the description how to find out the chances of integration of the hearing handicapped persons in the socio-cultural milieu of the majority society, which may contribute not only to better awareness of both the expert public and general public, but also to finding conceivable needs of social services for these people.

Submitted by MAÍSA KICH GRECCO null (maisakg@bol.com.br) on 2016-03-23T13:56:53Z No. of bitstreams: 1 Dissertação Maísa Kich Grecco.pdf: 2876385 bytes, checksum: 386e37f57cf8947da28a13b9dd7efb66 (MD5) / Approved for entry into archive by Ana Paula Grisoto (grisotoana@reitoria.unesp.br) on 2016-03-24T14:28:39Z (GMT) No. of bitstreams: 1 grecco_mk_me_bauru.pdf: 2876385 bytes, checksum: 386e37f57cf8947da28a13b9dd7efb66 (MD5) / Made available in DSpace on 2016-03-24T14:28:39Z (GMT). No. of bitstreams: 1 grecco_mk_me_bauru.pdf: 2876385 bytes, checksum: 386e37f57cf8947da28a13b9dd7efb66 (MD5) Previous issue date: 2016-02-16 / O ouvinte, se bem treinado, pode fornecer estímulos discriminativos e reforçadores para respostas do falante. No entanto, também pode emitir comportamentos supressores do comportamento verbal. Nos casos de deficiência auditiva, os pais podem ter dificuldade em estimular o comportamento verbal ainda que a privação sonora seja superada pelo implante coclear, pois ouvir e se comunicar oralmente requer aprendizagem. Considerando a importância do treino de pais enquanto audiência para estabelecimento do comportamento verbal de falante de crianças com deficiência auditiva, o presente estudo objetivou ampliar o repertório comportamental de ensino de operantes verbais de mães de crianças com deficiência auditiva e implante coclear por um programa instrucional desenvolvido para esse fim; e verificar se este programa aumentou a frequência de emissão de operantes verbais por seus filhos considerando a qualidade da produção oral. Participaram duas crianças de idades entre cinco e sete anos com deficiência auditiva neurossensorial pré-lingual e usuárias de implante coclear e suas mães. Foram avaliados comportamentos de ensino de comportamento verbal emitidos pelas mães e operantes verbais emitidos pelas crianças antes e após a intervenção, de acordo com um delineamento de linha de base múltipla entre participantes. Um questionário sondou comportamentos com função de antecedente e consequente emitidos pelas mães para os operantes verbais ecoico, tato, mando e intraverbal emitidos pelos filhos. As crianças foram avaliadas nos mesmos operantes verbais em tentativas discretas. O programa instruiu as mães a fornecer antecedentes e consequentes para operantes verbais emitidos pelos filhos. Os resultados compararam o número de operantes verbais identificados pelas mães e de comportamentos de ensino desses, antes e após a intervenção, e as produções orais das crianças. Foi observado um aumento no relato de comportamentos de ensino das duas mães após a intervenção para a maioria dos operantes verbais, fornecendo mais antecedentes e consequentes. Nas produções orais das crianças, observou-se uma fala mais precisa logo após as mães realizaram a intervenção. Pode-se sugerir que ampliar o repertório de ensino de operantes verbais das mães afeta positivamente a fala de seus filhos. Estudos futuros devem refinar esse programa enquanto tecnologia de ensino aplicável em escala maior. / The listener, if well trained, can provide discriminative and reinforcing stimuli to the speaker's answers. However, it can also issue suppressing behaviors of verbal behavior. In cases of hearing impairment, parents can find it difficult to stimulate verbal behavior although the sound deprivation is overcome by the cochlear implant because listen and communicate orally requires learning. Considering the importance of parent training as a hearing to establish the verbal behavior of children with hearing impairment speaker, this study aimed to extend the behavioral repertoire of verbal operant teaching of mothers of children with hearing loss and cochlear implants for an instructional program developed for this purpose; and verify that this program has increased the frequency of verbal operant by their children considering the quality of oral production. They included two children aged five and seven years with sensorineural hearing impairment before language and users of cochlear implants and their mothers. They were evaluated behaviors verbal behavior teaching issued by mothers and verbal operant issued by the children before and after the intervention, according to a line of delineation of multiple base among participants. A questionnaire probed behavior with a history of function and consequent issued by mothers to the echoic verbal operant, touch, command and intraverbal issued for the children. The children were evaluated in the same verbal operant in discrete trial. The program instructed mothers to provide antecedents and consequences for verbal operant issued for the children. The results compared the number of verbal operant identified by mothers and teaching these behaviors before and after the intervention, and the utterances of children. Reporting an increase in learning behavior of two mothers after surgery to most verbal operant was observed, providing more antecedents and consequences. The utterances of children, there was a more accurate speech soon after mothers underwent intervention. May be considered that expanding the verbal operant mothers teaching repertoire positively affects speech of their children. Future studies should refine the program as applicable learning technology on a larger scale.

abstract: Children with hearing impairment are at risk for poor attainment in reading decoding and reading comprehension, which suggests they may have difficulty with early literacy skills prior to learning to read. The first purpose of this study was to determine if young children with hearing impairment differ from their peers with normal hearing on early literacy skills and also on three known predictors of early literacy skills – non-verbal cognition, executive functioning, and home literacy environment. A second purpose was to determine if strengths and weaknesses in early literacy skills of individual children with hearing impairment are associated with degree of hearing loss, non-verbal cognitive ability, or executive functioning. I assessed seven children with normal hearing and 10 children with hearing impairment on assessments of expressive vocabulary, expressive morphosyntax, listening comprehension, phonological awareness, alphabet knowledge, non-verbal cognition, and executive functioning. Two children had unilateral hearing loss, two had mild hearing loss and used hearing aids, two had moderate hearing loss and used hearing aids, one child had mild hearing loss and did not use hearing aids, and three children used bilateral cochlear implants. Parents completed a questionnaire about their home literacy environment. Findings showed large between-group effect sizes for phonological awareness, morphosyntax, and executive functioning, and medium between-group effect sizes for expressive vocabulary, listening comprehension, and non-verbal cognition. Visual analyses provided no clear pattern to suggest that non-verbal cognition or degree of hearing loss were associated with individual patterns of performance for children with hearing impairment; however, three children who seemed at risk for reading difficulties had executive functioning scores that were at the floor. Most prekindergarten and kindergarten children with hearing impairment in this study appeared to be at risk for future reading decoding and reading comprehension difficulties. Further, based on individual patterns of performance, risk was not restricted to one type of early literacy skill and a strength in one skill did not necessarily indicate a child would have strengths in all early literacy skills. Therefore, it is essential to evaluate all early literacy skills to pinpoint skill deficits and to prioritize intervention goals. / Dissertation/Thesis / Doctoral Dissertation Speech and Hearing Science 2017

No description available.

A família é sempre um fator de grande importância no processo de habilitação da criança com implante coclear. O desenvolvimento da linguagem depende do envolvimento dos pais no processo de habilitação e exige um compromisso contínuo, para que a criança com deficiência auditiva tenha benefícios com o seu implante coclear. A família tem assumido uma sobrecarga significativa ao longo do processo, trazendo repercussões na vida familiar e nas próprias necessidades e interesses. Nesse contexto, o objetivo deste estudo é compreender a vivência de mães, na trajetória da infância à adolescência de seus filhos com implante coclear, buscando apreender os significados e sentidos atribuídos por elas nessa experiência. O estudo foi de natureza qualitativa e o método utilizado foi a investigação fenomenológica, que consiste na apreensão do fenômeno tal como ele se manifesta para a pessoa que o vivencia. Foram entrevistadas 12 mães das primeiras crianças que realizaram a cirurgia, no programa de implante coclear do Centro de Pesquisas Audiológicas do Hospital de Reabilitação de Anomalias Craniofaciais da Universidade de São Paulo. Os depoimentos, mediados por uma questão norteadora e submetidos ao processo de análise fenomenológica, revelaram as seguintes categorias temáticas: A ressonância subjetiva do diagnóstico; Conhecendo o implante coclear e tomando decisões; A vivência da angústia na cirurgia; O nascimento da audição; Vivenciando o cotidiano no processo de habilitação; A experiência de momentos críticos no percurso da habilitação; Relações familiares; A fase escolar: uma nova etapa de enfrentamento; O processo do adolescer vivenciado com superproteção e com novos desafios; O apoio do psicólogo, da equipe e outros; Temporalidade e projetos de vida. Foi utilizado o referencial teórico de Romero, que nos levou à compreensão da vivência dessas mães, a partir da afetividade, que é o modo como elas são afetadas subjetivamente na sua relação com o mundo e, nessa relação, mostraram como se vinculam e o significado que elas dão ao que vem ao seu encontro, revelando o sentido de sua existência com um filho com implante coclear. / The family is always a major important factor in the habilitation process of the child with cochlear implant. The development of language depends on the parental involvement in the habilitation process and requires a continuous commitment, so that the child with hearing impairment may be benefited by the cochlear implant. The family has been assuming a significant overload during the process, causing repercussions in the family life and the needs and interests. Within this context, this study aimed to understand the experience of mothers in the trajectory of infancy to adolescence of their children with cochlear implants, aiming to identify the meanings and feelings assigned by them in this experience. The study was qualitative and the method comprised phenomenological investigation, which consists of apprehension of the phenomenon as it is manifested to the person experiencing it. The interviews were applied to 12 mothers of the first children submitted to surgery in the cochlear implant program of the Center for Audiological Research of the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo. The reports, mediated by a guiding question and submitted to the phenomenological analysis process, revealed the following thematic categories: the subjective resonance of diagnosis; knowing the cochlear implants and making decisions; the experience of anxiety in the surgery; the birth of hearing; experience the daily life in the habilitation process; the experience of critical moments in the habilitation process; family relationships; the school age: a new stage of coping; the process of adolescing experienced with overprotection and new challenges; the support of the psychologist, staff and others; temporality and life projects. The theoretical reference of Romero was used, which led us to understand the experience of these mothers, based on the affectivity, which is the way through which they are subjectively affected in their relationship with the world and, in that relationship, they showed how they link themselves and the meaning they assign to what comes to them, revealing the meaning of their existence with a child with cochlear implant.

O objetivo do presente estudo foi avaliar a efetividade da capacitação dos agentes comunitários de saúde, por meio da videoconferência, na área de saúde auditiva infantil. Participaram da pesquisa 50 profissionais divididos aleatoriamente em dois grupos de acordo com a metodologia de ensino: 31 agentes comunitários de saúde participaram da capacitação de forma presencial e 19 por meio de videoconferência. A atividade ocorreu em um encontro de oito horas, por meio de aulas expositivas sobre o conteúdo ministrado e a utilização do material adaptado Primary ear and hearing care training resource basic, intermediate and advanced levels (WHO, 2006) proposto pela Organização Mundial da Saúde, de forma simultânea para ambos os grupos. A capacitação contemplou os temas: Audição e deficiência auditiva; Tipos, prevenção e causas da deficiência auditiva; Técnicas de identificação e diagnóstico da deficiência auditiva e Aspectos gerais da deficiência auditiva. A efetividade da capacitação por meio da videoconferência foi avaliada por meio de questionário pré e pós-capacitação aplicado aos agentes comunitários de saúde (WHO, 2006). Adicionalmente, outro questionário foi aplicado a fim de verificar a qualidade da capacitação e satisfação dos participantes. Os resultados demonstraram que ambos os grupos apresentaram diferença estatisticamente significante quando considerado o desempenho apresentado no instante pré e póscapacitação, de forma mais expressiva para o grupo que participou da capacitação de forma presencial, tanto na análise do escore total como quando considerado os temas abordados separadamente. A análise qualitativa da videoconferência como metodologia de ensino comparada a capacitação presencial, de acordo com a visão dos ACS foi muito semelhante, sendo considerada de fácil entendimento permitindo a interação com o ministrante. A videoconferência como metodologia de ensino é efetiva para a capacitação dos agentes comunitários de saúde na área de saúde auditiva, porém deve ser utilizada de forma complementar à capacitação realizada de forma presencial. / The present work aimed to verify the effectiveness of a training program for health care professionals, by videoconference, in infantile hearing health Program. The 50 professionals, divided randomly in two groups, constituted the sample: 31 health care professionals to face-to-face instruction and 19, by videoconference. The training was provided in eight hours, through classes and a textbook adapted from the material Primary ear and hearing care training resource basic, intermediate and advanced levels (WHO, 2006), by World Health Organization in both groups, simultaneously. The topics focused were as follows: normal and impaired hearing; types, prevention and causes of the hearing impairment; procedures to identify and diagnose the hearing impairment and global aspects of hearing impairment. To investigate the effectiveness of a training program, was conduced an application to the pre and post-questionnaire in the health care professionals (WHO, 2006). Another questionnaire was applied to evaluate the training quality and participants satisfaction. The results obtained showed, in both groups, an increase in the score in the post questionnaire, as compared to the one initially applied. However, the performance was more expressive in the group trained face-to-face, considering total and topics scores isolated. The quality evaluation of videoconference, compared by face-to-face instruction, in the opinion of health care professionals was similar, and was considered easy and interactive. This study allowed us to conclude that the videoconference, as learning tool, is effective for health care professionals training in infantile hearing Program, but must be utilized complementary a face-to-face instruction.

Playing and enjoying games might seem like a simple task to most people even though many games rely heavily on sensory, cognitive and motoric ability. To create games that are accessible and inclusive to a wide range of audiences, it is important that design choices are considered carefully. This thesis aims to provide an investigation into closed captioning and enhanced speech bubbles. The goal is to clarify and to compare what effects these features have on the perception of situational and affective information and how they affect the immersion of non-disabled players. Two experiments were performed with a total of 38 participants at the University of Skövde. Each experiment investigated a separate accessibility feature and evaluated their influence on the gameplay experience. By performing two experiments, it was possible to identify the strengths and weaknesses of both features in comparison to each other. The results show that closed captions can have a negative effect on the immersion of the player and that enhanced speech bubbles increase immersion and provide additional affective information to the player.

Abstract The symptom complex originating from the inner ear, known as Meniere's disease, was studied especially from the epidemiologic point of view. A total of 442 patients' charts were retrospectively analysed in several hospital districts of Finland. The period of 1992-1996 was covered. The main focus was on the epidemiological assessment of the disease in Finland. To clarify the epidemiological figures, the validity of the diagnostic assessment was examined using the latest guidelines (1995) of the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology - Head and Neck Surgery (AAO-HNS) as a gold standard. The diagnostic tools used in the different hospitals were documented and evaluated, and diagnostic accuracy at the different levels of the health care system was evaluated. The clinical picture of Meniere's disease was characterised, and the therapeutic modalities used were evaluated. The audiometric configurations were classified according to two principles. The prognosis of hearing impairment was specified by creating a multivariable model. Half of the patients (N = 221) fulfilled the AAO-HNS criteria for definite disease. The prevalence and incidence of definite cases of Meniere's disease appeared to be lower in Finland than could be expected based on previous international studies. A prevalence of at least 43 per 100,000 and an average annual incidence of 4.3 per 100,000 were obtained. The prevalence rates in the catchment areas of the university and central hospitals did not differ statistically, but a significant (p < 0.001) difference was found between the average prevalences in the northern and southern Finnish hospital districts. Fluctuation of hearing in repeated audiometric measurements appeared to be a highly sensitive (94%) diagnostic test to detect definite Meniere's disease. According to the multivariable model created in this study, the hearing impairment in Meniere's disease affects equally males and females, and the deterioration is about 1 dB per year due to the duration of the disease and 0.5 dB per year due to aging. The disease was controlled conservatively in 69% of the cases. A gently sloping high-frequency audiometric pattern was most prevalent according to the EU Work Group classification and a flat pattern according to the mid-frequency-based classification. The variability of diagnostic criteria, diagnostic tools and therapeutic modalities shows an evident need for up-to-date therapy recommendations for Meniere's disease in Finland.