Burdens imposed on the relatives of those with severe brain damage due to injury.
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Adaptation, Psychological↗
Biomedical subjects
D N Brooks
Publications and source records attributed to D N Brooks.
The nature of physical, mental and social deficits contributing to the categories of good recovery, moderate and severe disability in the Glasgow Global Outcome Scale.
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Brain Injuries↗
Counselling and its effect on hearing aid use.
The objective of this study was to determine if subjects who received pre- and post-issue counselling made better use of their National Health Service body-worn hearing aids than those who received no counselling. Assessment was by both subjective and objective methods, the latter employing a small use-time measuring device concealed within the aid. The findings suggested that subjects issued with hearing aids in the conventional NHS manner used their hearing aids even less than indicated by previous studies and achieved a low competence in handling. Significantly better use was made of their aids by subjects given a moderate amount of counselling. These patients were also considerably more adept in handling their aids and achieved a greater reduction in social hearing handicap than the non-counselled patients.
Aged↗
Aural rehabilitation of hearing-impaired adults (official policy of the British Society of Audiology).
This report, which outlines the official policy of the British Society of Audiology on the aural rehabilitation of hearing impaired adults, (a) estimates the prevalence of hearing impairment in adults in the United Kingdom; (b) identifies the main problems associated with hearing impairment in adults; (c) outlines the main aural rehabilitative procedures and (d) puts forward recommendations for future developments in this area.
Adult↗
Hearing aid candidates--some relevant features.
The age of individual seeking NHS aids has risen steadily since the service was commenced, and the median age is now over 70 years. The major type of hearing loss observed is sensorineural, but a substantial proportion of hearing aid candidates still have a significant conductive element in their hearing loss. This latter group of patients tend to be significantly younger than those without middle ear involvement. The hearing loss when applying for a hearing aid tends to be around 50 dB but is age dependent, younger subjects coming with smaller hearing losses. The most disturbing information obtained on questioning applicants was the long time lapse between recognition of hearing impairment and application for a hearing aid. This averaged almost ten years. The true delay is probably considerably greater than this and must have a substantial bearing on the outcome of hearing aid fitting. Public education and counselling of hearing aid users are suggested as vita needs.
Age Factors↗
Psychological consequences of blunt head injury.
89 severely closed head injured cases were tested on measures of verbal learning, and verbal and nonverbal intelligence, and their performance was compared with that of 30 orthopaedic cases. Head injured cases had severe deficits on all the tests. Severity of injury (judged by post-traumatic amnesia duration) was significantly related to poor performance on the learning and nonverbal intelligence tests, but not on the verbal intelligence test. The effect of injury on the family was studied in a further group of 35 head injured cases, showing that family burden within six months of injury was related to the presence of childish behaviour and loss of interest in the patient, together with other behavioural and affective changes. Physical deficits were not significant in this respect.
Adolescent↗
Cognitive recovery during the first year after severe blunt head injury.
Cognitive recovery was examined in 24 severe closed head injured patients tested at 3, 6 and 12 months after injury, and 12 patients tested, in addition, at one month. A retested non-head injured control group was used, and where appropriate, alternative test forms were employed to control for practice effects. Tests of intellectual, perceptual/constructional skills, linguistic and memory functions were used, showing that by 12 months the only statistically significant differences between head injured and control patients were on learning and constructional tasks. Individual patients showed widely varying recovery patterns which made prediction of recovery difficult.
Adolescent↗
Auditory screening--time for reappraisal.
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Audiometry↗
Wechsler Memory Scale performance and its relationship to brain damage after severe closed head injury.
Eighty-two patients with severe head injury were tested on the Wechsler Memory Scale and compared with 34 normal subjects. Head injured patients had severe memory difficulties, particularly on Logical Memory and Associate Learning. Severity of head injury (post-traumatic amnesia duration) was related to poor memory, as was increasing age, but both persisting neurological signs, including dysphasia, and skull fracture were not.
Adult↗
Middle ear effusion in children.
The middle ear function of over 100 school children has been observed for more than seven years with the aid of an electroacoustic impedance instrument. The technique readily demonstrates middle ear abnormalities. A few children may have middle ear malfunction for considerable periods without this being detected by those responsible for their health care. The presence of fluid in the middle ear is not necessarily an indication for treatment. The concept of acoustic impedance screening is advocated with suitable safeguards to prevent over-referral.
Audiometry↗
Long and short term memory in head injured patients.
A group of severely head injured patients were compared with 15 controls on auditory vocal digit span, and on a free recall memory task, enabling short term memory (STM) and long term memory (LTM) to be examined. The free recall curves differed for the two groups suggesting that the head injured patients had an essentially normal STM, but a poor LTM. This was supported by the finding of a significantly lower number of semantic errors (presumably retrieved from LTM) and a normal digit span (STM) in the head injury patients. The severity of the injury as judged by post-traumatic amnesia or the presence of neurological signs at the time of memory testing showed only a weak relationship to the severity of the memory deficit. The presence of a skull fracture was of minor importance in determining the severity of the LTM defect. Patients tested early after the injury were significantly poorer on STM, but not on LTM.
Adolescent↗
Cognitive recovery after severe head injury. 1. Serial testing on the Wechsler Adult Intelligence Scale.
The Wechsler Adult Intelligence Scale was administered serially to 40 severely head-injured adults, and the results compared with a matched group of 40 non-injured men. The scores on the verbal subtests showed less initial impairment and were faster to recover to the level of the comparison group than were the non-verbal subtest scores. Verbal IQ of the head-injury group approached that of the comparison group within about one year of injury, while recovery of Performance IQ continued over about three years.
Adolescent↗
Middle-ear impedance measurements in screening.
Middle-ear disorders are the major cause of hearing loss in the young school child, the majority of sensorineural disorders already having been detected. Mild conductive deafness may lead to educational retardation, psychological and social problems as well as to more severe middle-ear problems. It is consequently important to detect persistent middle-ear conditions as early as possible. Pure-tone audiometry has been shown to be a poor method of identifying middle-ear effusions. Impedance measurement is considerably more efficient, and different approaches are reviewed in the light of long-term studies of middle-ear effusion.
Audiometry↗
Otitis media and child development. Design factors in the identification and assessment of hearing loss.
Otitis media with effusion (OME) is the major cause of auditory dysfunction in preschool and early-grade schoolchildren. At especially high risk are children with cleft palate/lip; some groups of mentally retarded children; children from underprivileged communities and children with severe or profound sensorineural hearing loss. In neonates the major concern is to identify those with severe sensorineural hearing loss but awareness of the likelihood of OME is also vital. The hearing loss associated with OME in its early stages may be as small as 10--15 dB and in consequence conventional hearing tests employing pure tones are inadequate is screening procedures. Acoustic impedance testing has proved to be a practicable, acceptable, sensitive and efficient method of identification of OME in infants and children. Impedance measurement cannot, as yet, provide accurate assessment of hearing loss, but this is probably not a serious drawback. The primary requirement is to detect OME in order that swift and effective treatment can be instituted.
Acoustic Impedance Tests↗
Tympanometry:between ear symmetry and normative values.
Marked asymmetry of auditory function between left and right ears would normally be indicative of some abnormality. This study was designed to investigate the limits of tympanometric symmetry in normal individuals. A limiting ratio of 4/3 between left and right ear compliances is suggested. Applying this criterion and strict criteria for normality of middle ear pressure and reflex thresholds, a value for middle ear compliance was obtained with a considerably smaller range for "normality" than from previous studies. A marked difference between middle ear compliances of male and female subjects was observed, and evidence was adduced to suggest that this was due to differences in size of the ear canal and tympanic membrane.
Acoustic Impedance Tests↗