Recent advances in otitis media. Diagnosis and screening.
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Biomedical subjects
Publications and source records attributed to J L Northern.
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The purpose of this project was to evaluate the use of the Early Language Milestone Scale (ELM) in screening language skills in young children. In this study, 657 children from birth to 36 months of age were evaluated with the ELM. The overall failure rate was 8%. Children who failed the ELM screening were evaluated with the Sequenced Inventory of Communication Development (SICD) that was used as the "gold standard" for diagnosing language disorders. In the 12-month age and younger group, there was poor agreement between the ELM Scale and the SICD. For infants 13 to 24 months of age, there was moderately good agreement between the SICD and a second ELM that was administered 1 to 2 weeks after the initial screening. In the 25- to 36-month age group, there was excellent agreement between the SICD and a rescreen ELM. The agreement between the two instruments indicated that the rescreen ELM correctly classified 79% of the 13- to 24-month-old infants and 89% of the 25- to 36-month-old toddlers.
Early identification of hearing loss is critical in enhancing auditory and language skills in the hearing-impaired infant. Various strategies for infant hearing screening are discussed. The current status of technology for screening, including auditory brainstem response audiometry, is also discussed.
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The patient with noise induced hearing loss presents complex aural rehabilitative problems. Such patients are not generally good candidates for "traditional" aural rehabilitation involving speech reading therapy and auditory training. Instead aural rehabilitation efforts involve individual evaluation of the communication handicap, non-medical relief for tinnitus, possible hearing aid use with carefully selected amplification and earmold, and counseling on hearing and listening.
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Controversy presently exists concerning the relationship between loudness discomfort levels (LDL's) and acoustic reflex thresholds (ART's). In this study, LDL's and ART's were obtained for two groups of ten normal-hearing adult subjects and one group of ten adult subjects with bilateral sensorineural hearing losses. The procedure involved obtaining LDL's and ART's under earphones and under sound field conditions for four different acoustic stimuli: pure tones, warble tones, spondaic words, and speech spectrum noise. One group of normal-hearing subjects and the hard-of-hearing group of subjects were given "too loud, uncomfortably loud, or annoyingly loud" LDL instructions while a second group of normal hearing subjects were instructed to respond when a sound "first starts to become uncomfortable." Results indicated that LDL's, irregardless of instructional pattern, were reported at consistently higher sound pressure levels than the ART's, for all groups of subjects. The magnitude of the differences between the LDL's and ART's varied according to LDL instrucitons, type of test stimulus, hearing sensitivity of the subjects (normal hearing or hard-of-hearing) and transducer used for stimulus presentation. The results of this study demonstrate that ART's correlate too poorly with the LDL to permit ART's to be used as an objective measure of loudness discomfort.
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