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Biomedical subjects

R L Schow

Publications and source records attributed to R L Schow.

16 recordsLinked to original sources
PubMed1999

Implications from factor analysis for central auditory processing disorders.

Central auditory processing disorders among school-age children have been challenging to identify and treat. Many issues remain that need to be resolved. Here, we compare and contrast findings on 331 school-age children who were given two of the more common central auditory processing disorder tests (Staggered Spondaic Word [SSW] Test and the SCAN Screening Test for Auditory Processing Disorders). These results replicate and reinforce many of the psychometric findings reported earlier. The use of factor analysis with these test results was explored. Significantly, two factors emerged, including an auditory binaural separation from competition factor and a monaural low redundancy degradation factor. These findings help us define the nature of processes probed by the SCAN screening test and the SSW test. Furthermore, these findings clarify the use of SSW and SCAN because they showed both SSW Left Competing and Right Competing loading within the same factor, whereas the three subtests on SCAN sorted into two rather than three factors.

Adolescent↗
PubMed1991

Considerations in selecting and validating an adult/elderly hearing screening protocol.

This article presents important factors related to hearing impairment, medical concerns related to hearing, hearing handicap, and epidemiological principles as considerations in selection of a protocol in adult/elderly hearing screening (18 yr and older). I encourage protocol validation which incorporates a series of criteria: medical conditions, rates of failure for handicap and impairment, handicap perspectives, hearing aid use and satisfaction, and follow-up data when referred. Three different pure-tone fence levels (20 dB, 25 dB, and 40 dB at 1000, 2000, and 4000 Hz) are proposed for further study by virtue of their utility for different settings and populations. Finally, a possible protocol is proposed for use with the different pure-tone fences.

Adult↗
PubMed1990

Self-assessment and impairment in adult/elderly hearing screening--recent data and new perspectives.

Because self-assessment measures are helpful in identifying handicap/communication difficulties, they have an important place in hearing screening protocols for adult/elderly persons. When impairment is used as the criterion, questionnaire results can be used to calculate sensitivity, specificity, predictive values, and efficiency for a variety of fences. Findings are summarized for 2825 persons on three different questionnaires that reveal adequate, reasonably similar, and predictable relationships between impairment and self-assessment findings. However, evidence on "deny-ers" (persons with impairment who deny their handicap) and "complainers" (persons who complain about handicap but have no impairment) are also presented. These latter findings show a strong rationale for using self-assessment measures in their own right, and not simply as an alternate, less effective method for measuring pure-tone impairment.

Adult↗
PubMed1990

Hearing screening in a dental office using self-assessment.

Experiences in a statewide health fair screening program prompted development of alternate methods for screening hearing of adults including one in a dental office summarized here. Because it was considered impractical to use pure-tone screening, several self-assessment procedures were tested against pure-tone findings in a pilot study. As a result, the Rating Scale for Each Ear (RSEE) was selected for use. In the pilot and main study, 796 adult dental patients were evaluated and 21 to 29% failed the screening, depending on whether self-assessment procedures or pure tones were used. Although the dental office staff was generally supportive of the program, there were some problems in implementation. The number who returned for follow-up (N = 14) was disappointing, but there were several very positive benefits to the program including distribution of earplugs and education on the adverse effects of noise. In terms of general feasibility of such screening, from an epidemiology standpoint the program was judged to have good efficacy and efficiency but there were serious problems in effectiveness.

Adolescent↗
PubMed1990

Fundamental issues in self-assessment of hearing.

The history of self-assessment for hearing is reviewed from its beginning use in the 1930s to its emerging importance in the 1980s. It is presented as a more systematic method for interviewing the patient, and although it does not always agree with pure-tone findings, it should be recognized as a useful assessment method to be used in combination with other measures of hearing. The uses for self-assessment, psychometric concerns, issues in the definition of hearing domains (disorder, impairment, handicap, disability), and new frontiers also are discussed in this overview article.

Hearing Disorders↗
PubMed1989

Self-assessment of hearing in rehabilitative audiology: developments in the USA.

Self-assessment of hearing is being used for screening, diagnostic, and rehabilitative audiology. Hearing handicap/disability measures were derived on a large number of patients who were classified based on pure tone findings into Pure Tone Groups (PTGs). A systematic relationship was found between handicap/disability as measured with Self-Assessment of Communication (SAC) and PTG. Handicap/disability ratings were also found to be systematically related to use of hearing aids.

Attitude to Health↗
PubMed1983

Threshold inaccuracies in an elderly clinical population: ear canal collapse as a possible cause.

In a sample of 80 persons in the 60-79-year age range, threshold shifts suggestive of collapsible ear canals were found in over one third of the subjects. A very conservative interpretation of the data suggests that at least 10-16% of these 60-79-year old elderly subjects have collapsible ear canals. Neither sex nor age was related significantly to prevalence. Results of this study indicate that in testing elderly persons there are threshold inaccuracies, relating possibly to collapsible ear canals, which, if not taken into account, may cause unacceptably large errors in both clinical and research applications.

Adult↗
PubMed1980

Hearing levels among elderly nursing home residents.

Specific frequency and degree of hearing loss data were determined for 202 elderly nursing home residents (159 females, 43 males) drawn from five nursing homes in three cities. Mean hearing levels and distribution of degree of hearing loss are presented for subjects by decade groups. Data also are presented by sex and by ear. Pure tone averages (500, 1000, 2000 Hz) for the better ear showed a substantial deterioration in each decade interval beginning from ages in the 60s and extending into the 90s. The prevalence of loss of hearing sensitivity for all subjects was 82% when a 26 dB pure tone average was used as a cutoff; 48% had pure tone averages greater than 40 dB. Consideration of collapsed ear canals on a sub-group of this sample suggested that conventional threshold findings slightly overestimated the prevalence of loss in this population.

Age Factors↗
PubMed1980

Collapsed ear canals in the elderly nursing home population.

In a sample of 104 elderly nursing home residents, collapsed ear canals were found in 41% of the subjects. Age emerged as a significant factor in these data since collapsed ear canals were significantly more common among the nursing home residents that were age 80 or over. Based on these findings, mean hearing threshold data on this population will overestimate hearing loss by 2-8 dB when collapsing ear canals are not considered.

Aged↗
PubMedDate not supplied

Comparison of ASHA's immittance guidelines and standard medical diagnostic procedures.

Immittance procedures and medical evaluation based on case history and otoscopy were administered to 115 youngsters from a large pediatric practice. Using ASHA immittance guidelines, a reasonable 73% overall agreement was achieved between immittance and medical recommendations of "pass", "at risk", and "fail/treat". When using medical findings as the criterion, there were three definite cases of under-referral (false negatives) and five over-referrals (false positives) in this sample group.

Acoustic Impedance Tests↗
PubMedDate not supplied

Success of hearing aid fitting in nursing homes.

A program is described for providing aural rehabilitation and hearing aid services in nursing homes. Results are summarized for these activities in one 55-bed nursing home during a two-year period. During that time, 25 residents were identified as potential hearing aid candidates, but only four from this group would participate in a hearing aid trial. Only two of the four ultimately became regular hearing aid users. Implications of these findings are discussed and positive benefits are described. However, it is recommended that unless better results can be obtained with other methods, then hearing professionals may be well advised to devote the majority of their efforts in attempts to help the large number of hearing-impaired persons who are not residing in nursing homes.

Aged↗
PubMedDate not supplied

Hearing aid evaluation based on measures of benefit, use, and satisfaction.

A comprehensive follow-up protocol was designed and utilized to assess benefit, use, and satisfaction from hearing aids. The benefit assessments included functional gain measures, and speech intelligibility in quiet and in noise. Hearing aid use was evaluated based on a questionnaire which asked for an estimate of daily use in hours and also an accounting of times when the aid was not in use during the day. Two use values were derived, an absolute daily use value and an adjusted percentage of use value. Satisfaction also was assessed using a questionnaire. The subjects were asked to indicate their general satisfaction with the aid on a seven-point scale. Two communication assessment questionnaires were used to assess communication handicap. Data are provided on 45 subject. The subjects were categorized into groups according to both low- and high-frequency hearing. These preliminary mean scores by group can be used as target goals for benefit, use, and satisfaction on persons fit with hearing aids. The protocol as used can provide considerable evaluative clinical information in a reasonable amount of time.

Adult↗
PubMedDate not supplied

Hearing handicap scores and categories for subjects with normal and impaired hearing sensitivity.

The hearing handicap scale, a commonly used self-assessment measure, was administered to 50 subjects with normal hearing and hearing impairment. These subjects were then divided into three groups based on pure tone test results so that the range of hearing handicap scale scores could be determined for different hearing sensitivities. Subjects in one group of 20 exhibited hearing sensitivity of 10 dB hearing threshold level or better. A second group of 10 subjects had hearing sensitivity of 11--25 dB hearing threshold level. The third group of 20 subjects had sensitivity poorer than 25 dB hearing threshold level. Percentage scores for the subjects with the most sensitive hearing clustered from 0 to 20% with a mean score of 7.8%. The intermediate group had a mean score of 25.6%. Scores for the hearing-impaired group clustered between 40 and 70% with a mean score of 54%. Score variability was about twice as great in the two groups with poorer sensitivity. It is suggested that hearing handicap performance may be classified into one of four categories, ranging from no handicap to severe handicap.

Adolescent↗
PubMedDate not supplied

Acoustic impedance values in the elderly.

The purpose of this study was to evaluate the effects of age on acoustic impedance values in the elderly. Pure tone, otoscopic, and impedance testing were conducted with subjects from 20 to 29, 60 to 69, and 70 to 79 years of age. Results revealed a slight, but nonsignificant, tendency for static compliance values to decrease with age, suggesting that the use of separate compliance norms for the elderly may not be warranted.

Acoustic Impedance Tests↗