High prevalence of hearing loss at the special olympics: is this representative of people with intellectual disability?

BACKGROUND: The Healthy Hearing (HH) programme at the Special Olympics (SO) revealed hearing disorders in between 16 and 40% of athletes. However, it is not clear whether these prevalence represents the entire population with intellectual disability. Therefore, this study compares the hearing status of SO athletes with an intellectual disability (ID) to students with ID at a special needs school. MATERIALS AND METHODS: The HH screening was performed in 637 athletes (mean age 27.1 years, range 9.7-70.6 years) during the 2008 German SO Summer Games - and in 198 special needs students (mean age 12.7 years, range 6.7-20.0 years). RESULTS: Twenty-two per cent of athletes and 18% of students failed the HH screening. Approximately 60% of the total participants received recommendations for further follow-up and treatment without between-group differences. CONCLUSIONS: The results of the HH screening at SO events are assumed to be representative of children and adolescents with ID in special needs schools.

[Fool's gold standards in language screening. Sensitivity and specificity of the Hessian child language screening test (Kindersprachscreening, KiSS)]. / Katzengoldstandards in der Sprachstandserfassung. Sensitivität und Spezifität des Kindersprachscreenings (KiSS).

BACKGROUND: The German Kindersprachscreening (KiSS) is a universal speech and language screening test for large-scale identification of Hessian kindergarten children requiring special educational language training or clinical speech/language therapy. PARTICIPANTS AND METHODS: To calculate the procedural screening validity, 257 children (aged 4.0 to 4.5 years) were tested using KiSS and four language tests (Reynell Development Language Scales III, Patholinguistische Diagnostik, PLAKSS, AWST-R). The majority or consensus judgements of three speech-language professionals, based on the language test results, served as a reference criterion. The base (fail) rates of the professionals were either self-determined or preset based on known prevalence rates. RESULTS: Screening validity was higher for preset than for self-determined base rates due to higher inter-judge agreement. The confusion matrices of the overall index classification of the KiSS (speech-language abnormalities with educational or clinical needs) with the fixed base rate expert judgement about language impairment, including fluency or voice disorders, yielded a sensitivity of 88% and a specificity of 78%, for just language impairment 84% and 75%, respectively. Specificities for disorders requiring clinical diagnostics in the KiSS (language impairment alone or combined with fluency/voice disorders) related to the test-based consensus expert judgment was about 93%. Sensitivities were unsatisfactory because the differentiation between educational and clinical needs requires improvement. CONCLUSION: Since the judgement concordances between the speech-language professionals was only moderate, the development of a comprehensive German reference test for speech and language disorders with evidence-based algorithmic decision rules rather than subjective clinical judgement is advocated.

[Validity criteria of a short test to assess speech and language competence in 4-year-olds]. / Psychometrische Gütekriterien eines Kurztests zur Erfassung des Sprachstands 4-jähriger Kinder.

BACKGROUND: A psychometrically constructed short test as a prerequisite for screening was developed on the basis of a revision of the Marburger Speech Screening to assess speech/language competence among children in Hessen (Germany). PARTICIPANTS AND METHODS: A total of 257 children (age 4.0 to 4.5 years) performed the test battery for speech/language competence; 214 children repeated the test 1 year later. RESULTS: Test scores correlated highly with scores of two competing language screenings (SSV, HASE) and with a combined score from four diagnostic tests of individual speech/language competences (Reynell III, patholinguistic diagnostics in impaired language development, PLAKSS, AWST-R). Validity was demonstrated by three comparisons: (1) Children with German family language had higher scores than children with another language. (2) The 3-month-older children achieved higher scores than younger children. (3) The difference between the children with German family language and those with another language was higher for the 3-month-older than for the younger children. CONCLUSION: The short test assesses the speech/language competence of 4-year-olds quickly, validly, and comprehensively.

[Improved efficiency in swallowing diagnostics using an electronic documentation system]. / Effektivierung der Schluckdiagnostik durch ein elektronisches Dokumentationssystem.

BACKGROUND: The aim is to present a German-language electronic documentation system for the fiberoptic endoscopic evaluation of swallowing (FEES) in order to make routine swallowing diagnostics and therapeutic recommendations more effective and as initial confirmation of its suitability for daily use. METHODS: Time-efficient, precise, and complete documentation is provided by an interactive findings system via preset text fields and integration of representative frames with automatic report generation. This documentation system (FEED) (Flexible Endoscopic Evaluation of Dysphagia, XION medical GmbH, Berlin) was applied to 301 digitized FEES recordings. RESULTS: Of the parameters required by the FEES protocol, 97% were recorded in 9 min on average. Altogether, the application of FEED resulted in a time-saving of more than 50% as compared to free protocols. The use of the Murray and Rosenbek scales enabled a graded evaluation of swallowing disorders. CONCLUSIONS: FEED shortens documentation time, improves report quality and has proven to be a practical instrument in making routine swallowing diagnostics and therapy more effective.

[Cost analysis of a universal newborn hearing screening for clinics using the State of Hesse as an example]. / Kostenanalyse des universellen Neugeborenen-Hörscreenings für Kliniken am Beispiel Hessens.

BACKGROUND: The implementation of a universal newborn hearing screening (UNHS) in Germany in 2009 requires a realistic cost calculation for health insurance companies and participating clinics MATERIAL AND METHODS: Screening costs from 60 Hessian clinics were analyzed over 2.5 years whereby 94,203 children had been screened either with a 2-step (TEOAE, AABR) or a 1-step procedure (AABR). RESULTS: The TEOAE-AABR screening at EUR 13.16 per child was more cost-efficient. For a population with a high rate of at-risk babies a sole AABR device with screening costs of EUR 16.87 presents a more efficient alternative. High quality of screening performance and qualification of screening staff markedly reduced total cost. Overhead costs for tracking, quality assurance, control of completeness, and securing structural screening requirements, considered as essential screening costs, were calculated at EUR 4.00 per child. The total costs in Hesse would therefore be EUR 17.16 per child for TEOAE-AABR screening and EUR 20.87 per child for an AABR screening. CONCLUSION: In a mixed calculation which can be cautiously extrapolated from the Hessian data for Germany as a whole, costs would be EUR 18.40 per registered child.

High prevalence of hearing disorders at the Special Olympics indicate need to screen persons with intellectual disability.

BACKGROUND: Persons with intellectual disabilities (ID) are at increased risk for hearing impairment which often remains undetected. If left untreated, such hearing impairments may worsen the social and communicative problems of these persons. The aims of this study are to determine the prevalence of hearing impairment, to specify type and degree of hearing loss, and to evaluate the sensitivity and specificity of the screening in this population. METHODS: During the German Special Olympics Summer Games 2006, 552 athletes with ID had their hearing screened according to the international protocol of Healthy Hearing, Special Olympics. This screening protocol includes otoscopy, measurement of distortion product otoacoustic emissions, and - if necessary - tympanometry and pure tone audiometry (PTA) screening at 2 and 4 kHz. Additionally, 195 athletes underwent a full diagnostic PTA. The results of the screening and diagnostic PTA were compared. RESULTS: Of the 524 athletes who completed the screening protocol, 76% passed and 24% failed it. Ear wax was removed in 48% of all athletes. 42% of the athletes were recommended to consult an otolaryngologist or an acoustician. Of the 99 athletes whose screening-based suspicion of a hearing loss was confirmed with diagnostic PTA, 74 had an undetected hearing loss. The correlation (Cramer's V) between screening and diagnostic PTA was .98. The sensitivity of the screening was 100% and the specificity 98%. DISCUSSION: The screening reliably detects hearing disorders among persons with ID. The prevalence of hearing impairment in this population is considerably higher than in the general population, and the proportion of undetected hearing impairments is large, even among people with only mild and moderate ID, as examined in this study. Therefore, a screening is highly recommended, and special attention from caregivers and professionals as well as regular hearing assessment and standard therapy programmes are required for persons with ID.

Female coital orgasm and male attractiveness.

Female coital orgasm may be an adaptation for preferentially retaining the sperm of males with "good genes." One indicator of good genes may be physical attractiveness. Accordingly, R. Thornhill, S. W. Gangestad, and R. Comer (1995) found that women mated to more attractive men reported an orgasm during a greater proportion of copulations than did women mated to less attractive men. The current research replicates this finding, with several design variations. We collected self-report data from 388 women residing in the United States or in Germany. Results support the hypothesis that women mated to more attractive men are more likely to report an orgasm at the most recent copulation than are women mated to less attractive men, after statistically controlling for several key variables. Discussion addresses (a) the inability of the present research to specify the causal link between female orgasm and male attractiveness and (b) the proactive nature of female sexuality documented in recent research guided by an evolutionary perspective.

Discriminative grandparental solicitude as reproductive strategy.

1,857 adults rated the grandparental solicitude they received in childhood. Through a simple model based on the evolutionary concepts of ontogenetically differentiated reproductive strategy and paternity confidence, an ordered discriminative pattern of grandparental caregiving was predicted and confirmed by solid main effects, based on 603 complete cases. The maternal grandmother was the most caring. Unlike prevalent gender stereotypes, she was followed by the maternal grandfather, the paternal grandmother, and the paternal grandfather. The preferential grandparental solicitude was not influenced by residential distance, grandparent age, and availability of other grandparents. A predicted higher correlation for male than for female progenitors between solicitude and phenotypic resemblance could be confirmed.

A note on some reinforcing properties of university lectures.

Contingency management systems in university courses have sometimes assigned the role of reinforcing stimulus to lectures and demonstrations. Attending a lecture was made contingent upon having previously finished certain course assignments. The present paper investigated some variables that control student attendance at lectures. Attendance remained high throughout each course at those class meetings where quizzes contributing to course grades were given or where impending quizzes were discussed. Attendance at lectures over the reading assignments or over material unrelated to course quizzes rapidly declined. When students were given course credit for attending these lectures, or when the lectures included information for future quizzes, attendance increased. When attending these lectures was made contingent upon having completed certain assignments the prior week, no increase in assignment completion was noted and the attendance at the lectures decreased even further. All lectures were given during one class meeting each week. Attendance at the other class meetings during the week remained stable.