Evaluation of a hearing screening questionnaire for use with Ecuadorian school-aged children.

OBJECTIVE: The purpose of this study was to evaluate the accuracy of a teacher-administered hearing screening questionnaire to detect hearing loss among first-grade Ecuadorian children in public schools. DESIGN: A cross-sectional design was used to compare screening results from the teacher-administered questionnaire and pure-tone audiometry. STUDY SAMPLE: Children were randomly selected from 117 schools. The study was conducted in two phases to accommodate different school calendars in the country. Data for both screening methods were available for 4616 children. RESULTS: For Phase 1, almost 90% who failed the questionnaire passed audiometry; and, 85% who failed audiometry passed the questionnaire. A revised questionnaire was used for Phase 2 and 70% who failed the questionnaire passed audiometry; and 85% who failed audiometry, passed the questionnaire. Of the 27 children identified in Phase 2 as having hearing loss at the time screening was done, 88.9% failed audiometry, but only 22.2% failed the questionnaire. CONCLUSIONS: Because there was little agreement between the questionnaire and the audiometry, it was recommended that the questionnaire not be used to screen Ecuadorian children for hearing loss. The results of this evaluation of the school hearing screening program provided the Ecuadorian government with important information to guide policy decisions.

Measuring Costs and Outcomes of Tele-Intervention When Serving Families of Children who are Deaf/Hard-of-Hearing.

BACKGROUND: Optimal outcomes for children who are deaf/hard-of-hearing (DHH) depend on access to high quality, specialized early intervention services. Tele-intervention (TI), the delivery of early intervention services via telehealth technology, has the potential to meet this need in a cost-effective manner. METHOD: Twenty-seven families of infants and toddlers with varying degrees of hearing loss participated in a randomized study, receiving their services primarily through TI or via traditional in-person home visits. Pre- and post-test measures of child outcomes, family and provider satisfaction, and costs were collected. RESULTS: The TI group scored statistically significantly higher on the expressive language measure than the in-person group (p =.03). A measure of home visit quality revealed that the TI group scored statistically significantly better on the Parent Engagement subscale of the Home Visit Rating Scales-Adapted & Extended (HOVRS-A+; Roggman et al., 2012). Cost savings associated with providing services via TI increased as the intensity of service delivery increased. Although most providers and families were positive about TI, there was great variability in their perceptions. CONCLUSIONS: Tele-intervention is a promising cost-effective method for delivering high quality early intervention services to families of children who are DHH.