Comparison of transient evoked otoacoustic emissions and distortion product otoacoustic emissions when screening hearing in preschool children in a community setting.

OBJECTIVE: The first purpose of this study was to compare transient evoked otoacoustic emissions (TEOAE) with distortion product otoacoustic emissions (DPOAE) to determine if they resulted in equivalent signal-to-noise ratios (SNRs) when used for hearing screening in a preschool population in a community setting. The second purpose was to determine if the OAE methods would result in equivalent pass/refer rates. The third purpose was to determine the agreement between the pass/refer rates from a tympanometric screening and the pass/refer rates from each OAE method. METHODS: Thirty-three preschool children ages 4 months to 4 years, 4 months were tested using DPOAE and TEOAE. The frequencies 800-4000Hz were compared. The tympanometric gradient was obtained from a tympanogram done on each ear. A multivariate statistic was used to compare the emission SNR from both methods. A chi(2) statistic was used to compare the pass/refer rates from both methods. The agreement between the pass/refer rates from the OAE screens and from the tympanometric gradient were compared. RESULTS: TEOAE and DPOAE SNRs were significantly different in the low frequency however, there were no significant differences found in the high frequencies. There were no significant pass/refer differences found between the methods at any frequency. When comparing the agreement between the OAE methods with the tympanometry, both methods produced nearly equivalent agreement with tympanometric gradient. However, the overall correspondence between OAE findings and tympanometry was not perfect. CONCLUSIONS: Both methods are effective and especially equivalent in the high frequencies and can be recommended for use in a preschool population in the field. Tympanometric gradient disagreed with both OAE screening results about 25% of the time. Finally, our study also found that higher refer rates can be expected when young (<3 years) preschool children are included in the screen.

Do children and adults with language impairment recognize prosodic cues?

PURPOSE: Prosodic cues are used to clarify sentence structure and meaning. Two studies, one of children with specific language impairment (SLI) and one of adults with a history of learning disabilities, were designed to determine whether individuals with poor language skills recognize prosodic cues on par with their normal-language peers. METHOD: Participants were asked to determine whether low-pass filtered sentences matched unfiltered target sentences. Filtered sentences either matched the target sentence exactly or differed on between 1 and 3 parameters that affected the prosodic profile of the sentences. RESULTS: Children with SLI were significantly poorer than their normal peers in determining whether low-pass filtered sentences matched or were different from unfiltered target sentences. The children's performance, measured in terms of response accuracy, deteriorated as the similarities between filtered and unfiltered sentences increased. Adults revealed a pattern of differential reaction time to sentence pairs that reflected their relative degree of similarity. There was no difference in performance accuracy for adults with a history of language/learning disabilities compared with their peers. CONCLUSION: Given that prosodic cues are known to assist language processing, the weak prosodic skills of preschool children with SLI may limit the amount of benefit that these children derive from the presence of prosodic cues in spoken language. That the adult sample did not show a similar weakness in this skill may reflect developmental differences, sampling differences, or a combination of both.

A comparison of two methods of hearing screening in the preschool population.

UNLABELLED: The outcome of hearing screening using conventional pure tone behavioral testing was compared with the outcome employing measures of transient otoacoustic emissions (TEOAEs) in a preschool population under conditions typical of educational settings. Two hundred children ranging in age from 2 years 1 month to 5 years 10 months were screened. Nearly equal numbers of children were referred from the two types of screening activities. The majority of referrals from the pure tone screening were due to an inability to condition the children to respond. Only 10% of the children referred from the TEOAE screening received a referral due to an inability to cooperate. Approximately 44% of the children referred from the pure tone screening also failed the immittance screening, whereas 62% of those who referred from the TEOAE screening also failed immittance screening. LEARNING OUTCOMES: As a result of completing this activity, the learner will obtain information about vocabulary development in children with hearing loss, referral rates from preschool hearing screening programs and the influence of middle ear status on referrals.