Audiometric screening of a population with intellectual disability

Abstract

KEY WORDSintellectual disability, screening audiometry, psycho-acoustic method Design: PTA was performed at six frequencies at the screening level 20 dB HL. Referral criteria were threshold levels ≥25 dB HL at two or more frequencies for one ear or both.Study sample: 1478 participants in ages 7-91 were included.Results: 1470 (99.5%) people cooperated in screening of which 1325 (90%) could be tested on both ears at all six frequencies. A majority, 987 (66.8%), performed ordinary PTA, 234 (15.8%) conditioned play audiometry, and 249 (16.9%) behavioural observation audiometry. 669 (45%) passed and 809 (55%) failed according to referral criteria. Of those failing, 441 (54.5%) accepted referral to clinical evaluation. Conclusions:PTA with slight modifications is applicable for screening of a population with mild to profound intellectual disability. The most challenging and time-consuming activity is to introduce the test procedure in a way that reduces anxiety and establishes trust. AUDIOMETRIC SCREENING OF A POPULATION WITH INTELLECTUAL DISABILITYAn intellectual disability (ID) is frequently associated with communication difficulties, and an ID in combination with a temporary or permanent hearing impairment (HI) involves considerable communicative impediments for the affected individual. These problems will be even more accentuated if additional disabilities occur. However, if the hearing problems are minimized, the capability for communication expands, reducing the negative psychological and social consequences and improving the quality of life (Fulton & Lloyd, 1975; van Schrojenstein Lantman-de Valk et al., 1994;Evenhuis et al., 2001). Therefore, access to hearing investigations including standardized, universal, recurrent hearing screening must be offered people with intellectual disability. Screening methodsGeneral criteria for an effective screening method are to simply, rapidly, non-invasively and cheaply separate the participants into two groups -pass and fail -according to a stipulated screening level (Wilson & Jungner, 1968;Davis et al., 1997). The most common hearing screening methods fulfil these criteria. Recording of otoacoustic emissions (OAE) and automated auditory brainstem responses (ABR) are successfully used for neonatal hearing screening (White et al., 1994), while pure tone audiometry (PTA) is usually preferred for hearing screening of older children and adults, e.g. for hearing tests on school-children and on noise-exposed populations (American Speech-Language-Hearing Association, 1997; Rabinowitz et al., 2011).Screening by PTA provides frequency specific results as the best basis for assessing the need for further interventions, while a limitation of the neonatal screening methods is the lack of 5 frequency specific information regarding estimated hearing thresholds, since broad-band clicks is the normal type of stimulation. Hearing investigations -Previous researchA literature survey of hearing investigations for screening and/or diagnostic purposes among older children and adults with ID ...

Audiometric Threshold Measurement In Children With Intellectual Disability: Preferred Response Mode

“…These findings can be connected with data reported by DiGiovanni & Repka (2007), who obtained comparable and statistically insignificant different threshold levels across response modes at audiometric test frequencies in a typical population [12]. The comparable results of the current study are expected since audiometric procedures involve simple tasks that can be successfully and reliably performed by individuals having a mental age over 2½ years [18,[24][25].…”

The importance of hearing: a review of the literature on hearing loss for older people with learning disabilities

“…However, much literature gave evidence to the contrary, including for those with severe or profound learning disabilities (Van Buggenhout et al ., ). It was suggested that the test method adopted is less important than its execution, that reducing anxiety and establishing trust are vital (Andersson et al ., ) and that, under the right conditions, the standard hearing test (pure tone audiometry) was possible for many of the population (Evenhuis, ).…”

“…The variety of hearing test methods chosen was largely determined by the extent of intellectual impairment in the populations studied; however, different forms of hearing assessment are not directly equivalent. Standard hearing assessment that involves the individual waiting for a sound, then responding in a repeatable way, tests the whole auditory pathway but was used as a diagnostic tool by only 2 studies (Buchanan, ; Van Buggenhout et al ., ), with a further 3 studies using this as a screening tool or in those that failed an earlier screen (Andersson et al ., ; Evenhuis, ; Meuwese‐Jongejeugd et al ., ). More objective measures that do not require the same level of compliance, such as auditory brainstem response testing (Evenhuis, ; Evenhuis et al ., ), are not representative of the whole auditory pathway and correction factors are required to give an estimate of true hearing levels.…”

“…Whilst steps must be taken when assessing hearing in individuals with learning disabilities to reduce anxiety and establish trust (Andersson et al ., ), it is imperative that all professionals do more to dispel the myth that hearing cannot be assessed in individuals with learning disabilities.…”

“…Although the prevalence of hearing loss in older adults with learning disabilities is high, a much smaller proportion were found to have hearing assessed than in the general population (Strydom et al, 2005;Van Buggenhout et al, 1999) and assessment was more likely to occur for younger adults (Maatta et al, 2011). This was reported to be due to difficulties in organising assessments (Evenhuis et al, 2004) and the perception that people with learning disabilities are unable to participate meaningfully in assessment (Andersson et al, 2013).…”