Abstract
BackgroundWhilst evidence indicates many children experience troublesome tinnitus, specialist services for children are far less established than those available for adults. To date, there is limited understanding of how paediatric tinnitus is managed in the UK, and to what extent current practice reflects what is recommended. This service evaluation aimed to 1) profile how tinnitus in children is managed in UK clinical practice, and assess to what extent care provided by services reflects advice included in the British Society of Audiology (BSA) Tinnitus in Children Practice Guidance, 2) collate clinician opinions on how services may be optimised, and 3) identify common problems experienced by children who present with bothersome tinnitus in clinic.MethodsAs part of a larger survey, eight questions regarding services for paediatric tinnitus were distributed to UK NHS audiology services via email and social media. Representatives from eighty-seven services responded between July and September 2017.ResultsFifty-three percent of respondents reported that their department provided a paediatric tinnitus service. Among these services, there was widespread use of most BSA recommended assessments and treatments. Less widely used practices were the assessment of mental health (42%), and the use of psychological treatment approaches; cognitive behavioural therapy (CBT) (28%), mindfulness (28%), and narrative therapy (14%). There was varied use of measurement tools to assess tinnitus in children, and a minority of respondents reported using adult tinnitus questionnaires with children. Frequently reported tinnitus-related problems presented by children were sleep difficulties, concentration difficulties at school, situation-specific concentration difficulties, and emotional distress.ConclusionsApproaches used to manage children with troublesome tinnitus in UK NHS services are largely consistent and reflective of the current practice guidance. However, findings from this study indicate specialist staff training, access to child-specific tools, and the treatment and referral of children with tinnitus-related psychological problems represent key areas in need of optimisation.
Highlights
Whilst evidence indicates many children experience troublesome tinnitus, specialist services for children are far less established than those available for adults
There is limited understanding of how paediatric tinnitus is managed in the United Kingdom (UK), and the extent to which current practice reflects the recommended approaches described in the British Society of Audiology (BSA) Guidance
Several tinnitus questionnaire measures are available for use with adults and are sensitive to the tinnitus-related problems they experience, none have been designed for use with children [14]. The purpose of this service evaluation was to 1) profile how tinnitus in children is managed in UK clinical practice, and assess to what extent care provided by services reflects advice included within BSA Guidance, 2) collate clinician opinions on how services may be optimised, and 3) identify common problems experienced by children who present with bothersome tinnitus in clinic
Summary
Whilst evidence indicates many children experience troublesome tinnitus, specialist services for children are far less established than those available for adults. Tinnitus is the perception of sound in the ears or head without any external source This symptom can be troublesome, causing problems in many different areas of life, such as with sleep, psychological health, or cognitive performance [1, 2]. The need to optimise clinical management of children with tinnitus was highlighted by members of the public and clinicians in a 2011/2012 priority setting consultation exercise [13] To address this need, the 2015 BSA “Tinnitus in Children Practice Guidance” [14] was developed, offering a toolkit of child-friendly clinical management strategies to support paediatric service providers. There is limited understanding of how paediatric tinnitus is managed in the UK, and the extent to which current practice reflects the recommended approaches described in the BSA Guidance
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