Minimal Hearing Research Articles

Bess and Hearing Screening: Portending the Challenges in Children

This article summarizes the significant contributions of Fred H. Bess to the early detection of hearing loss in infants and children. Based on public health and educational policy, Bess challenged audiologists to view hearing screening as a responsibility that brought with it the need to develop screening tools that are effective in identifying hearing loss—whether for use with infants, preschoolers, or school-age children—and that adhere to important screening principles. A review of his influence on pertinent guidelines, position statements, and recommendations highlights his belief that early identification of hearing loss is critical if children are to overcome the significant obstacles presented by even mild and unilateral hearing losses. This section is followed by a review of seminal papers that stimulated research in universal newborn hearing screening programs and the detection of unilateral and minimal hearing loss. We conclude with a review of selected studies that build on Bess's earlier work and strive to drive our field forward to practices that are both evidence-based and effective in detecting hearing loss in children.

The Need for Standardization of Methods for Worldwide Infant Hearing Screening: A Systematic Review

No uniform case definition presently exists for infant hearing screening programs worldwide especially for minimal hearing loss (HL). This article systematically reviewed the current practices in developing countries for programs aimed at early detection of "disabling" congenital and early-onset HL and found significant variations which undermine comparability of key findings in the reported studies. Implications for the exclusion of minimal HL are explored within the context of the International Classification of Functioning, Disability and Health (ICF) of the World Health Organization and its adapted version for children and youth (ICF-CY). A revised World Health Organization classification that accounts for all categories of HL based on ICF-CY may provide a suitable framework for improved uniformity in reporting standards.

Effect of Minimal Hearing Loss on Children’s Ability to Multitask in Quiet and in Noise

The purpose of the present study was to examine the effect of minimal hearing loss (HL) on children's ability to perform simultaneous tasks in quiet and in noise. Ten children with minimal HL and 11 children with normal hearing (NH) participated. Both groups ranged in age from 8 to 12 years. The children categorized common words (primary task) while completing dot-to-dot games (secondary task) in quiet as well as in noise presented at 0 dB and +6 dB signal-to-noise ratios (SNRs). It was hypothesized that the children's progression through the dot-to-dot games would slow as they encountered more difficult listening environments. This hypothesis was based on the theory that listeners have limited cognitive resources to allocate to any combination of tasks. The dot rate of both groups decreased similarly in the multitasking conditions relative to baseline. However, no other differences between groups or listening conditions were revealed. Significantly poorer word categorization was observed for the children with minimal HL in noise. These data suggest that children with minimal HL may be unable to respond to a difficult listening task by drawing resources from other tasks to compensate.

Outcomes of Children with Mild Bilateral Hearing Loss and Unilateral Hearing Loss

Studies of children with minimal hearing loss have included children with varying degrees of hearing loss, ranging from 16 dB hearing level (HL) to 44 dB HL. Because children with unilateral, high-frequency, and mild bilateral hearing loss have not previously been identified in the newborn period, it has been difficult to describe the developmental progress of these children. With the early hearing detection and intervention programs, a significant population of very young children is being identified with mild bilateral hearing loss and unilateral hearing loss, some of whom are receiving no intervention services, whereas others begin using amplification and are enrolled in varying intensities and types of intervention services. Although not all children with mild bilateral hearing loss and unilateral hearing loss have significantly delayed development compared with their peers with normal hearing, approximately one third evidence significant difficulties in their language, academic, and social-emotional development. Researchers are striving to identify those characteristics of the children with minimal hearing loss at greatest risk for developmental delay. For a significant portion of children with minimal hearing loss, a hearing loss of any degree appears sufficient to interrupt the normal continuum of communication development and academic skills. This article will present a summary of the current body of literature that has found that children with mild bilateral hearing loss and unilateral hearing loss have significant developmental delays in language, academic, and social-emotional development when compared with typically hearing peers, as well as some studies that have not found such delays. The reasons for these discrepancies will be discussed.

Capturing blocked‐entrance binaural signals from open‐entrance recordings

Binaural recordings enable us to capture all sound attributes including spatial information, room effect, and source characteristics in a given environment. It has been shown that blocked‐entrance binaural recordings provide advantages over open‐entrance recordings, primarily because the blocked‐entrance recordings is not influenced by the ear canal acoustics of the individual for which it is recorded. However, blocking the ear canal for recoding imposes an obvious disruption to normal hearing conditions, which may be unacceptable for applications in which binaural audio capturing is desired but without interfering the individual's hearing and doing. In this work we propose a strategy for the recording of binaural audio with minimal hearing interference, and for transforming these recordings to blocked‐entrance versions that are more suitable for analysis and reproduction of binaural audio in a more general context. To this purpose, equalization filters are derived from the ratio between blocked and open ear canal transfer functions. Different transfer‐function measuring techniques and inverse filtering methods are evaluated.

Acceptability, benefit and costs of early screening for hearing disability: a study of potential screening tests and models

Acceptability, benefit and costs of early screening for hearing disability: a study of potential screening tests and models

Minimal Hearing Loss Leading to the Diagnosis of Temporal Lobe Tumor

Minimal Hearing Loss Leading to the Diagnosis of Temporal Lobe Tumor

Wyniki badań przesiewowych słuchu u wybranej populacji dzieci szkół podstawowych na Śląsku

The aim of this study was analysis of results of audiologic evaluation in the group of 191 children with hearing loss. Children were selected from the group of 8885 pupils of primary schools in Silesia by screening test "Słysze" in 2002. Universal Screening Program of Hearing in Children and Teenage "Słysze" was created and introduced in to the clinic practice by Institute of Physiology and Pathology of Hearing in Warsaw in 1999. The screening program consists of: pure tone examination and speech audiometry in noise. Children with hearing loss detected by this test in 2002 were followed laryngological and audiological examination. Special attention was paid on articulation disturbances, communicational and educational problems in children with hearing loss. The authors focused also attention on "discreet signs of hearing deficiency" (not reacting to commands, turning up a TV-set, loud speech). The validation of screening test "Słysze" was also conducted. In the selected population of primary schoolchildren in Silesia hypoacusis occurred in 6% of examined children, in "city" schools the percentage proved to be higher than in "village" schools. In the group aged 6 to 10 the conductive hearing loss occurred considerable more frequently. Eustachian tube dysfunctions in children with conductive hearing loss occurred more frequently in the group of the younger ones. Older than 10 years old in most cases proved to have perceptive-type of hearing loss. The hearing loss hinders a child's psycho-intellectual development, it is important to detect it as early as possible. The evaluations showed that despite frequent occurrence of "discreet symptoms of hypoacusis", only 17.8% of parents suspected hearing loss in their own child. According to the frequency of parents' signals of "discreet symptoms of hypoacusis" it was found that the fact of turning up TV sound was the most powerful sign indicating the probability of hearing loss (45.5%). The most common risk factors of hearing loss in schoolchildren were also estimated. A characteristic, homogenous group of 34 children (17.8%) was the group with MSHL minimal sensorineral hearing loss of high frequencies (6-8 kHz). Results obtained give evidence of low level of awareness in the society concerning the problem of hypoacusis, which confirms the necessity to screening of hearing in schoolchildren and improving of health care in this respect. Diagnosing hypoacusis in case of children is an interdisciplinary problem, requiring cooperation of medical circles but also teachers, speech therapists and parents.

Assessment of School Functioning Among Israeli Arab Children with Hearing Loss in the Primary Grades

The study examined school functioning of Israeli Arab children with hearing impairment (HI) who were included in regular education classrooms, in comparison to their classmates with normal hearing (NH). Ninety-three children (60 NH and 33 HI), grades 1-6, participated. Teachers evaluated the children using the Arabic version of the Screening Instrument for Targeting Educational Risks (SIFTER; Anderson, 1989); they also reported children's achievement levels in Arabic and mathematics. Results demonstrated that the HI children's functioning was lower than that of the NH children. Children with unilateral and minimal hearing losses had lower functioning than those with more severe hearing loss. As grade level increased, functioning decreased among HI children. Use of the SIFTER was beneficial in detecting children with difficulties. Regular, ongoing SIFTER use and appropriate follow-up on the results may better enable each child to perform optimally in class.

Teachers' Perceptions About Minimal Hearing Loss

A 25-item survey was administered to 45 teachers to identify what they knew about Minimal Hearing Loss (MHL) and to verify or refute five possible misperceptions reported earlier by Goldberg and McCormick Richburg (2004). Results support the importance of an educational audiologist on the service delivery team to help teachers understand the ramifications of MHL and assist in meeting the educational and psychosocial needs of students with this type of loss. Results also suggest areas for in-service education for classroom teachers, especially regarding the issue of preferential seating.

Comments on Progress, Medical Care, and the Overuse of Technology

Comments on Progress, Medical Care, and the Overuse of Technology

DPOAE-grams in patients with acute tonal tinnitus

To investigate cochlear outer hair cell function in patients with acute tonal tinnitus and normal or near-normal hearing threshold. Prospective controlled study in an academic tertiary health center. Distortion products of otoacoustic emissions (DPOAE)-grams of 32 ears with acute tonal tinnitus and normal hearing or minimal hearing loss were compared with those of 17 healthy nontinnitus ears. Tinnitus ears exhibited relatively increased amplitudes of DPOAE at high frequencies (4-6.3 kHz) when compared with the group of healthy ears and relatively decreased DPOAE amplitudes at middle frequencies (1650-2400 Hz). Statistically significant ( P < 0.01) increased mean values of DPOAE amplitudes were observed only at a frequency of f2 equal to 4.9 kHz. These findings suggest an altered functional state of the outer hair cells at a selected high-frequency region of the cochlea in ears with acute tonal tinnitus and normal or near-normal hearing threshold.

Minimal Hearing Impairment: The Importance of Education

Minimal Hearing Impairment: The Importance of Education

The effects of degree and type of hearing loss on children's performance in class

This study evaluated school functioning of a sample of children with hearing impairments who were mainstreamed in regular educational settings. Participants comprised 47 children aged 7;2 to 9;3 years with various degrees and types of hearing loss. Teachers evaluated the children using the Hebrew version of the Screening Instrument For Targeting Educational Risks (SIFTER) (Anderson, 1989). Results demonstrated that some children with unilateral hearing loss as well as children with minimal hearing loss showed lower performance than children with more severe hearing loss. Also, children with hearing aids performed better than those without hearing aids. These findings suggest first that professionals need to become more aware of the possible adverse effects of minimal or unilateral hearing loss on students' functioning in the educational system, and second that consideration should be given to increasing the provision of necessary services.

The effects of degree and type of hearing loss on children's performance in class

This study evaluated school functioning of a sample of children with hearing impairments who were mainstreamed in regular educational settings. Participants comprised 47 children aged 7;2 to 9;3 years with various degrees and types of hearing loss. Teachers evaluated the children using the Hebrew version of the Screening Instrument For Targeting Educational Risks (SIFTER) (Anderson, 1989). Results demonstrated that some children with unilateral hearing loss as well as children with minimal hearing loss showed lower performance than children with more severe hearing loss. Also, children with hearing aids performed better than those without hearing aids. These findings suggest first that professionals need to become more aware of the possible adverse effects of minimal or unilateral hearing loss on students' functioning in the educational system, and second that consideration should be given to increasing the provision of necessary services.

Minimal Hearing Impairment

This article addresses five commonly stated misperceptions concerning the effects of minimal hearing loss on the education of children. Helping educators and other professionals recognize these and other possible misperceptions is the first step in appropriately educating children with minimal hearing loss. Making educators and other professionals aware of the need for proper diagnoses and management strategies is crucial for the achievement of effective educational outcomes for these children. Furthermore, resolving these misperceptions will assist in reducing the financial and psychosocial costs frequently associated with the education of these children.

Children with Minimal Hearing Loss

Children with minimal hearing loss are often not identified, and the educational implications of their hearing disability are unrealized. Because children with special learning problems have been shown to have a higher incidence of hearing loss than typical learners (Flexer, Millin, &amp; Brown, 1990), special educators should be particularly aware of this significant issue. The purpose of this article is to clarify what is meant by minimal hearing loss (MHL), to summarize issues associated with MHL, and to describe instructional modifications for children with MHL.

Minimal Hearing Loss is Not Minimal

Minimal Hearing Loss is Not Minimal

Minimizing Minimal Hearing Loss in the Schools: What Every Classroom Teacher Should Know

(2002). Minimizing Minimal Hearing Loss in the Schools: What Every Classroom Teacher Should Know. Preventing School Failure: Alternative Education for Children and Youth: Vol. 46, No. 2, pp. 86-92.

Capability of serum to convert streptomycin to cytotoxin in patients with aminoglycoside-induced hearing loss

Individual variations in sensitivity to the ototoxic effects of aminoglycoside antibiotics are well documented. Our research demonstrates that there is an apparent difference in serum from patients who are resistant or susceptible to aminoglycoside ototoxicity. In the first study, the cytotoxicity of sera from patients with and without hearing loss after various time periods following the discontinuation of aminoglycoside treatment was assayed using the isolated outer hair cell toxicity assay. The results indicate that sera from patients with hearing loss were significantly more toxic than sera from patients with normal hearing or minimal hearing loss. This toxicity may persist for up to 1 year after discontinuation of aminoglycoside therapy. In a second study, sera were obtained from patients who had received aminoglycoside therapy several years previously. None of these sera was toxic to isolated outer hair cells in vitro. Streptomycin was then incubated with the sera or a protein fraction isolated from sera, and the incubation mixtures were tested for toxicity. The percentage of damaged outer hair cells was significantly higher when streptomycin had been treated with sera or a serum protein fraction from patients with hearing loss (58±10% and 68±9%, respectively) than with sera or a serum protein fraction from a control group (10±5% and 17±4%, respectively). In addition, several incubation mixtures were analyzed using high performance liquid chromatography. A new chromatographic peak was only found in the incubations of streptomycin with serum protein from patients with hearing loss. The results suggest that sera from individuals sensitive to aminoglycoside antibiotics may metabolize these drugs to cytotoxins.