MILD AND UNILATERAL HEARING LOSS: PSYCHOSOCIAL

MI

REFERENCE DESIGN RECRUIT- CASE SUBJE
Questionnaire Total: N =
Newman CW, MENT DEFINITION
Jacobson GP, Research Outpatients With hear
Hug GA, from Henry Mild: PTA* .5, loss: N =
Sandridge SA. Objectives: Ford 1, 2 kHz* of
Perceived To quantify Hospital in ≤40 dB* HL* in Controls:
hearing self-perceived Detroit, MI. the better ear
handicap of “hearing (mean 22.8 dB
patients with handicap” in a HL).
unilateral or sample of
mild hearing adults with Two sub- 63 adults
loss. Ann Otol unilateral or samples: 64 years
Rhinol mild bilateral age 48.7
Laryngol. hearing loss (1) Unilateral SD 11.6 y
1997;106(3): using the normal: 43
210–4. HHIA.* subjects (68%) No record
with 0–25 dB prior hear
To identify HL in better aid use.
specific ear; mean 15.8
emotional and dB; SD* 7.3 (≤ No eviden
social- 40 dB in conductiv
situational affected ear). hearing lo
problems through p
assessed by (2) Mild tone air a
the HHIA. bilateral: 20 bone
(32%) subjects conductio
with 26–40 dB audiomet
HL; mean 32 tympanom
dB; SD 4.6. and otosc
examinat

* HHIA = Hearing Handicap Inventory for Adults; PTA = pure tone average
deviation

ILD AND UNILATERAL HEARING LOSS: PSYCHOSOCIAL

ECTS ASSESSMENT RESULTS AUTHOR’S
= 63 Mean HHIA score for
TOOLS unilateral normal subjects CONCLUSIONS
ring HHIA: a was 33.5 (SD 21.8), and
63 standardized mean HHIA score for Adults with
test that subjects with mild bilateral unilateral normal or
: N/A quantifies self- hearing loss was 41.9 (SD mild bilateral
perceived 33.5). hearing loss should
s 18– handicap using be considered
(mean a 25-item scale High SD shows that there is candidates for
years; composed of a great variability in perceived audiologic
years) 13-item handicap among individuals rehabilitation,
emotional with both unilateral normal including at least
d of subscale and a and mild bilateral hearing patient–family
ring 12-item social- loss. counseling
situational regarding
nce of subscale. 75% of subjects with communication
ve unilateral normal and mild strategies and the
oss Possible scores bilateral losses reported option to evaluate
pure range from 0 some degree of the potential
and (no perceived communication and benefits from
handicap) to psychosocial problems. amplification.
on 100 (significant
try, perceived For subjects with unilateral
metry, handicap). normal hearing loss, items
copic related to feeling frustrated,
tion. upset, and left out had the
three highest scores

For subjects with mild
bilateral hearing loss, items
associated with irritability,
feeling upset, and feeling
left out were perceived as
the 3 greatest emotional
consequences of hearing
loss.

e; kHz = kilohertz; dB = decibel; HL = hearing level; SD = standard

MI

REFERENCE DESIGN RECRUIT- CASE SUBJECTS
Case studies DEFINITION Total: N = 19
Stein D. compared to MENT Aged: 5–12
Psychosocial norms on years. With hearing
characteristics of standardized Subjects loss: N = 19
school-age tests. identified PTA* .5, 1, 2
children with from files at kHz.* Controls: N/A
unilateral hearing Systematic various
losses. J Acad investigation of clinics, In good ear, 19 children 5
Rehabil Audiol specific agencies, ≤15 dB* HL.* years, 6
1983;16:12–22. psychosocial and private months–11
characteristics, practices in In affected ear, years, 7
such as the ≥30 dB HL. months.
behavior and Louisville
self-esteem, area.
and
measurements UHL for at least
of academic 2 years.
and linguistic
skills of Enrollment in
children with regular
UHL.* classroom,
child has no
Research known learning
disabilities or
Objective: other
To clarify some educational,
possible effects mental, or
of UHL on physical
classroom handicaps.
learning, social
adjustment, 2/3 children
development of with UHL had
peer right ear loss.
relationships,
and vocational 68% had
achievement. severe-to-
profound
losses.

* UHL = unilateral hearing loss; PTA = pure tone average; kHz = kilohertz
TRF = Teacher’s Report Form; RCBP = Revised Child Behavior Profiles; P
Evaluation of Language Function Screening Test

ILD AND UNILATERAL HEARING LOSS: PSYCHOSOCIAL

ASSESSMENT AUTHOR’S

TOOLS RESULTS CONCLUSIONS

Behavioral measures: Behavioral measures: Results
suggested
-CBCL* 42% (8 of 19) showed children
performed
-TRF* behavior problems based on adequately
academically and
-RCBP* the RCBP. had good self-
esteem.
-PRS*

A A Total Behavior Problem Ratings for teachers and

Score was derived for each parents were not consistent

child from the CMBC and for 7 of 19 children.

recorded on the RCBP.

Each score was determined Measures of self-esteem: Author suggested
that 8 children
to be within “clinical” or All but two children scored

“normal” limits established within the norm. might have

by the authors. undiagnosed

Measures of self-esteem: Measures of academic and language
-Piers-Harris Children’s learning
linguistic skills: problems not
The children showed scores

Self-Concept Scale (The on PRS subscales indicating related to hearing

Way I Feel About Myself). interpersonal and social loss.

adjustment problems.

Measures of academic and 37% (N = 7) scored below
acceptable levels.
linguistic skills: 5 of 7 rated by parents and/or
-CELF* teachers as having excessive
-PRS behavior problems on CBCL.
Data showed better class
“…in lieu of formal tests of performance associated with
intelligence and school fewer behavioral problems.
achievement…teacher 8 children referred for
judgments of children’s language screening on basis
classroom performance and of low scores on one or more
intellectual status were of the subscales on PRS.
obtained using a Teacher’s
Information Sheet.”

Demographic Variables:
No differences.

z; dB = decibel; HL = hearing level; CBCL = Child Behavior Checklist;
PRS = Myklebust Pupil Rating Scale Revised; CELF = Clinical

MI

REFERENCE DESIGN RECRUIT- CASE
Questionnaire/case DEFINITION
Watkin P, study; observational. MENT Permanent hearing
Baldwin M, Waltham losses were
Laoide S. The Waltham Forest Forest Health classified according
Parental Health Authority sent Authority in to the British
suspicion and questionnaires to all East London. Society of
identification of parents of children Audiology
hearing referred for From 1973– recommendations:
impairment. audiologic services, 1988 the
Arch Dis Child. including the Waltham Mild bilateral: 21–
1990;65(8):846 question, “‘Do you Forest Health 40 dB* HL* (N =
–50. think your child has Authority 39).
any problem with collected
his/her hearing?” information on Moderate bilateral:
audiologic 41–70 dB HL (N =
Sensitivity of parental referrals and 33).
suspicion was assessments
calculated by on children with Severe bilateral:
percentage of permanent 71–95 dB HL (N =
parents who correctly hearing loss. 17).
identified hearing loss
before audiologic Profound bilateral:
assessment divided >95 dB HL (N =
by all children 22).
diagnosed with
hearing loss. Unilateral: >55 dB
HL in one ear (N =
Research Objective: 60).
To measure the
contribution that
parental suspicion
has made in the
identification of
childhood deafness.

* dB = decibel; HL = hearing level

ILD AND UNILATERAL HEARING LOSS: PSYCHOSOCIAL

SUBJECTS ASSESSMENT RESULTS AUTHOR’S
Total: N = 25% of children with
171 TOOLS permanent hearing loss CONCLUSIONS
Questionnaire. identified as a result of Early
With parental concern; 60% of identification of
permanent children with permanent hearing loss
hearing loss: hearing loss identified through both
N = 171 through screening; 15% parental vigilance
noticed by a person other and sensitive
Bilateral N = than parent. hearing
111 screening
Parental suspicion noted in programs should
Unilateral 30% of children with continue.
N = 60 unilateral hearing loss, 19%
for mild or moderate The probability of
Controls: N/A bilateral loss, and 26% with a parent
severe or profound bilateral suspecting a
All lived in loss. hearing loss
the district in increases as the
1989 and Screening responsible for child’s age
were born identification of 57% of increases, but the
after January children with unilateral sensitivity of
1973. hearing loss, 71% of mild or parental
moderate bilateral hearing suspicion even in
loss, and 46% of children older preschool
with severe or profound children was less
bilateral loss. than 50%.

Person other than parent
noticed hearing loss for
13% of children with
unilateral loss, 10% of mild
or moderate bilateral loss,
and 28% with severe or
profound bilateral loss.