Reading Comprehension

Much has been written about the components that contribute to reading success, such as vocabulary knowledge, phonological awareness, orthographic knowledge, syntax, and inference and integration skills. But much less is known about how these skills contribute to reading comprehension in learners who are deaf or hard of hearing (DHH). With the spread of universal hearing screening of newborns, and the new generation of technologies in hearing compensation (i.e., digital hearing aids and cochlear implants [CIs]), the prospects for children with hearing loss with regard to successful reading comprehension should be substantially improved. However, despite these developments, reading and writing often remain a challenge for DHH children. The chapter begins with a summary of the skills required for successful comprehension in typically hearing readers, and then considers what we know about reading comprehension in DHH children. It concludes with a discussion of where researchers should be focusing their future investigations in order to serve educators and learners most effectively.

Methodological aspects of testing vestibular evoked myogenic potentials in infants at universal hearing screening program

Motor development in infants is dependent upon the function of the inner ear balance organ (vestibular organ). Vestibular failure causes motor delays in early infancy and suboptimal motor skills later on. A vestibular test for newborns and infants that is applicable on a large scale, safe and cost effective is in demand in various contexts: in the differential diagnosis of early onset hearing loss to determine forms associated with vestibular failure; in early hearing habilitation with cochlear implant, indicating the vestibular predominant side; and in the habilitation of children affected by motor skill disorders, revealing the contribution of a vestibular failure. This work explored the feasibility of cervical vestibular evoked myogenic potentials (VEMP) in conjunction with newborn universal hearing screening program. VEMP was measured after the hearing tests and was evoked by bone-conducted stimuli. Moreover, stimulus delivery was regulated by neck muscle activity, with infants rested unconstrained in their parents´ arms and with the head supported by the operator´s hand. This VEMP protocol showed a high level of feasibility in terms of test viability and result reproducibility. VEMP integrated into the newborn hearing screening program may represent a practical method for large-scale assessment of balance function in infants.

Teacher Prescreening for Hearing Loss in the Developing World

The goal of this prospective cohort study was to characterize the ability of teachers to identify schoolchildren at risk of hearing loss in order to maximize hearing screening efficiency in low-resource settings. At 4 semirural schools in Malindi, Kenya, preselected schoolchildren perceived as hearing impaired were compared to children thought to have normal hearing using portable audiometry. Eight of 127 children (54% male) failed hearing screening, all of who were identified by schoolteachers as having a high risk of hearing loss. Thus, for every 5 children prescreened by schoolteachers, an average of 1 child would be identified as having hearing loss. Overall, teacher prescreening had a 100% hearing loss identification rate and a 20% referral rate. In conclusion, in resource-limited settings, where universal hearing screening is challenging, teachers can effectively identify children with hearing loss for early intervention.

Universal hearing screening in newborns: experience in a tertiary care hospital of Mangalore, Karnataka, India

Background: The aim of the study was to do universal hearing screening of all newborns using otoacoustic emission (OAE), to know the incidence and risk factors of hearing loss in neonates.Methods: This was a prospective observational study done in a tertiary care hospital in Mangalore city in Karnataka. 950 neonates were screened with distortion product otoacoustic emission (DPOAE) during the study period of one year from 2017 to 2018. A repeat test was done at one and a half months of age if the first test failed. Auditory brain stem evoked response (ABER) was performed at 3 months of age if both the tests failed. Babies with hearing loss were referred to ENT specialist for further management. Comparison of the variables was done by student’s t test and Chi-square test. P-value <0.05 was considered statistically significant.Results: Out of the 950 newborns screened with DPOAE test, 204 (21.4 %) babies had abnormal screen either in single or both ears. 7 out of 204 (3.43%) babies had abnormal OAE on repeat testing at one and half months. 2 out of 7 babies (0.96 %) had significant hearing loss ABER was performed at 3 months of age.Conclusions: Early identification by screening of hearing loss prevents a significant public health concern. Early recognition and intervention prior to 6 months have a significant positive impact on development.

Screening of high-risk newborns for hearing in MRMC using OAE and BERA

<p class="abstract"><strong>Background:</strong> Hearing is necessary to learn languages and speech and to develop cognitive skills. As hearing is important for normal educational and social development, hearing loss can be disastrous and for the family it can be very distressing. With early detection of hearing loss using OAE and BERA, we can ensure normal language development and help the growing child to lead a near normal life.</p><p class="abstract"><strong>Methods:</strong> 500 cases- out of which 400 normal babies and 100 high risk babies are taken for the study who attend Pediatric OPD and IPD of Basaweshwara Teaching and General Hospital (BTGH) and Sangameshwar hospital attached to MRMC. </p><p class="abstract"><strong>Results:</strong> Out of 400 cases 2 cases have impaired hearing and out of 100 cases with high risk 6 cases have hearing loss.</p><p class="abstract"><strong>Conclusions:</strong> This study highlights the need for OAE and BERA for early identification of hearing loss and that although universal hearing screening programs are warranted but most of the cases with hearing loss can be identified based on the risk factors and High-risk Screening can suffice in areas with limited resources.</p>

Universal hearing screening of newborn to detect hearing loss and aid in early intervention: multicentre study

Background: Significant hearing loss is one of the most common major abnormalities present at birth. Screening for hearing loss in new-born is based on two concepts. First, a critical period exists for optimal language skills to develop, and Second, earlier intervention produces better outcomes.Methods: A two-stage screening protocol, in which new-born are screened first with two staged Transient Evoked Oto-acoustic Emissions TEOAE, using handheld TEOAE device, followed by confirmation with Auditory Brainstem Response (ABR). The objective was to study the incidence of hearing impairment in “healthy” and “high risk‟ newborns. A prospective observational study of hearing impairment screening was conducted on 4400 newborns, the study was done as a multi-centre study in 3 different hospitals during January 10 - December 14.Results: 4400 new born, born during the study period were screened, which included 4162(94.7%) healthy neonates and remaining 238(5.3%) high risk neonates. 24 newborn among the cohort of 4400, had hearing impairment confirmed by ABR. The overall incidence of hearing impairment is 5.45/ 1000 screened with 95 % confidence interval between 4.28-11.6. Incidence of hearing impairment in the "no risk‟ group was 2.4/1000 with 95 % confidence interval between 2.01- 4.66. Whereas incidence of 58.8/1000 with 95 % confidence interval is between 1.96-10.32 was seen in "at risk‟ group. Also, this study shows Universal hearing screening of newborns with a two staged screening protocol using TEOAE followed by confirmation with ABR is not only cost effective for detection of hearing loss but also aids in early intervention.Conclusions: The incidence of hearing impairment in our study (5.45 per 1000) is much higher than results shown in previous studies and national average of 4/1000.