ABSTRACT
OBJECTIVE: To determine the ability of neonatal clinical, audiologic, and computed tomography (CT) findings to predict long-term neurodevelopmental outcome in children with symptomatic congenital cytomegalovirus (CMV) infection. METHODS: Longitudinal cohort study of children (n = 41) with symptomatic congenital CMV infection evaluated at birth and followed up with serial age-appropriate neurodevelopmental testing. The performance of birth characteristics as predictors of long-term outcome were determined, and clinical and CT scoring systems were developed and correlated with intellectual outcome. RESULTS: Microcephaly was the most specific predictor of mental retardation (100%; 95% CI 84.5-100) and major motor disability (92.3%; 95% CI 74.8-99). An abnormality detected by CT was the most sensitive predictor for mental retardation (100%; 95% CI 82.3-100) and motor disability (100%; 95% CI 78.2-100). A highly significant (P <.001) positive correlation was found between head size at birth and the intelligence/developmental quotient (IQ/DQ). Approximately 29% of children had an IQ/DQ >90. There was no association between sensorineural hearing loss at birth and cognitive outcome. However, children with sensorineural hearing loss on follow-up (congenital and late-onset) had a lower IQ/DQ (P =.006) than those with normal hearing. CONCLUSIONS: The presence of microcephaly at birth was the most specific predictor of poor cognitive outcome in children with symptomatic congenital CMV infection, whereas children with normal findings on head CT and head circumference proportional to weight exhibited a good cognitive outcome.
Subject(s)
Cytomegalovirus Infections/congenital , Developmental Disabilities/virology , Nervous System Diseases/virology , Cerebral Palsy/diagnosis , Cerebral Palsy/virology , Chorioretinitis/diagnosis , Chorioretinitis/virology , Cytomegalovirus Infections/complications , Developmental Disabilities/diagnosis , Female , Hearing Loss, Sensorineural/diagnosis , Hearing Loss, Sensorineural/virology , Humans , Infant, Newborn , Intellectual Disability/diagnosis , Intellectual Disability/virology , Longitudinal Studies , Male , Microcephaly/diagnosis , Microcephaly/virology , Nervous System Diseases/diagnosis , Neurologic Examination , Prognosis , Sensitivity and Specificity , Tomography, X-Ray ComputedABSTRACT
This study was designed to replicate the test-retest reliability and critical difference components of the Profile of Hearing Aid Performance (PHAP) as established by Cox and Gilmore (1990). Subjects were 18 experienced hearing aid users ranging in age from 62 to 74 years old. The initial and retest administrations of the PHAP were conducted with no rehabilitative treatment pertaining to hearing loss or amplification provided during the intervening period. The interval between the first and second administrations of the profile was 4-5 months. The mean test-retest difference scores obtained in this investigation were small, not unlike those reported by Cox and Gilmore (1990). Critical difference (CD) values closely approximated those of the previous study except for the Background Noise subscale and the Environment C scale. A pooled estimate of each standard deviation of test-retest differences was computed using data from both investigations. This resulted in critical differences considered to be more precise than the CD values derived from either study alone. Findings strongly support the utility of the PHAP as an effective tool for generating reliable information regarding self-perceived hearing aid performance.