Measuring resonance frequency of the middle ear in school-aged children: potential applications for detecting middle ear dysfunction.

OBJECTIVE: This study established a normative range of resonance frequency (RF) values as estimated using Wideband Tympanometry (WBT) and determined the ability of WBT-estimated RF to predict the presence of middle ear dysfunction in school-aged children. DESIGN: Cross-sectional data were collected using a hearing screening test battery consisting of WBT, Pure Tone Screening (PTS), 226- kHz tympanometry, and ipsilateral Acoustic Stapedial Reflexes (ASR). STUDY SAMPLE: About 1590 children aged 4-13 years. RESULTS: RF significantly decreased from 4 to 13 years of age (4-6 years, 928.95 kHz; 7-9 years, 872.80 kHz; 10-13 years, 863.68 kHz). RF had area under the receiver operating characteristic curve (AROC) values between 0.589 and 0.626 to predict ears that failed PTS or 226- kHz tympanometry. RF below 627 kHz accurately predicted the presence of a Type B tympanogram (AROC 0.945). RF had high test-retest reliability with Intra-Class Coefficient value of 0.817 and good agreement according to Bland-Altman plot analysis. CONCLUSIONS: WBT-estimated RF had fair diagnostic accuracy for predicting PTS and tympanometry results, but had excellent accuracy for predicting the presence of middle ear dysfunction, indicated by a Type B tympanogram. WBT-estimated RF does not require age-, gender-, ear- or ethnicity-specific normative data for clinical use with children.

Wideband Tympanometry Findings in School-aged Children: Effects of Age, Gender, Ear Laterality, and Ethnicity.

OBJECTIVES: Wideband tympanometry (WBT) measures middle-ear function across a range of frequencies (250 to 8000 Hz) while the ear-canal pressure is varied from +200 to -300 daPa. WBT is a suitable test to evaluate middle-ear function in children, but there is a lack of age-, ear-, gender-, or ethnicity-specific data throughout the literature. The purpose of this study was to investigate the effects of age, ear laterality, gender, and ethnicity on the WBT data retrieved from children aged 4 to 13 years determined to have normal middle-ear function. DESIGN: Data were collected cross-sectionally from 924 children aged 4 to 13 years who passed a test battery consisting of 226-Hz tympanometry, ipsilateral acoustic stapedial reflexes, and pure-tone screening, and without significant history of middle-ear dysfunction. Participants were grouped according to their age: 4 to 6 years, 7 to 9 years, 10 to 13 years. Wideband absorbance values were extracted at 0 daPa (WBA0) and tympanometric peak pressure (WBATPP). RESULTS: The effects of age, frequency, and pressure (WBA0 versus WBATPP) were statistically significant. There were significant differences between WBA0 and WBATPP for all age groups such that WBA0 had lower absorbance at low frequencies (250 to 1600 Hz) and greater absorbance at mid to high frequencies (2500 to 8000 Hz). Statistically significant effects of age were present for WBA0 and WBATPP such that absorbance generally increased with age from 250 to 1250 Hz and decreased with age from 2000 to 5000 Hz. There were no significant main effects of gender, ear, or ethnicity. CONCLUSIONS: Gender-, ear-, and ethnicity-specific clinical WBA0 and WBATPP norms are not required for diagnostic purposes; however, age-specific norms may be necessary. Age-related changes in middle-ear function were observed across WBA0 and WBATPP. The data presented in this study are a suitable clinical reference for evaluating the outer- and middle-ear function of school-aged children.

A preliminary investigation of sound-field amplification as an inclusive classroom adjustment for children with and without Autism Spectrum Disorder.

PURPOSE: This study aimed to determine if sound-field amplification (SFA) could be used as an inclusive classroom adjustment to support primary school students with and without Autism Spectrum Disorder (ASD). METHODS: A two-group, randomised controlled trial (RCT) with crossover was conducted involving 13 students with ASD (9 males, aged 7.6 to 8.4 years) and 17 typically progressing students without ASD (7 males, aged 7.6 to 9.3 years) from 10 primary schools in and near to Brisbane, Australia. Eighteen of these children had an SFA system in their classrooms in semester one and 12 in semester two of their fourth year of formal schooling (Year 3). Potential proximate benefits were assessed using teacher questionnaire and video analysis of student listening behaviours. Potential distant benefits were assessed using measures of phonological processing in quiet and in noise, attention, memory, and educational achievement. RESULTS: Potential proximate benefits were observed for all students with teachers rating student listening behaviours higher with SFA versus without SFA. Potential distant benefits were observed for students with ASD who showed greater improvements in one area of phonological processing (blending nonsense words in noise) following SFA versus no SFA. No other potential proximate or distant benefits following SFA were observed. CONCLUSIONS: SFA could be used as an inclusive classroom adjustment to support some primary school students with and without ASD by potentially putting those students in a better position to learn, but their learning must still take place over time and realistic expectations of what can reasonably be achieved by SFA alone are needed.