Progress in the early identification of hearing impaired infants in Mississippi.

The prevalence of permanent congenital hearing loss is three to four infants per thousand live births. Because early intervention is effective in preventing speech and language delay, the NIH has recommended universal newborn hearing screening. Prior to this recommendation, several states, including Mississippi which had one of the first hospital based screening programs, had statewide programs. In 1981 the Lions Clubs of Mississippi and the University of Mississippi Medical Center began an infant hearing screening program, which was described in Volume XXX of The Journal of the Mississippi State Medical Association. This program was recognized in 1986 with an award from the U.S. Secretary of Health and Human Services, and by 1989, the Lions Club had persuaded twenty-two hospitals that this was a needed service. Twelve years after the start of the program in Mississippi, the National Institutes of Health (NIH) recommended universal newborn hearing screening. This article reviews Mississippi's efforts toward early identification of hearing loss and provides an update on the current screening program.

"That imperfect instrument": Galton's whistle, Bierce's damned thing, and the phenomenon of superior nonhuman sensory range.

When the Galton whistle was introduced in the 1870s, it was the first demonstration many had encountered of the phenomenon that nonhumans sometimes exceed humans in sensory range, for example perceiving ultraviolet light and ultrasonic signals. While some empirical research had explored this possibility beforehand, this area of perceptual research progressed slowly. A horror short story by Ambrose Bierce in 1893, "The Damned Thing," used the concept of superior nonhuman sensory range as a twist ending, seemingly anticipating scientific discoveries to come or at least understanding the implications of the early findings well in advance of the field. This article analyzes Bierce's possible sources, with Bierce representing the general educated nonscientist and providing insights into the spread of this concept into public and scientific awareness. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The History of Pediatric and Adult Hearing Screening.

OBJECTIVES/HYPOTHESIS: To document the history of hearing seeing in children and adults. STUDY DESIGN: A literature search in all languages was carried out with the terms of hearing screening from the following sources: Pub Med, Science Direct, World Catalog, Index Medicus, Google scholar, Google Books, National Library of Medicine, Welcome historical library and The Library of Congress. METHODS: The primary sources consisting of books, scientific reports, public documents, governmental reports, and other written material were analyzed to document the history of hearing screening. RESULTS: The concept of screening for medical conditions that, when found, could influence some form of the outcome of the malady came about during the end of 19th century. The first applications of screening were to circumscribe populations, schoolchildren, military personnel, and railroad employees. During the first half of the 20th century, screening programs were extended to similar populations and were able to be expanded on the basis of the improved technology of hearing testing. The concept of universal screening was first applied to the inborn errors of metabolism of newborn infants and particularly the assessment of phenylketonuria in 1963 by Guthrie and Susi. A limited use of this technique has been the detection of genes resulting in hearing loss. The use of a form of hearing testing either observational or physiological as a screen for all newborns was first articulated by Larry Fisch in 1957 and by the end of the 20th century newborn infant screening for hearing loss became the standard almost every nation worldwide. CONCLUSIONS: Hearing screening for newborn infants is utilized worldwide, schoolchildren less so and for adults many industrial workers and military service undergo hearing screening, but this is not a general practice for screening the elderly. LEVEL OF EVIDENCE: NA Laryngoscope, 131:S1-S25, 2021.

Analysis of the changes in the Polish Universal Neonatal Hearing Screening Program over 15 years of activity.

INTRODUCTION: One of the examples of a nationwide pro-health program in Poland is the Polish Universal Neonatal Hearing Screening Program (PUNHSP). The Program is aimed at early diagnosis and intervention in children with hearing impairments and it is an example of a well-managed program. Presenting the results of the PUNHSP activity as well as organizational aspects and own experience can significantly help institutions managing other programs to achieve high efficiency in their functioning. The aim of this work is a detailed analysis of the Program evaluation during the 15 years of its activity, i.e. the identification of changes and the consequences of their introduction in the perspective of improving quality and efficiency. MATERIALS AND METHODS: The material is PUNHSP data, registered in the Central Database of the Program and organizational information related to management, IT support and PUNHSP infrastructure. The analysis was based on quality assessment parameters (identification of changes and the purpose of their introduction) and effectiveness (consequences of introducing changes). The analysis concerns the whole period of PUNHSP activity - from 2002 to 2017. RESULTS: As a result of the analysis, 13 main modifications of the Program were identified as the "change" criteria and 11 smaller ones - side ones resulting from the necessity to adapt the PUNHSP functionality to current needs. The changes were grouped into five categories: legal, administrative, management, audit and control, as well as IT, changes. DISCUSSION: When analyzing the PUNHSP evaluation, it can be assumed that the changes introduced positively influenced the various aspects of the PUNHSP activity, but do not exhaust the possibilities of further optimization of its activity. CONCLUSIONS: The Program requires constant development in order to increase the efficiency and effectiveness of its operation, and the solutions used in it could be a stimulus to improve and create other pro-health programs.

A brief history of audiology at Mayo Clinic.

Audiometric hearing tests were conducted at the Mayo Clinic in Rochester at the beginning of the 1930s. The list price for one of its audiometers at that time was 3,500 dollars, which translates into approximately 37,000 dollars in 2003 currency. Physicians and residents in training were responsible for conducting hearing tests in the 1930s and 1940s. In the early 1940s a registered nurse was trained as an audiometrist to assist for some of the audiometric testing. The first "consulting audiologist" at the Mayo Clinic in Rochester was hired in 1949, early in the development of audiology as a profession. Growth in demand for audiologic services for larger numbers of patients and in the variety of services provided to them led to marked increases in personnel, space, and specialization over the years.

Alfred Gardiner Brown (1838-1882) M.R.C.S.Eng., F.R.C.S.(Ed.). His contribution to the history of the development of the tuning fork.

Alfred Gardiner Brown was the first designated Aural Surgeon to be appointed to the consultant staff of The London Hospital, at the age of 38. In July 1880 he published the paper showing his adaptation of the way in which the tuning fork was applied to the head and its use in measuring hearing power by comparing it with the sense of touch. Had he been blessed with a longer life it is highly probable that he would have made a significant contribution as he was of an innovative and inventive mind. He died at the age of 44.

The master hearing aid.

As early as the 1930s the term Master Hearing Aid (MHA) described a device used in the fitting of hearing aids. In their original form, the MHA was a desktop system that allowed for simulated or actual adjustment of hearing aid components that resulted in a changed hearing aid response. Over the years the MHA saw many embodiments and contributed to a number of rationales for the fitting of hearing aids. During these same years, the MHA was viewed by many as an inappropriate means of demonstrating hearing aids; the audio quality of the desktop systems was often superior to the hearing aids themselves. These opinions and the evolution of the MHA have molded the modern perception of hearing aids and the techniques used in the fitting of hearing aids. This article reports on a history of the MHA and its influence on the fitting of hearing aids.

Hearing screening for newborns: the midwife's role in Early Hearing Detection and Intervention.

Universal newborn hearing screening is becoming the standard of care in the United States. However, there has been some controversy around this pediatric preventive health care practice. In 2001, the US Preventative Services Task Force (USPSTF), the leading independent panel of experts on prevention and primary care in the United States, reviewed the scientific literature and found inconclusive evidence to recommend for or against universal newborn hearing screening. As a result of this lack of recommendation, some pediatric providers were not screening the hearing of all newborn infants. The USPSTF released an update in July 2008 concluding there is scientific evidence to recommend newborn hearing screening for all infants. Universal newborn hearing screening is the first step in the national Early Hearing Detection and Intervention (EHDI) program. EHDI includes not only universal newborn hearing screening but also diagnostic evaluation for any infant failing the initial hearing screen and intervention services for any infant diagnosed with hearing loss. During the prenatal and postnatal periods, obstetric care providers can play a vital role in the EHDI process through education, screening, referral, and assistance with follow-up. Through these services, clinicians can work with parents and pediatric care providers to help newborns and infants develop communication and language skills that will last a lifetime.

Medical inspection of State schoolchildren in Australia, c. 1905-14.

From about 1905 some medical practitioners pressed State governments to back official physical examinations of State school children. Their campaign embodied a broader project to identify and reduce incapacities undermining public hygiene and national efficiency. Some of the activists became inspectors in Tasmania, Victoria, South Australia and Queensland. Evidence about their relations with children, teachers, parents, communities and local GPs seems to be meagre but worth pursuing. The campaign's immediate and longterm effects on child health apparently disappointed its proponents 'hopes, but still might have helped many children and benefited national fitness. Later repercussions of boys being classed as 'fit' could prove deadly in the Great War.

Diagnostic audiology: historical perspectives.

In summary, the modern era of diagnostic audiometry began with the era of loudness recruitment in the 1950s, followed closely by the era of acoustic impedance in the 1960s and 1970s and, most recently, the era of evoked potentials in the 1970s and early 1980s. Throughout this period, the era of speech audiometry has grown slowly but steadily. Jay Sanders has made important contributions in each of these areas, but his most important legacy will be the continuing contributions of his many dedicated and loyal students in the years to come.

[History of the tuning fork. II: Evolution of the classical experiments by Weber, Rinne and Schwabach]. / Die Geschichte der Stimmgabel. Teil II: Die Entwicklung der klassischen Versuche nach Weber, Rinne und Schwabach.

BACKGROUND: Since the 17th centrury it was known that sounds could be perceived via air conduction and bone conduction and that this provided a means of differentiating between hearing disorders located in the middle ear and those located in the acoustic nerve. For a long time to come, however, there was no need for such a differential diagnosis. After the invention of the tuning fork in 1711 this instrument had soon become widely used in music, but it took well over 100 years until it was introduced into physiology and otology. FROM DIRECTIONAL HEARING TO WEBER'S TEST: J. B. Venturi, a physicist in Modena, Italy, in 1802 had shown that the perception of the direction from which a sound is coming is governed by the fact that one ear is hit by the sound more intensely than the other ear. C. T. Tourtual, a physician in Münster, Germany, demonstrated in 1827 that this also holds true for sound conducted via the skull bones. He used a watch as sound source. He found that occlusion of both ear canals would increase the sensation in both ears equally, but that occlusion of only one ear would increase the sensation only in the occluded ear, thus giving the impression that the sound were coming from that side. He was interested in a comparison between vision and audition, and he concluded that with regard to recognizing the direction of a sensory signal vision was superior to audition. In the same year 1827 C. Wheatstone, a physicist in London, investigating the mode of vibration of the tympanic membrane and using a tuning fork found the same phenomena as Tourtual and some more effects. E. H. Weber, an anatomist and physiologist in Leipzig, Germany, described the very same phenomena as Tourtual and Wheatstone once more in 1834. He wanted to prove that airborne sound is perceived by the vestibulum and the semicircular canals, bone conducted sound by the cochlea. None of these investigators was thinking of a clinical use of their findings and made no such suggestion. E. Schmalz, an otologist in Dresden, Germany, in 1845 introduced the tuning fork and the test later named after Weber into otology and explained in great detail all possibilities of a diagnostic evaluation of the test. His grand achievement, however, passed unnoticed at his time. THE RINNE TEST: A. Rinne, a physician in Göttingen, Germany. In 1855 described the test which later was named after him, in an elaborate treatise on the physiology of the ear. He wanted to demonstrate that in man and animals living in the air, as opposed to those living in water, the conduction of sound via the bones of the skull is just an unavoidable side effect of sound perception. He mentioned a clinical application of his test only in a footnote and obviously never used it himself in a systematic way. His test was made generally known by Lucae in Berlin only after 1880. The value of Weber's and Rinne's tuning fork tests was much disputed even at the turn of the century and only gradually became generally accepted.

[History of instrumental measuring of hearing acuity: the first acumeter]. / Zur Geschichte der apparativen Hörschärfemessung: Die ersten Akumeter.

The necessity of measuring the acuity of hearing in a reproducible way arose for the first time when the invention of Volta's pile in 1800 seemed to present the opportunity of curing deafness. For this purpose Chr. H. Wolke in Jever, Northern Germany, in 1802 devised two instruments which he called "acumeter". Details of these instruments were hardly known, and Wolke's publication was believed to be lost. The author has now succeeded in tracing Wolke's publication and another associated paper by J. J. A. Sprenger. Hence, the circumstances of Wolke's and Sprenger's work and details of these first acumeters are now being published together with original figures and the correct dimensions of the instruments. The acumeters had a pendulum-like hammer that would strike against a plate swinging down from varying heights that could be read in degrees of angle from a scale. One of the instruments was made of wood. It was 1.50 m high, with the pendulum raised to the maximal position 2.70 m. The other instrument of similar construction was made of metal and about half the size of the first one, with a height of 0.70 m or 1.30 m respectively. For comparison Itard's acumeter is presented which was published in 1821. It worked on the same principle, and it is likely that Itard had been inspired by Wolke's paper. The development of mechanical acumeters after Wolke's and Itard's instruments is outlined briefly.

The early descriptions of the so-called tuning-fork tests of Weber, Rinne, Schwabach, and Bing. III. The development of the Schwabach and Bing tests.

In the third and last part of this study the development of the so-called tuning-fork tests of Schwabach and Bing is discussed. The attention is called to the work of Schmalz (1849), Lucae (1880) and Emerson (1884). These authors preceeded Schwabach (1885) in using and describing the test which became only generally accepted through Schwabach's extensive study and since then bears his name. As to the so-called Bing or occlusion test, Bing's (1891) work is reviewed and the attention is drawn to an early and apparently forgotten description of this test by Rinne (1885).

[The Galton whistle and discovery of presbycusis. Images from the history of otorhinolaryngology, exemplified by equipment from the collection of the Ingolstadt German Medical History Museum]. / Die Galton-Pfeife und die Entdeckung der Altersschwerhörigkeit. Bilder aus der Geschichte der Hals-Nasen-Ohren-Heilkunde, dargestellt an Instrumenten aus der Sammlung im Deutschen Medizinhistorischen Museum in Ingolstadt.

One of the many interests of Sir Francis Galton (1822-1911), a singularly versatile English research worker, was anthropometry, i.e. measuring and comparing physical attributes in men. Here he introduced the concept of eugenics. He thought that the upper hearing threshold for high-pitched tones might be an attribute specific to each species, and in order to prove this he devised a whistle which was later named after him. Using this instrument he found that the upper hearing threshold in animals actually differs very much with the species and that in humans it is regularly depressed with age. The relevant passages of his book Inquiries into Human Faculty of 1883 are quoted in translation. Burckhardt-Merian from Basel, Switzerland, introduced Galton's whistle into otology in 1885. Appropriate instruments were soon developed by König in Paris and Edelmann in Munich and became commercially available. Zwaardemaker in Utrecht, the Netherlands, was the first to systematically investigate hearing in the elderly using Galton's whistle, and he derived from these studies what he called the "prebyacusial law." Technical details of Galton's whistle are described with reference to Edelmann's final refined version of the instrument of 1900. During the first 30 years of this century, Galton's whistle was in wide use, but due to unavoidable inherent flaws it later gave way to the monochord and eventually to tone audiometry.

The early descriptions of the so-called tuning-fork tests of Weber, Rinne, Schwabach, and Bing. II. The "Rhine Test" and its first description by Polansky.

Concerning the first description of the so-called tuning-fork test of Rinne the literature refers to a publication by him in 1855. In this work Rinne describes, among many other observations, a method to compare air and bone conduction hearing, and adds the remark that the technique could be used for the diagnosis of deafness. It appears, however, that long before Rinne, Polansky (1842) gave a complete account of the test and its practical use. Polansky's description seems to have been forgotten. Rinne's report, too, was lost for a long period until 25 years later when Lucae (1882) and Schwabach (1885) confirmed the usefulness of the test which - in spite of its earlier discovery by Polansky - has born Rinne's name ever since.