Conclusion. High frequency immittance measurements demonstrate promise in clarifying middle ear status for neonates but age-and gender-specific norms should be consulted. Objective. To describe high frequency immittance measurements using a 1000 Hz probe tone for a sample of 278 neonatal ears (0-4 weeks of age) in order to compile normative tympanometric and acoustic reflex criteria. Subjects and methods. Assessment of neonatal ears included 1000 Hz probe tone immittance measurements (tympanograms and ipsilateral acoustic reflexes), and distortion product oto-acoustic emission (DPOAE) screening. Results were compared and normative values were compiled for immittance measures in ears controlled for normal middle ear functioning (n=250). Results. Comparison of immittance results to OAE screening outcome provides estimates of sensitivity and specificity for middle ear fluid with tympanometry of 57% and 95%, and 57% and 90% for acoustic reflex presence, and 58% and 87% for combined tympanogram and acoustic reflex results, respectively. Normative data indicate that static peak admittance values differ significantly across gender and age with the 5th percentile cut-off value for the entire sample at 1.4 mmho. The 90% range of tympanic peak pressure normative values increases with increasing age from 140 daPa for neonates 1 week of age to 210 daPa for neonates 2-4 weeks of age. Acoustic reflexes were elicited at 93±9 dB with a 90% normality range of 80-105 dB.
Early identification of hearing loss followed by a timely and effective intervention programme for children with hearing impairment is necessary to minimise the negative effects of hearing loss on the development of cognition, psychosocial and verbal communication skills. Such early intervention programmes need to be multidisciplinary, technologically sound and take cognisance of the context in which the child and family function. The main aim of this study is to obtain accurate and reliable baseline information regarding current status of the intervention process for children with hearing loss in Mauritius, a developing country. An exploratory, descriptive qualitative research design is selected to achieve this aim. Questionnaire-based interviews were carried out to obtain information from 37 hearing impaired children's parents regarding the median ages of suspicion of hearing loss, diagnosis and placement of hearing aids. The referral Contents
The role of speech-language therapists (SLTs) in schools in South Africa needs to be revisited based on the changing educational needs in the country. Th is article builds on a paper by Kathard et al. (2011), which discussed the changing needs of the country with regard to the role of SLTs working in schools. South African policy changes indicated a shift from supporting the child to supporting the teacher, but also place more emphasis on the support of all learners in literacy in an eff ort to address past inequities. Th is paper addresses several of the questions that emerged from Kathard et al. and explores the collaborative roles played by SLTs on four levels in the education context. Collaboration at the learner level (level 1) focuses on prevention and support, whereas collaboration at the teacher level (level 2) is described in terms of training, mentoring, monitoring and consultation. Collaboration can also occur at the district level (level 3), where the focus is mainly on the development and implementation of support programmes for teachers in areas of literacy and numeracy. Collaboration at the level of national and provincial education (level 4) is key to all other roles, as it impacts on policy. Th is last level is the platform to advocate for the employment of SLTs in schools. Such new roles and responsibilities have important implications for the preparation of future SLTs. Suggestions for curricular review and professional development are discussed. It is proposed that SASLHA responds to the changes by developing a position statement on the roles and responsibilities of SLTs in schools.
Newborn hearing screening is the procedure of choice for ensuring optimal outcomes for infants with hearing loss, whether in a developed or developing country. Unfortunately, apart from a small number of recent exceptions, newborn hearing screening has been a practice reserved for the developed world. Despite the prevailing challenges towards implementing hearing screening in developing countries, there are existing structures in these countries that need to be investigated as possible platforms from which programs can be actualized. Immunization clinics, constituting part of a primary healthcare approach characteristic of developing countries, offer one such a platform. A novel service delivery model, based on initial results from a pilot study, was developed for infant hearing screening at immunization clinics in South Africa as an integrated part of primary, secondary, and tertiary levels of healthcare. This type of model is a first step toward ensuring that infants with hearing loss in developing communities are afforded opportunities for optimal development and societal integration through accountable and contextually relevant early hearing detection and intervention services.
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