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Developmental effects of WBA were evident for infants during the first 6 mo of life. The WBA data can be used as a reference for detecting disorders in the sound-conductive pathways (outer and middle ear) in young infants. Further development of age-specific normative WBA data in young infants is warranted.

Conductive hearing loss was found to be a common diagnosis among infants referred through screening. ATSI infants had significantly higher rates of middle ear pathology and conductive hearing loss at birth and showed poor resolution of middle ear pathology over time compared to non-ATSI infants. Future research using a direct measure of middle ear function as an adjunct to the automated auditory brainstem response screening tool to distinguish conductive from sensorineural hearing loss may facilitate prioritization of infants for assessment, thus reducing parental anxiety and streamlining the management strategies for the respective types of hearing loss.

The risk prediction model had accurate discrimination and satisfactory calibration. Validation results indicate that it may generalize well to new infants. The model could potentially be used in diagnostic and screening settings. In the context of screening, probabilities provide an intuitive and flexible mechanism for setting the referral threshold that is sensitive to the costs associated with true and false-positive outcomes. In a diagnostic setting, predictions could be used to supplement visual inspection of absorbance for individualized diagnoses. Further research assessing the performance and impact of the model in these contexts is warranted.

The high incidence of ear disease and hearing loss in Australian Indigenous children is well documented. This study aims to consider the effect of hearing loss and native-language phonology on learning English by Australian Indigenous children. Twenty-one standard Australian English consonants were considered in a consonant-vowel (CV) context. Each consonant was paired with each other to yield 'same' and 'different' consonant pairs. The participants were classified into three groups: (1) English speaking, non-Indigenous children without history of hearing loss and otitis media (three males, four females, mean age 13.7 years); (2) Indigenous children speaking Tiwi as their native language, without history of hearing loss and otitis media and learning English as a second language (two males, three females, mean age 12.1 yrs) and (3) Indigenous children speaking Tiwi as their native language, with a history of hearing loss and otitis media since childhood (six females, mean age 13.1 years). The reaction time from the onset of the second word of the pair to the pressing of a 'same' or 'different' button was measured. The results demonstrated that discrimination of consonants was differentially affected by differences in language. Hearing loss further complicated the difficulties that a child was already having with English. Hearing loss tended to affect discrimination of English consonants more than those in the native language. The study suggests that amplification alone does not suffice and recommended that phonological awareness programs, with or without amplification, need to be part of a reading program from preschool with Indigenous children learning English as a 'school' language.

This study provided convincing evidence that Aboriginal neonates had significantly lower WBA values than their Caucasian counterparts, although both groups had equal pass rates, as determined by the test battery. Although the two ethnic groups showed significant differences in WBA, the factors contributing to such differences remain undetermined. Further research is warranted to determine the factors that might account for the difference in WBA between the two ethnic groups.

Background: Wideband absorbance (WBA) measured at ambient pressure (WBAA) does not directly accountfor middle ear pressure effects. On the other hand, WBA measured at tympanometric peak pressure(TPP) (WBATPP) may compensate for the middle ear pressure effects. To date, there are no studies thathave compared WBAA and WBATPP in ears with surgically confirmed otitis media with effusion (OME).<br />Purpose: The purpose of this study was to compare the predictive accuracy of WBAA and WBATPP inears with OME.<br />Research Design: Prospective cross-sectional study.<br />Study Sample: A total of 60 ears from 38 healthy children (mean age = 6.5 years, SD = 1.84 years) and60 ears from 38 children (mean age = 5.5 years, SD = 3.3 years) with confirmed OME during myringotomywere included in this study.<br />Data Collection and Analysis: Results were analyzed using descriptive statistics and analysis of variance.The predictive accuracy of WBAA and WBATPP was determined using receiver operating characteristics(ROC) analyses.<br />Results: Both WBAA and WBATPP were reduced in ears with OME compared with that in healthy ears.The area under the ROC (AROC) curve was 0.92 for WBAA at 1.5 kHz, whereas that for WBATPP at 1.25kHz was 0.91. In comparison, the AROC for 226-Hz tympanometry based on the static acoustic admittance(Ytm) measure was 0.93.<br />Conclusions: Both WBAA and WBATPP showed high and similar test performance, but neither test performedsignificantly better than 226-Hz tympanometry for detection of surgically confirmed OME.<br />

Although wideband absorbance (WBA) provides important information about middle ear function, there is limited research on the use of WBA to evaluate eustachian tube dysfunction (ETD). To date, WBA obtained under pressurized condition has not been used to evaluate ETD.The objective of the study was to compare WBA at 0 daPa and tympanometric peak pressure (TPP) conditions in healthy ears and ears with ETD.A cross-sectional study design was used.A total of 102 healthy ears from 79 participants (mean age = 10.0 yr) and 43 ears from 32 patients with ETD (mean age = 16.0 yr) were included in this cross-sectional study. WBA was measured at 0 daPa (WBA0) and TPP WBA at TPP (WBATPP).WBA results were analyzed using descriptive statistics and t-tests with the Bonferroni correction. An analysis of variance with repeated measures was applied to the data.WBA0 was significantly lower in the ETD group than in the control group. The WBA0 of the control group demonstrated a broad peak between 1.25 and 4 kHz, whereas the WBA0 of the ETD group had a peak between 2.5 and 4 kHz. WBATPP of the ETD group approached values close to that of the control group. In the control group, WBATPP was only 0.06 to 0.09 higher than WBA0, whereas in the ETD group, WBATPP was 0.29 to 0.42 higher than WBA0 between 0.6 and 1.5 kHz. A differential pattern of WBA at TPP relative to 0 daPa was observed between ears with ETD and ears with otitis media with effusion (OME) and negative middle ear pressure (NMEP).Hence, a comparison of WBA0 and WBATPP can provide potentially useful diagnostic information, and hence can be used as an adjunct tool to evaluate ETD. This is important especially in young children or some adults who are unable to perform maneuvers such as Toynbee or Valsalva during ETD assessment. Further research is needed to verify the results using test performance measures to determine whether WBA0 and WBATPP can objectively determine the presence of ETD or OME with NMEP.