Hearing in Athletes with Intellectual Disabilities: The Need for Improved Ear Care

Abstract

Background The Special Olympics offer the opportunity for athletes with intellectual disabilities to participate in a range of sports at regional, national and international level. A parallel Healthy Athletes programme was introduced to ensure safety at the games but also to collect data on the health needs of those with intellectual disabilities (ID). Method This study reports on the introduction of a hearing screen for the first time at national games in Great Britain. Given the availability of free local healthcare it was unclear whether the screen would simply duplicate services already accessed locally. Results Of the 996 athletes who went though the hearing screen 40% were identified with a previously unrecognised hearing loss, 52% required medical ear care and 43% required wax removal. Despite complex competing stimuli within the screening area only 15 of the subjects were unable to complete the full screen. Local clinical services are carried out in more controlled environments therefore it is reasonable to presume that it would be possible for them to provide assessment of ear care and ongoing audiological assessments where needed. It was found that carers and sports coaches were generally unaware of the hearing needs of the athletes, in spite of the fact that they worked so closely with them.Conclusions The importance of imparting information to carers and coaches, together with the need for access to regular ear care locally is underlined in this study.

The importance of hearing: a review of the literature on hearing loss for older people with learning disabilities

“…Data suggested that presbyacusis, the hearing loss associated with age, developed 20-30 years earlier than in other individuals with learning disabilities, and 30-40 years earlier than the general population. This may be an underrepresentation, as the study only included individuals with intellectual capacity sufficient to carry out a standard hearing test and intellectual impairment was shown to correlate with increased level of loss (Evenhuis et al, 2001;Maatta et al, 2006;McCracken et al, 2011). Other studies confirmed these differences in age of development of presbyacusis between populations, despite variation in the prevalence figures…”

Outcome of 10 years of ear and hearing screening in people with intellectual disability in Europe: A multicentre study

“…The World Health Organisation (2018b) states that people with disabilities have the same type of general healthcare needs as the general population, but they face a range of barriers in accessing the health and rehabilitation services they need. These barriers include prohibitive costs, limited availability of services, physical barriers like inaccessible premises (World Health Organisation, 2018b), inadequate skills and knowledge from healthcare professionals (Ali et al, 2013; Aulagnier et al, 2005; Evenhuis et al, 2001; Kerr et al, 2003; McShea, 2015; Slater et al, 2019), communication issues impacting the understanding of risks and treatment plans, healthcare professionals' inattention to the impact on daily activities, time and resource shortage during consultations, behavioural and attitudinal barriers (Marks et al, 2019; Slater et al, 2019), diagnostic overshadowing where behaviours or symptoms of hearing loss are falsely attributed to the person's intellectual disability (Carvill, 2001), or their complaints, signs and symptoms are not recognised or taken seriously, by their guardians, sports coaches or even by their health professionals (Andersson et al, 2013; McCracken et al, 2011; McShea, 2015; Purcell et al, 1999).…”

“…And even with proper training, underdiagnosing remains a problem in people with intellectual disability (Ali et al, 2013; Evenhuis et al, 2001; Kerr et al, 2003). More importantly, there is evidence that even if diagnoses are made, many health professionals do not acknowledge the need for management, and the problem may be underestimated, misinterpreted or even ignored because of barriers regarding behaviour, nonverbal and verbal communication, cost, time and resources (McCracken et al, 2011; McShea, 2015; Purcell et al, 1999; Slater et al, 2019). Carvill (2001) stated that the relationship between intellectual disability and hearing loss is multiplicative rather than additive.…”

Hearing Loss Diagnosis and Management in Adults with Intellectual and Developmental Disabilities

“…In addition to the high prevalence level of hearing loss in patients with IDD, studies have also shown a positive correlation between the severity of IDD and hearing loss [9]. Finally, many studies highlight that hearing loss often goes unidentifed and undertreated in patients with IDD, with previously undiagnosed hearing loss ranging from 19% to 58.7% [5,[10][11][12][13]. While hearing loss in patients without IDD can negatively impact multiple spheres of life such as cognition, communication, social contacts, safety, and occurrence of depression, patients with IDD are even more vulnerable to these consequences, making early screening, diagnosis, and treatment vital [10].…”