Hearing problems in the learning disability population: is anybody listening?

Abstract

Accessible summary• people with learning disability tend to have more hearing problems than other people.• often these hearing problems are not picked up by doctors, nurses, carers or even by the people themselves.• living with undetected hearing loss means people miss out on information, social opportunities and entertainment.• routine screening for hearing loss would improve the lives of many people with learning disability. SummaryWe undertook this project because we believed that hearing loss experienced by the target population was greater than the referral figures suggested. Therefore, we set up a trial service initiative designed to examine the efficacy of different referral routes into audiology services for adults with learning disability. This retrospective analysis focuses on the generation of data on hearing loss on a small population sample (n = 136) gathered over a 6-month period in 2012. We suggest remedial action now to prevent more problems in the future.

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

“…The fact that people with intellectual disability or their guardians often—in up to 74%—are not aware at all of any of the ear and hearing problems revealed by the screening results that has been demonstrated previously (Herer, 2012; Hild et al, 2008; McClimens et al, 2014; Meuwese‐Jongejeugd et al, 2006). This lack of awareness of increased prevalence of ear and hearing problems in people with intellectual disability, and the barriers these people face, are prominent reasons to establish frequent and proactive systematic hearing screenings for all people with intellectual disability, at different stages in life, for the purpose of diagnostic elaboration, therapeutic management and long‐term follow‐up.Due to the high amount of earwax, a screening programme should include earwax removal if necessary (Evenhuis et al, 2004).…”

“…People with intellectual disability are often not aware of their hearing loss, and this may also remain unrevealed to their guardians (Herer, 2012). Literature indicates that hearing loss may be undetected in 26%–74% of this population (Hild et al, 2008; McClimens et al, 2014; Meuwese‐Jongejeugd et al, 2006). Although people with intellectual disability may have more frequent encounters with medical professionals than the population without intellectual disability, it is also true that many medical professionals consider themselves to be insufficiently aware of the risk factors, and not well trained to manage ear and hearing problems in people with intellectual disability (Aulagnier et al, 2005; Slater et al, 2019).…”

An alternative approach for detecting hearing loss in adults with learning disabilities

“…Otoscopy and TEOAE assessment were completed in a similar manner to that of McClimens et al. (2015). These authors elected not to perform tympanometry prior to TEOAE; however, we included this step to ensure normal middle ear function prior to assessment of the cochlea, in order to reduce the number of false‐positive “no clear response” TEOAE results caused by possible conductive components.…”

“…Where this occurs, the responsibility for reporting may fall to a proxy, such as a caregiver. However, caregivers are known to be unreliable in their ability to detect hearing loss in people they support (McClimens et al., 2015). In one study, caregivers estimated over 70% of individuals they supported had satisfactory hearing, though subsequent testing revealed only 11% actually did (Kerr et al., 2003).…”

“…With the literature suggesting a 40% prevalence of hearing loss for people with learning disabilities (Emerson et al., 2012), this is further evidence that the annual health check for hearing is insufficient in its current format, and alternatives should be considered. One such alternative to tackle under‐diagnosis of hearing loss is objective hearing screening (Janicki & Dalton, 1998; McClimens et al., 2015). This has been implemented successfully for athletes with learning disabilities at Special Olympic events (Hild et al., 2008).…”