Hearing screening for school children: utility of noise-cancelling headphones

BMC Ear, Nose and Throat Disorders

Bradley McPherson¹  Ada Hiu Chong Lo¹ 

[1] Division of Speech and Hearing Sciences, Faculty of Education, University of Hong Kong, Pokfulam Road, Pokfulam, Hong Kong

关键词: School children;    Hearing screening;    Hearing loss;    Headphones;    Background noise;   

Others  :  862714
DOI  :  10.1186/1472-6815-13-6

 received in 2013-02-28, accepted in 2013-05-17,  发布年份 2013

【 摘 要 】

Background

Excessive ambient noise in school settings is a major concern for school hearing screening as it typically masks pure tone test stimuli (particularly 500 Hz and below). This results in false positive findings and subsequent unnecessary follow-up. With advances in technology, noise-cancelling headphones have been developed that reduce low frequency noise by superimposing an anti-phase signal onto the primary noise. This research study examined the utility of noise-cancelling headphone technology in a school hearing screening environment.

Methods

The present study compared the audiometric screening results obtained from two air-conduction transducers—Sennheiser PXC450 noise-cancelling circumaural headphones (NC headphones) and conventional TDH-39 supra-aural earphones. Pure-tone hearing screening results (500 Hz to 4000 Hz, at 30 dB HL and 25 dB HL) were obtained from 232 school children, aged 6 to 8 years, in four Hong Kong primary schools.

Results

Screening outcomes revealed significant differences in referral rates between TDH-39 earphones and NC headphones for both 30 dB HL and 25 dB HL criteria, regardless of the inclusion or exclusion of 500 Hz results. The kappa observed agreement (OA) showed that at both screening intensities, the transducers’ referral agreement value for the 500 Hz inclusion group was smaller than for the 500 Hz exclusion group. Individual frequency analysis showed that the two transducers screened similarly at 1000 Hz and 2000 Hz at 25 dB HL, as well as at both 30 dB HL and 25 dB HL screening levels for 4000 Hz. Statistically significant differences were found for 500 Hz at 30 dB HL and at 25 dB HL, and for 1000 Hz and 2000 Hz at 30 dB HL. OA for individual frequencies showed weaker intra-frequency agreement between the two transducers at 500 Hz at both intensity criterion levels than at higher frequencies.

Conclusions

NC headphones screening results differed from those obtained from TDH-39 earphones, with lower referral rates at 500 Hz, particularly at the 25 dB HL criterion level. Therefore, NC headphones may be able to operate at lower screening intensities and subsequently increase pure-tone screening test sensitivity, without compromising specificity. NC headphones show some promise as possible replacements for conventional earphones in school hearing screening programs.

【 授权许可】

   
2013 Lo and McPherson; licensee BioMed Central Ltd.

【 图 表 】

【 参考文献 】

• [1]White K: Twenty years of early hearing detection and intervention (EHDI): where we’ve been and what we’ve learned. American Speech-Language-Hearing Association: Rockville MD; 2010. [Paper presented at the American speech-language-hearing association audiology virtual conference]
• [2]Fortnum H, Summerfield A, Marshall D, Davis A, Bamford J, Yoshinaga-Itano C, Hind S: Prevalence of permanent childhood hearing impairment in the United Kingdom and implications for universal neonatal hearing screening: Questionnaire based ascertainment study. Br Med J 2001, 323(7312):536-542.
• [3]Grote J: Neonatal screening for hearing impairment. Lancet 2000, 355(9203):513-514.
• [4]American Academy of Pediatrics: Recommendations for preventive pediatric health care. Pediatrics 2007, 120:1376.
• [5]Rao RS, Subramanyam MA, Nair NS, Rajashekhar B: Hearing impairment and ear diseases among children of school entry age in rural South India. Int J Ped Otorhinolaryngol 2002, 64:105-110.
• [6]Carney A, Moeller M: Treatment efficacy: hearing loss in children. J Speech Lang Hear Res 1998, 41:S61-S64.
• [7]Downs MP: Contribution of mild hearing loss to auditory learning problems. In Auditory disorders in school children: the Law, identification, remediation. 4th edition. Edited by Roeser RJ, Downs MP. New York: Thieme; 2004:233-248.
• [8]Kennedy CR, McCann DC, Campbell MJ, Law CM, Mullee M, Petrou S, Watkin P, Worsfold S, Yuen HM, Stevenson J: Language ability after early detection of permanent childhood hearing impairment. New Eng J Med 2006, 354:2131-2141.
• [9]Olusanya BO: Addressing the global neglect of childhood hearing impairment in developing countries. PLoS Med 2007, 4(4):e74.
• [10]Olusanya BO, Newton VE: Global burden of childhood hearing impairment and disease control priorities for developing countries. Lancet 2007, 369:1314-1317.
• [11]Yoshinaga-Itano C, Sedey A, Coulter D, Mehl A: Language of early- and later-identified children with hearing loss. Pediatrics 1998, 102:1161-1171.
• [12]Wang CN, Bovaird S, Ford-Jones E, Bender R, Parsonage C, Yau M, Ferguson B: Vision and hearing screening in school settings: reducing barriers to children’s achievement. Paediatr Child Health 2011, 16:271-272.
• [13]Sabo MP, Winston R, Macias JD: Comparison of pure tone and transient otoacoustic emissions screening in a grade school population. Am J Otol 2000, 21:88-89.
• [14]Sideris I, Glattke TJ: A comparison of two methods of hearing screening in the preschool population. J Commun Disord 2006, 39:391-401.
• [15]American Speech-Language-Hearing Association: Guidelines for screening for hearing impairments and middle ear disorders. ASHA 1990, 32:17-24.
• [16]Flanary VA, Flanary CJ, Colombo J, Kloss D: Mass hearing screening in kindergarten students. Int J Ped Otorhinolaryngol 1999, 50:93-98.
• [17]Olusanya BO, Okolo AA, Adeosun AA: Predictors of hearing loss in school entrants in a developing country. J Postgrad Med 2004, 50:173-179.
• [18]Sarafraz M, Ahmadi K: A practical screening model for hearing loss in Iranian school-aged children. World J Pediatr 2009, 5:46-50.
• [19]Sliwa L, Hatzopoulos S, Kochanek K, Pilka A, Senderski A, Skarzynski PH: A comparison of audiometric and objective methods in hearing screening of school children. A preliminary study. Int J Ped Otorhinolaryngol 2011, 75:483-488.
• [20]Bento RF, Albernaz PLM, Di Francesco RC, Wiikmann C, Frizzarini R, Castilho AM: Detection of hearing loss in elementary schools: a national campaign. Int Congr Ser 2003, 1240:225-229.
• [21]Gell PM, White E, Newell K, Mackenzie I, Smith A, Thompson S, Hatcher J: Practical screening priorities for hearing impairment among children in developing countries. Bull World Health Organ 1992, 70:645-655.
• [22]Jacob A, Rupa V, Job A, Joseph A: Hearing impairment and otitis media in a rural primary school in South India. Int J Ped Otorhinolaryngol 1997, 39:133-138.
• [23]McPherson B, Law MMS, Wong MSM: Hearing screening for school children: comparison of low-cost, computer-based and conventional audiometry. Child Care Health Dev 2010, 36:323-331.
• [24]Bess FH, Sinclair JS, Riggs DE: Group amplification in schools for the hearing impaired. Ear Hear 1984, 5(3):138-144.
• [25]Crandell C, Bess F: Speech recognition of children in a “typical” classroom setting. ASHA 1986, 29:87.
• [26]Hay B: A pilot study of classroom noise levels and teacher’ reactions. Voice+ 1995, 4:127-134.
• [27]Knecht HA, Nelson PB, Whitelaw GM, Feth LL: Background noise levels and reverberation times in unoccupied classrooms: predictions and measurements. Am J Audiol 2002, 11:65-71.
• [28]Moodley A: Acoustic conditions in mainstream classrooms. J Brit Assoc Teachers Deaf 1989, 13:48-54.
• [29]Shield B, Dockrell JE: External and internal noise surveys of London primary schools. J Acoust Soc Am 2004, 115:730-738.
• [30]Zannin PHT, Marcon CR: Objective and subjective evaluation of the acoustic comfort in classrooms. Appl Ergon 2007, 38:675-680.
• [31]Institute ANS: Acoustical performance criteria, design requirements and guidelines for schools (Standard S12.60-2002). American National Standards Institute: Washington, DC; 2002.
• [32]American Speech-Language-Hearing Association: Acoustics in educational settings: technical report. http://www.asha.org/docs/html/TR2005-00042.html webcite
• [33]Choi CY, McPherson B: Noise levels in Hong Kong primary schools: implications for classroom listening. Int J Disabil Dev Ed 2005, 52:345-360.
• [34]Shield B, Greenland E, Dockrell J: Noise in open plan classrooms in primary schools: a review. Noise Health 2010, 12:225-234.
• [35]Olusanya BO: Classification of childhood hearing impairment: Implications for rehabilitation in developing countries. Disabil Rehabil 2004, 26:1221-1228.
• [36]Benavot A, Gad L: Actual instructional time in African primary schools: factors that reduced school quality in developing countries. Prospects 2004, 34(3):291-310.
• [37]Lepore SJ, Shejwal B, Kim BH, Evans GW: Associations between chronic community noise exposure and blood pressure at rest and during acute noise and non-noise stressors among urban school children in India. Int J Environ Res Public Health 2010, 7:3457-3466.
• [38]Hallett CP, Gibbs AC: The effect of ambient noise and other variables on pure tone threshold screening in a population of primary school entrants. Brit J Audiol 1983, 17(3):183-190.
• [39]McPherson B, Knox E: Test-retest variability using the Liverpool screening audiometer in a field environment. Brit J Audiol 1992, 26:139-141.
• [40]American Academy of Audiology: Childhood hearing screeening guidelines. 2011. http://www.cdc.gov/ncbddd/hearingloss/recommendations.html webcite
• [41]Williams W: The calculation of maximum permissible ambient noise levels for audiometric testing to a given threshold level with a specified uncertainty. National Acoustic Laboratories Report 2010, 133:1-11.
• [42]International Organization for Standardization (ISO): ISO 8253–1 Acoustics-Audiometric test methods, part 1: Basic pure tone air and bone conduction audiometry. Geneva: International Organization for Standardization; 1989.
• [43]Gan WS, Kuo SM: An integrated audio and active noise control headset. IEEE Trans Consumer Electronics 2002, 48(2):242-247.
• [44]Krüger H, Jeub M, Schumacher T, Vary P, Beaugeant C: Investigation and development of digital active noise control headsets. Tel Aviv, Israel: Proceedings of International Workshop on Acoustic Echo and Noise Control (IWAENC); 2010.
• [45]Kuo SM, Gan WS: Active noise control system for headphone applications. IEEE Trans Control Systems Technol 2006, 14:331-335.
• [46]Sauert B, Vary P: Near end listening enhancement optimized with respect to speech intelligibility index and audio power limitations. Aalborg, Denmark: Proceedings of European Signal Processing Conference (EUSIPCO); 2010:1919-1923.
• [47]Schumacher T, Kruger H, Jeub M, Vary P, Beaugeant C: Active noise control in headsets: A new approach for broadband feedback ANC. Prague, Czech Republic: Proceedings of the IEEE International Conference on Acoustics, Speech and Signal Processing (ICASSP); 2011:417-420.
• [48]Bommier A, Lamber S: Education demand and age at school enrollment in Tanzania. J Hum Resour 2000, 35:177-203.
• [49]Schlauch RS, Nelson P: Puretone evaluation. In Handbook of clinical audiology. 6th edition. Edited by Katz J, Medwetsky L, Burkard R, Hood LJ. Baltimore: Lippincott Williams & Wilkins; 2009:30-49.
• [50]American Speech-Language-Hearing Association: Guidelines for audiologic screening. http://www.asha.org/policy/GL1997-00199.htm webcite
• [51]Bamford J, Fortnum H, Bristow K, Smith J, Vamvakas G, Davies L, Taylor R, Watking P, Fonseca S, Davis A, Hind S: Current practice, accuracy, effectiveness and cost-effectiveness of the school entry hearing screen. Health Technol Assess 2007, 11(32):1-168.
• [52]Mathers C, Smith A, Concha M: Global burden of hearing loss in the year 2000. Geneva: World Health Organization; 2003:1-30. [Global burden of disease 2000]
• [53]Saunders JK, Vaz S, Greinwald JH, Lai J, Morin L, Mojica K: Prevalence and etiology of hearing loss in rural Nicaraguan children. Laryngoscope 2007, 117:387-398.
• [54]Silman S, Silverman CA, Arick DS: Pure-tone assessment and screening of children with middle-ear effusion. J Am Acad Audiol 1994, 5:173-182.
• [55]Seely DR, Gloyd SS, Wright AD, Norton SJ: Hearing loss prevalence and risk factors among Sierra Leonean children. Arch Otolaryngol Head Neck Surg 1995, 121:853-858.
• [56]McPherson B, Holborow CA: A study of deafness in west Africa: the Gambian hearing health project. Int J Ped Otorhinolaryngol 1985, 10:115-135.
• [57]McPherson B, Swart SM: Childhood hearing loss in sub-Saharan Africa: a review and recommendations. Int J Ped Otorhinolaryngol 1997, 40:1-18.
• [58]Miller SA, Omeme JA, Bluestone CD, Torkelson DW: A point prevalence of otitis media in a Nigerian village. Int J Ped Otorhinolaryngol 1983, 5:19-29.
• [59]Minja BM, Machemba A: Prevalence of otitis media, hearing impairment and cerumen impaction among school children in rural and urban Dar es Salaam, Tanzania. Int J Ped Otorhinolaryngol 1996, 37:29-34.
• [60]Olusanya BO, Okolo AA, Ijaduola GTA: The hearing profile of Nigerian school children. Int J Ped Otorhinolaryngol 2000, 55:173-179.
• [61]Saim A, Saim L, Saim S, Ruszymah BHI, Sani A: Prevalence of otitis media with effusion amongst pre-school children in Malaysia. Int J Ped Otorhinolaryngol 1997, 41:21-28.
• [62]Zakzouk SM: Epidemiology and etiology of hearing impairment among infants and children in a developing country: Part II. J Otolaryngol 1997, 26:402-410.
• [63]Wake M, Poulakis Z: Slight and mild hearing loss in primary school children. J Paediatr Child Health 2004, 40:11-13.
• [64]Davis A, Reeve K, Hind S, Bamford J: Children with mild and unilateral hearing loss. In A sound foundation through early amplification 2001. Proceedings of the second international conference. Edited by Seewald RC, Gravel JS. Chicago: Phonak AG; 2002:179-186.
• [65]Briscoe J, Bishop DV, Norbury CF: Phonological processing, language, and literacy: a comparison of children with mild-to-moderate sensorineural hearing loss and those with specific language impairment. J Child Psychol Psychiatry 2001, 42:329-340.
• [66]Amplivox Limited: Amplivox audiocups. http://sonici.com.au/wp-content/uploads/AMPLIVOX-Audiocups-Brochure.pdf webcite
• [67]Coles RRA: A noise-attenuating enclosure for audiometer earphones. Brit J Ind Med 1967, 24:41-51.
• [68]Wright DC, Frank T: Attenuation values for a supra-aural earphone for children and insert earphone for children and adults. Ear Hear 1992, 13:454-459.
• [69]Olusanya BO: Hearing impairment in children with impacted cerumen. Ann Trop Paediatr 2003, 23:121-128.
• [70]McPherson B, Olusanya BO: Screening for hearing loss in developing countries. In Audiology in developing countries. Edited by McPherson B, Brouillette R. Hauppauge, NY: Nova Publishers; 2008:75-105.