THE USE OF PURE TONES AND OTOACOUSTIC EMISSIONS IN A SCHOOL HEARING SCREENING PROGRAM
Amy Roller, graduate student
Donna Fisher
Smiley, faculty advisor
Department of Speech-Language Pathology
Statement of the problem: Screening for hearing impairment is vitally important in the public school system in order to separate students with a greater probability of having a hearing impairment from those who are apparently healthy. It is the job of a hearing screening to specify those students who need a further hearing evaluation from those who have normal hearing (Nozza & Sabo, 1992). In looking at current school screening practices, pure-tone audiometry has been considered a needed part of screenings and has even been termed the “Gold Standard.” In reality, however, pure tones do not screen for middle ear disorders or low and high frequency hearing loss. Thus, the pure tone standard may be currently missing children with these types of hearing disorders (Yockel, 2002). The purpose of the present study was to compare the pass/fail rates of a pure tone hearing screening with an otoacoustic emission (OAE) screening in the public school population. Methods: The participants in this study were 62 children (124 ears) in kindergarten in an elementary school in Central Arkansas. The children ranged in age from 5 to 6 years. Procedures: Each child’s hearing was screened with pure tones and OAEs. Pure tone screening was performed at 1000, 2000, and 4000Hz at 20dB HL in each ear. Failure to respond to any frequency resulted in a failed pure tone hearing screening. The equipment used for the OAE screening indicated whether or not the screening was a pass or a fail. Statistical analysis: A chi-square data analysis was conducted on the pass/fail results of the pure-tone hearing screening as compared to the otoacoustic emission screening results. A phi correlation was also performed to examine the strength of the relationship between the OAE and pure-tone results. The alpha level was set at .05. Results: The results of the two screening instruments were obtained for 126 ears from children in kindergarten. Seventy-two percent (72%) of the ears tested, either passed both screenings or failed both screenings. Eighteen percent (18%) failed one of the screenings but not the other. No statistically significant difference was found between the two screening instruments. Conclusions: It was concluded that otoacoustic emissions do show promise for use in school screening programs.
References
Nozza, R.J., & Sabo, D.L. (1992). Transiently evoked OAE for screening school-age children. The Hearing Journal, 45(11), 29-31.
Yockel, N.J. (2002). A comparison of audiometry and audiometry with tympanometry to determine middle ear status in school-age children. The Journal of School Nursing, 18(5), 287-292.
USE OF SPACED RETRIEVAL THERAPY
IN THE TREATMENT OF DEMENTIA
Marcilyn Kennedy and Tonya Poteat
Speech Language
Pathology
Memory impairment is the major defining symptom of dementia. The functional deficits that individuals with dementia experience in communication, activities of daily living, and quality of life result directly from memory impairment. Researchers attempting remediation of memory impairment in dementia often distinguish between explicit (declarative) memory and implicit (nondeclarative) memory. Explicit memory systems rely on conscious or intentional recall of specific past information or experiences, whereas implicit memory is mediated by unconscious retrieval of past experiences through habit or procedure. It is this implicit or procedural memory system that seems to be less impaired in persons with dementia. Bayles and Tomoeda (1998) propose several principles for improving communicative function in persons with dementia. First, demands on explicit memory systems should be reduced. Second, reliance on implicit memory systems should be increased. Third, activities that strengthen lexical and conceptual associations should be provided, and fourth, therapeutic activities should be familiar and meaningful to the person with dementia.
Spaced-Retrieval (SR) is a behavioral intervention that adheres to the above principles. It is a method of learning and retaining information by recalling that information over increasingly longer periods of time. When retrieval is successful, the interval preceding the next recall test in increased. If recall failure occurs, the participant is told the correct response and asked to repeat it. Intervals, therefore, are manipulated to facilitate production of a high number of correct responses (or correct utilization of procedures) to the stimulus question and retention of information over increasingly longer periods of time. Strength of association between concepts in semantic memory depends on how often they are activated. Thus, repeatedly bringing into consciousness these associations will result in their increased accessibility. SR, therefore, involves strengthening of associations, increasing reliance on implicit memory expression, and reducing demands on episodic and working memory (explicit memory). Despite case reports of positive treatment outcomes, SR is not commonly used by SLPs.
The purpose of this investigation was to collect pilot data regarding the results of using SR to improve/maintain communication skills. A single subject design (ABA) was used and four adults with dementia participated. The researchers worked with the participants and caregivers to identify communication goals that could be placed into one of the two categories: fact retrieval or strategy learning. Examples of fact retrieval deficits include: locations (residence, bathroom), names (relatives, therapist), important dates (birthdays, appointments, anniversaries), and names of functions objects (toothbrush, comb). Results showed successful recall of identified communication goals within sessions; however, generalization of these goals was not obtained across sessions. These results and their implications will be discussed.
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For more
information, send e-mail to: Jacquie Rainey, jacquier@mail.uca.edu |
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