CHILDREN WITH MINIMAL SENSORINEURAL HEARING-LOSS - PREVALENCE, EDUCATIONAL PERFORMANCE, AND FUNCTIONAL STATUS

Objective: This study was designed to determine the prevalence of mini mal sensorineural hearing loss (MSHL) in school-age children and to as sess the relationship of MSHL to educational performance and functiona l status. Design: To determine prevalence, a single-staged sampling fr ame of all schools in the district was created for 3rd, 6th, and 9th g rades. Schools were selected with probability proportional to size in each grade group. The final study sample was 1218 children. To assess the association of MSHL with educational performance, children identif ied with MSHL were assigned as cases into a subsequent case-control st udy. Scores of the Comprehensive Test of Basic Skills (4th Edition) (C TBS/4) then were compared between children with MSHL and children with normal hearing. School teachers completed the Screening Instrument fo r Targeting Education Risk (SIFTER) and the Revised Behavior Problem C hecklist for a subsample of children with MSHL and their normally hear ing counterparts. Finally, data on grade retention for a sample of chi ldren with MSHL were obtained from school records and compared with sc hool district norm data. To assess the relationship between MSHL and f unctional status, test scores of all children with MSHL and all childr en with normal hearing in grades 6 and 9 were compared on the COOP Ado lescent Chart Method (COOP), a screening tool for functional status. R esults: MSHL was exhibited by 5.4% of the study sample. The prevalence of all types of hearing impairment was 11.3%. Third grade children wi th MSHL exhibited significantly lower scores than normally hearing con trols on a series of subtests of the CTBS/4; however, no differences w ere noted at the 6th and 9th grade levels. The SIFTER results revealed that children with MSHL scored poorer on the communication subtest th an normal-hearing controls. Thirty-seven percent of the children with MSHL failed at least one grade. Finally, children with MSHL exhibited significantly greater dysfunction than children with normal hearing on several subtests of the COOP including behavior, energy, stress, soci al support, and self-esteem. Conclusions: The prevalence of hearing lo ss in the schools almost doubles when children with MSHL are included. This large, education-based study shows clinically important associat ions between MSHL and school behavior and performance. Children with M SHL experienced more difficulty than normally hearing children on a se ries of educational and functional test measures. Although additional research is necessary, results suggest the need for audiologists, spee ch-language pathologists, and educators to evaluate carefully our iden tification and management approaches with this population. Better effo rts to manage these children could result in meaningful improvement in their educational progress and psychosocial well-being.