A video-based performance in noise test for measuring audio-visual disability in young school children: test development, with validation by trained teachers, parents and audiometry as relative standards for disability

Background. impaired ability to detect target sounds in noisy surroundings is a particular feature of children with a history of otitis media with eff usion (OME). Children with current OME are also likely to experience diffic ulty in speech reception in classrooms where a high level of background noi se has been recorded. No tests are currently available which are feasible i n primary care and which objectively measure school-related disabilities. T he effects of speech in noise and the extent to which this is offset by spe ech reading contribute important dimensions to disability. Methods: a video -based speech reception test has been developed using the same principles i n 227 English and 182 Danish 4-8 year-old children. Distribution data was c ollected for both language versions of the test. The test has been compared with audiometry and teacher and parents assessments to establish its valid ity. Interpretation: there are no gold standards for audio-visual disabilit y in current clinical use. The poor positive predictive value of audiometry for likely classroom functioning is a cause for concern, particularly in r elation to inappropriate referral of children by primary care physicians. ( C) 1999 Elsevier Science Ireland Ltd. All rights reserved.