ORIGINAL ARTICLE
Diagnostic Accuracy of High-Frequency DistortionProduct Otoacoustic Emission Screening of Schoolchildren with Down Syndrome
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Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, The University of Queensland, Queensland, Australia
 
 
Publication date: 2014-03-31
 
 
Corresponding author
Carlie Driscoll   

Carlie Driscoll, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, 4072, Australia, Ph: +61 7 3365 3095, Fax: +61 7 3365 1877, e-mail: carlie.driscoll@uq.edu.au
 
 
J Hear Sci 2014;4(1):9-17
 
KEYWORDS
ABSTRACT
Background:
It has been suggested that children with Down syndrome (DS) may display high frequency hearing loss much earlier than those in the general population. The purpose of this study was to investigate the diagnostic accuracy of high-frequency distortion-product otoacoustic emissions (HFDPOAEs) as a screening technique for schoolchildren with DS.

Material and Methods:
Exactly 25 children with DS (15 males, 10 females, mean age =9.7 years, SD=2.6) were sampled from six special education schools. HFDPOAE results were compared to the reference test results – high-frequency pure tone audiometry (HFPTA) at 8 and 10 kHz.

Results:
Test performance was found to reach adequate levels (≥0.7) of accuracy for HFDPOAE SNR at 8 kHz and 10 kHz. The hit rate at 8 kHz was average, but moderately high at 10 kHz. True negative rates and positive posterior probabilities for the HFDPOAE test were high, and false alarm rates were acceptably low. However, the false negative rate was average at 8 kHz and negative posterior probabilities were moderately high at both frequencies. Efficiency index values were high indicating that a large proportion of HFDPOAE results were correct when compared with HFPTA results.

Conclusions:
Initial findings support the potential future use of HFDPOAE for screening children with DS for high-frequency hearing loss.

 
REFERENCES (48)
1.
Balkany TJ, Downs MP, Jafek BW et al. Hearing loss in Down’s syndrome: A treatable handicap more common than generally recognized. Clin Pediatr 1979; 18: 116–8.
 
2.
Shott SR. Down syndrome: common otolaryngolic manifestations. Am J Med Genet C Semin Med Genet 2006;142C: 131–40.
 
3.
Park AH, Wilson MA, Stevens PT et al. Identification of hearing loss in pediatric patients with Down syndrome. Otolaryngol Head Neck Surg, 2012; 146: 135–40.
 
4.
Kile JE. Audiologic assessment of children with Down syndrome. Am J Audiol, 1996; 5: 44–52.
 
5.
Kanamori G, Witter M, Brown J et al. Otolaryngolic manifestations of Down syndrome. Otolaryngol Clin North Am, 2000; 33: 1285–92.
 
6.
Dille MF. Perspectives on the audiological evaluation of individuals with Down syndrome. Semin Hear, 2003; 24: 201–10.
 
7.
Ramia M, Musharrafieh U, Khaddage W et al. Revisiting Down syndrome from the ENT perspective: review of the literature and recommendations. Eur Arch Otorhinolaryngol 2013; May.
 
8.
Buchanan LH. Early onset of presbyacusis in Down syndrome. Scand Audiol, 1990; 19: 103–10.
 
9.
Rappaport JM, Provencal C. Neuro-otology for audiologists. In: Katz J, editor. Handbook of Clinical Audiology. 5th ed. Baltimore: Lippincott Williams & Wilkins; 2002; 9–32.
 
10.
Driscoll C, Kei J, Bates D et al. Transient evoked otoacoustic emissions in children studying in special schools. Int J Pediatr Otorhinolaryngol, 2002; 64: 51–60.
 
11.
Kumar Sinha A, Montgomery JK, Herer GR et al. Hearing screening outcomes for persons with intellectual disability: a preliminary report of findings from the 2005 Special Olympics World Winter Games. Int J Audiol, 2008; 47: 399–403.
 
12.
Bennetts LK, Flynn MC. Improving the classroom listening skills of children with Down syndrome by using sound-field amplification. Downs Syndr Res Pract, 2002; 8: 19–24.
 
13.
Driscoll C, Kei J, McPherson B. Tympanometry and TEOAE testing of children with Down syndrome in special schools. Aust N Z J Audiol, 2003; 25: 85–93.
 
14.
McPherson B, Lai SP, Leung KK et al. Hearing loss in Chinese school children with Down syndrome. Int J Pediatr Otorhinolaryngol, 2007; 71: 1905–15.
 
15.
Kaga K, Marsh RR. Auditory brainstem responses in young children with Down’s syndrome. Int J Pediatr Otorhinolaryngol, 1986; 11: 29–38.
 
16.
Roizen NJ, Wolters C, Nicol T et al. Hearing loss in children with Down syndrome. J Pediatr, 1993;123: 9–12.
 
17.
Koike KJ, Wetmore SJ. Interactive effects of the middle ear pathology and the associated hearing loss on transient-evoked otoacoustic emission measures. Otolaryngol Head Neck Surg, 1999; 121: 238–44.
 
18.
Best V, Carlile S, Jin C et al. The role of high frequencies in speech localization. J Acoust Soc Am, 2005; 118: 353–63.
 
19.
Dreisbach LE, Siegel JH. Distortion-product otoacoustic emissions measured at high frequencies in humans. J Acoust Soc Am, 2001; 110: 2456–69.
 
20.
Harris FP. Distortion-product otoacoustic emissions in humans with high frequency sensorineural hearing loss. J Speech Hear Res, 1990; 33: 594–600.
 
21.
Beahan N, Reichman E, Kei J et al. DPOAE changes in young children with confirmed hearing loss due to ototoxicity. Aust N Z J Audiol, 2006; 28: 90–105.
 
22.
Beahan N. Investigating high frequency auditory function in normally hearing children and children receiving anti-cancer chemotherapy. Doctoral dissertation. Brisbane, Australia: University of Queensland; 2010.
 
23.
Dreisbach LE, Long KM, Lees SE. Repeatability of high-frequency distortion-product otoacoustic emissions in normalhearing adults. Ear Hear, 2006; 27: 466–79.
 
24.
Lyons A, Kei J, Driscoll C. Distortion product otoacoustic emissions in children at school entry: a comparison with pure-tone screening and tympanometry results. J Am Acad Audiol, 2004; 15: 702–15.
 
25.
Gorga MP, Neely ST, Dorn PA. Distortion product otoacoustic emission test performance for a priori criteria and for multifrequency audiometric standards. Ear Hear, 1999; 20: 345.
 
26.
Beahan N, Kei J, Driscoll C et al. High frequency pure tone audiometry (8–16 kHz) in children: a normative study. Aust N Z J Audiol, 2009; 31: 33–44.
 
27.
Siegel JH, Hirohata ET. Sound calibration and distortion product otoacoustic emissions at high frequencies. Hear Res, 1994; 80: 146–52.
 
28.
Zebian M, Hensel J, Fedtke T et al. Interpretation of distortion product otoacoustic emissions at higher frequencies. J Hear Sci, 2011; 1: 49–51.
 
29.
Hecker DJ, Lohscheller J, Bader C et al. A new method to analyze distortion product otoacoustic emissions (DPOAEs) in the high-frequency range up to 18 kHz using windowed periodograms. IEEE Trans Biomed Eng, 2011; 58: 2369–77.
 
30.
Topolska MM, Hassman E, Baczek M. The effects of chronic otitis media with effusion on the measurement of distortion products of otoacoustic emissions: presurgical and postsurgical examination. Clin Otolaryngol Allied Sci, 2000; 25: 315–20.
 
31.
Kei J, Brazel B, Crebbin K et al. High frequency distortion product otoacoustic emissions in children with and without middle ear dysfunction. Int J Pediatr Otorhinolaryngol, 2007; 71: 125–33.
 
32.
Tas A, Yagiz R, Uzun C et al. Effect of middle ear effusion on distortion product otoacoustic emission. Int J Pediatr Otorhinolaryngol, 2004; 68: 437–40.
 
33.
Flynn MC, Bennetts LK. Improving the classroom listening skills of children with Down syndrome by using sound-field amplification. Downs Syndr Res Pract, 2002; 8: 19–24.
 
34.
McDermott AL, Williams J, Kuo MJ et al. The role of bone anchored hearing aids in children with Down syndrome. Int J Pediatr Otorhinolaryngol, 2008; 72: 751–7.
 
35.
Jerger JF. Clinical experience with impedance audiometry. Arch Otolaryngol, 1970; 92: 311–24.
 
36.
Australian Standards AS IEC 60645.1-2002. Pure Tone Audiometers. Sydney: Standards Association of Australia; 2002.
 
37.
Australian Standard AS ISO 389.1-2007. Acoustics – Reference zero for the calibration of audiometric equipment – Reference equivalent threshold sound pressure levels for pure tones and supra-aural earphones in the range 0.125 to 8 kHz. Sydney: Standards Association of Australia; 2007.
 
38.
Australian Standards AS ISO 389.5-2003. Acoustics – Reference zero for the calibration of audiometric equipment. Part 5: Reference equivalent threshold sound pressure levels for pure tones in the frequency range 8 to 16 kHz. Sydney: Standards Association of Australia; 2003.
 
39.
Stelmachowicz PG, Beauchaine KA, Kalberer A et al. High frequency audiometry: test reliability and procedural considerations. J Acoust Soc Am, 1989; 85: 879–87.
 
40.
Carhart R, Jerger JF. Preferred method for clinical determination of pure-tone thresholds. J Speech Hear Disord, 1959; 24: 330–45.
 
41.
Beahan N, Kei J, Driscoll C et al. High-frequency pure-tone audiometry in children: a test–retest reliability study relative to ototoxic criteria. Ear Hear, 2012; 33: 104–11.
 
42.
Whitehead ML, Stagner BB, Lonsbury-Martin BL et al. Effects of ear-canal standing waves on measurements of distortion-product otoacoustic emissions. J Acoust Soc Am, 1995; 98: 3200–14.
 
43.
Stover L, Gorga MP, Neely ST et al. Toward optimizing the clinical utility of distortion product otoacoustic emission measurements. J Acoust Soc Am, 1996; 100: 956–67.
 
44.
O’Rourke C, Driscoll C, Kei J et al. A normative study of otoacoustic emissions in 6-year-old schoolchildren. Int J Audiol, 2002; 41: 162–9.
 
45.
Driscoll C, Kei J, McPherson B. Outcomes of transient evoked otoacoustic emission testing in 6-year-old school children: a comparison with pure tone screening and tympanometry. Int J Pediatr Otorhinolaryngol, 2001; 57: 67–76.
 
46.
Stach BA. Clinical Audiology: An introduction. Clifton Park, NY: Delmar Cengage Learning; 2010.
 
47.
Hassman E, Skotnicka B, Midro AT et al. Distortion products otoacoustic emissions in diagnosis of hearing loss in Down syndrome. Int J Pediatr Otorhinolaryngol, 1998; 45: 199–206.
 
48.
Werner LA, Mancl LR, Folsom RC. Preliminary observations on the development of auditory sensitivity in infants with Down syndrome. Ear Hear, 1996; 17: 455–68.
 
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