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Biomedical subjects

J Roush

Publications and source records attributed to J Roush.

At least 19 recordsLinked to original sources
PubMed2001

Parents' reactions and recommendations after diagnosis and hearing aid fitting.

This study was designed to explore parent reactions to the early stages of audiologic assessment and intervention. A total of 213 parents whose children were under the age of 6 years returned a mail survey. Respondents from 45 states participated. Parents were asked to (1) report the approximate age of diagnosis and hearing aid fitting; (2) comment on reasons for any delays encountered from diagnosis to fitting; and (3) respond to questions concerning their reactions to the initial fitting of amplification. The median age of identification was earlier than some previous investigations; however, substantial delays occurred between diagnosis and hearing aid fitting. Reasons for delay included the need for further audiologic evaluation, problems obtaining return appointments, illness of the child, and difficulties obtaining adequate earmolds. Parent reactions to hearing aids, once fitted, included concerns about appearance and questions about maintenance and use, but attitudes regarding hearing aids and their perceived benefits improved over time.

Adult↗
PubMed2000

Otitis media in childhood in relation to preschool language and school readiness skills among black children.

OBJECTIVE: To examine whether otitis media with effusion (OME) and associated hearing loss (HL) during the first 5 years of life were related to children's language skills during the preschool years and to school readiness skills at entry to kindergarten. METHODS: In a prospective study, the ears of 85 black children primarily from low-income families and recruited from community-based childcare programs were repeatedly examined from 6 months to 5 years of age for the presence of OME and from 6 months to 4 years of age for HL when well and ill with OME. Assessments were made annually of the children's child-rearing environments at home and in childcare, and children's language skills between 3 and 5 years of age and readiness skills in literacy and math were evaluated at entry into kindergarten. RESULTS: Children had either bilateral or unilateral OME approximately 30.4% and HL 19.6% of the observation time. OME and associated HL were significantly positively correlated with some measures of expressive language at 3 and 4 years of age; however, these direct relationships were no longer significant when the child's gender, socioeconomic status, maternal educational level, and the responsiveness and support of the home and childcare environments were also considered. Further, both OME and HL were moderately correlated with school readiness skills at entry to school, with children having more OME scoring lower in verbal math problems and with children with more HL scoring lower in math and recognizing incomplete words. These associations continued to remain significant even after partialing out the child and family background factors. CONCLUSIONS: There was not a significant relationship between children's early OME history or HL and language skills during the preschool years. However, children with more frequent OME had lower scores on school readiness measures. These associations were moderate in degree, however, and the home environment was more strongly related to academic outcomes than was OME or HL. These results should be interpreted cautiously when generalizing to other populations.

Auditory Threshold↗
PubMed2000

Early-onset sensorineural hearing loss in a child with Turner syndrome.

Turner syndrome is among the more common but less familiar syndromes that include sensorineural hearing loss and middle ear disease. This article provides a review of the syndrome, an illustrative case, and a review of specific issues relevant to audiologic management of patients with Turner syndrome.

Adolescent↗
PubMed1998

Otitis media, the caregiving environment, and language and cognitive outcomes at 2 years.

OBJECTIVE: To examine the relationship between otitis media with effusion (OME) and associated hearing loss between 6 and 24 months of age and children's language and cognitive development at 2 years of age. STUDY DESIGN: A prospective cohort design in which 86 African-American infants who attended group child-care centers were recruited between 6 and 12 months of age. Between 6 and 24 months, assessments included serial ear examinations using otoscopy and tympanometry, serial hearing tests, two ratings of the childrearing environment at home and in child care, and language and cognitive outcomes at 2 years. RESULTS: Children experienced either unilateral or bilateral OME an average of 63% and reduced hearing sensitivity an average of 44% of the time between 6 and 24 months of age. Although proportion of time with OME or with hearing loss was modestly correlated with measures of language and cognitive skills, these relationships were no longer significant when the ratings of the home and child-care environments were also considered. Children with more OME or hearing loss tended to live in less responsive caregiving environments, and these environments were linked to lower performance in expressive language and vocabulary acquisition at 2 years. CONCLUSIONS: Both OME and hearing loss were more strongly related to the quality of home and child-care environments than to children's language and cognitive development. Study results might be explained either by suggesting that children in less responsive caregiving environments experience conditions that make them more likely to experience OME and/or by suggesting that it may be more difficult for caregivers to be responsive and stimulating with children with more OME.

Black People↗
PubMed1997

Multifrequency tympanometry and evoked otoacoustic emissions in neonates during the first 24 hours of life.

Multifrequency, complex-component tympanograms and transient evoked otoacoustic emissions (EOAEs) were recorded in 55 neonates less than 24 hours of age. The purpose of the investigation was to determine the normal middle ear immittance characteristics of neonates less than 24 hours old (the approximate discharge age of well-babies) and to assess whether an association exists between transient EOAE response and middle ear status in neonatal ears. The tympanometric patterns recorded in the 55 neonates were, in general, not typical of those observed in older children and adults. Complex patterns were recorded at low probe frequencies indicating differences in the contribution of mass, stiffness, and resistance elements to admittance in the neonatal middle ear. Results from EOAE screening indicated a pass rate or partial pass rate of 82 percent. Although no clear association emerged between admittance characteristics and EOAE results, some interesting tendencies were noted.

Acoustic Impedance Tests↗
PubMed1996

Cancer-associated human papillomavirus types are selectively increased in the cervix of women in the first trimester of pregnancy.

OBJECTIVE: Because of incomplete data in the current literature, we sought to determine whether pregnancy is an independent risk for the detection of human papillomavirus infection. STUDY DESIGN: Pregnant patients in their first trimester who are seen for routine care at an obstetrics clinic and nonpregnant patients receiving routine care at a sexually transmitted diseases clinic and a gynecology clinic were recruited. Cervical cells were collected by saline solution lavage, and deoxyribonucleic acid was extracted and tested for the presence of human papillomavirus deoxyribonucleic acid with the hybrid capture assay. This assay detects the deoxyribonucleic acid of five "low cancer risk" and nine "high cancer risk" human papillomavirus types with two separate pools of deoxyribonucleic acid probes. RESULTS: Results from 245 pregnant women, 248 patients from the sexually transmitted diseases clinics, and 246 gynecology clinic patients were analyzed. Human papillomavirus deoxyribonucleic acid was detected in samples from 31% of the pregnant patients compared with 17.7% and 18.6% of the sexually transmitted diseases clinic and gynecology clinic patients, respectively. There was no significant difference in positivity for the "low-risk" human papillomavirus types among the three groups (positivity rates from 8.9% to 12.7%), but the pregnant patients had a significantly higher positivity rate for the "high-risk" human papillomavirus types (24.9% compared with 13.3% and 11.4% for the sexually transmitted diseases and gynecology clinic patients, respectively; p < 0.001). A multiple logistic regression analysis showed that pregnancy was an independent predictor of a positive test result for a "high-risk" human papillomavirus type (odds ratio 1.79, 95% confidence interval 1.11 to 2.89) but not a positive test result for a "low-risk" type. CONCLUSIONS: Because sexual activity was not greater among the pregnant patients, we propose that the increased detection of "high-risk" human papillomavirus types among the pregnant patients represents a selective activation of these viruses by hormonal or immunologic factors associated with pregnancy.

Adult↗
PubMed1996

Age of suspicion, identification, and intervention for infants and young children with hearing loss: a national study.

OBJECTIVE: This study was designed to seek a nationwide perspective on the status of identification and intervention for infants and young children with hearing loss. DESIGN: Three hundred thirty-one parents, whose children ranged from infancy to 5 yr of age, returned a mail survey that included respondents from 35 states. Parents were asked to report the approximate age of suspicion, diagnosis, hearing aid fitting, and initiation of early intervention services. Demographic information, risk factors, if known, and reasons for delay were also investigated. RESULTS: Results revealed substantial delays between parental suspicion, audiologic-medical diagnosis, fitting of acoustic amplification, and initiation of early intervention services; however, the pattern of delay was different for children with known risk factors than it was for those without known risk factors. The median age of identification and intervention was lower than that reported by some previous investigators, although a considerable range was reported for each category. CONCLUSIONS: The median age of identification and intervention, although still higher than optimal, may be improving. Further research is needed to identify the many factors that continue to delay the timely management of hearing loss in young children.

Age of Onset↗
PubMed1995

Prospective surveillance for otitis media with effusion among black infants in group child care.

OBJECTIVE: To document the prevalence of otitis media with effusion (OME) in 102 black children observed prospectively between 6 and 24 months of age. METHODS: Study children attended nine different center-based child care facilities. Middle ear status was assessed by pneumatic otoscopy and tympanometry every 2 weeks. RESULTS: All children, except one, had OME during the period of observation. The proportion of child-examinations revealing bilateral OME ranged from 76% between 6 and 12 months of age to 30% between 21 and 24 months of age. Effusions were considered purulent in only 13% of examinations revealing middle ear fluid. The mean incidence of purulent OME was 2.13 episodes per child per year. Sixty-six children had at least 4 months of continuous bilateral OME during the period of observation; 57 were followed without placement of tympanostomy tubes. Bilateral OME had resolved before the second birthday in 95% of these children, and within 3 months of achieving the 4-month criterion in 50% of subjects. CONCLUSIONS: Persistent bilateral OME occurs commonly between 6 and 18 months of age in infants who enter group child care during the first year of life. In this study, spontaneous resolution of bilateral effusion by 2 years of age was typical.

Acoustic Impedance Tests↗
PubMed1995

Otitis media, hearing sensitivity, and maternal responsiveness in relation to language during infancy.

The relation of otitis media with effusion (OME) and associated hearing loss to language and cognitive skills at 1 year of age was studied to determine whether OME-related hearing loss had a direct association with language and cognitive outcomes at 1 year of age or an indirect association with these outcomes, as mediated by the child-rearing environment. Subjects were 61 black infants attending community-based child care programs. The presence of OME was assessed biweekly from 6 to 12 months of age by otoscopy and tympanometry. Hearing was assessed with visual reinforcement audiometry when children were well and when ill with OME. Language and cognitive skills and the child-rearing environment at home and in child care were examined. The results indicated a modest correlation between hearing loss associated with OME and receptive language. However, the direct association between OME-related hearing loss and all the language and cognitive measures was negligible. Hearing loss had an indirect association with receptive and expressive language, cognitive development, and overall communication as mediated by child-rearing factors. That is, children with more frequent hearing loss tended to have less responsive mothers and home environments, and this association was linked to lower performance on the infant assessments.

Adult↗
PubMed1995

Developmental changes in static admittance and tympanometric width in infants and toddlers.

Longitudinal measures of peak-compensated static acoustic admittance and tympanometric width are reported for infants and toddlers from 6 months to 30 months of age, based on over 1600 assessments of 88 children during a 24-month period. The subjects were all African-American children in full-time day care. Significant age effects were observed, with younger children displaying lower static admittance values and wider tympanograms. The results of this investigation underscore the importance of age- and population-specific norms when using acoustic admittance measures to evaluate middle ear status in children.

Acoustic Impedance Tests↗
PubMed1995

FM amplification for enhancement of conversational discourse skills: case study.

The purpose of this single-subject pilot study was to examine the efficacy of FM amplification for enhancing the discourse skills of a 4-year-old girl with a history of speech-language impairments, otitis media with effusion (OME), and motoric delays. Over a period of several weeks, language treatment sessions were conducted with and without FM amplification, in a classroom setting. Sessions were videotaped and analyzed for the appropriateness and effectiveness of the subject's conversational turns during sessions with amplification and with no amplification. Although the number of sessions was small, more appropriate and effective conversational turns occurred during sessions with amplification.

Amplifiers, Electronic↗
PubMed1992

Identification of middle ear dysfunction in young children: a comparison of tympanometric screening procedures.

Two acoustic immittance screening procedures were evaluated in conjunction with pneumatic otoscopy, performed by a pediatric otolaryngologist. The subjects were 204 3- and 4-yr-old children from a rural area in eastern North Carolina. Pass-fail criteria were examined using two middle ear screening procedures: (1) a "traditional" procedure based on measures of tympanometric peak pressure and acoustic reflexes, and (2) the tympanometric measures contained within the American Speech-Language-Hearing Association's (ASHA) revised Guidelines for Screening for Hearing Impairment and Middle Ear Disorders. The traditional procedure resulted in low specificity but high sensitivity, whereas ASHA's immittance procedure resulted in high specificity but only moderate sensitivity. The negative predictive value was very high for both procedures; however, positive predictive value was low, especially for the traditional procedure. Advantages and disadvantages of the two procedures and future research needs are discussed.

Acoustic Impedance Tests↗
PubMed1992

Application of an implantable bone conduction hearing device to patients with unilateral sensorineural hearing loss.

This investigation, comprised of five studies, was undertaken to determine if individuals with newly acquired profound unilateral hearing losses would benefit from an implantable bone-conduction hearing device. The bone conductor was implanted on the side of the deaf ear at the time of translabyrinthine acoustic tumor resection. Two areas greatly affected by unilateral hearing loss, speech recognition in noise and sound localization, were examined. No improvement in aided performance could be documented in either area.

Adult↗
PubMed1992

A national survey of educational preparation programs for early intervention specialists.

To examine the status of preprofessional education in early intervention, we conducted a nationwide survey of college and university programs offering degrees in education of the deaf. Curriculum content and practicum experiences with infants and toddlers and their families were examined, as well as general comments and recommendations of program directors. Additional information was sought from programs offering specializations at the preschool level to determine whether they had CED affiliation, and if so, whether they were certified in the areas of parent-infant education or early childhood education. The findings are discussed in the context of Public Law 99-457 and the growing emphasis on family centered early intervention.

Adult↗
PubMed1991

Family-centered early intervention. The perceptions of professionals.

This paper, based on a nationwide survey, examines the attitudes and opinions of professionals regarding parent-professional involvement in the planning and implementation of goals and services for hearing-impaired infants and toddlers and their families. The implications of the findings are discussed as they pertain to PL 99-457, the new federal mandate for services to young children with special needs and their families.

Age Factors↗
PubMed1991

Implantable bone-conduction hearing device: practical considerations.

An implantable bone conduction hearing device can be of significant benefit to carefully selected patients with noncorrectable conductive hearing losses. However, for some patients the device has significant limitations. This paper presents several practical issues that need to be considered before a decision is made regarding implant surgery. It is recommended that, whenever possible, air conduction hearing aids remain the first option considered when a patient's conductive hearing loss cannot be resolved through traditional medical management.

Adult↗
PubMed1990

Clinical application of an implantable bone conduction hearing device.

For some patients, the transcutaneous bone-conduction implant offers a viable alternative to conventional amplification. However, this option should be employed only after considering the relative advantages and disadvantages of conventional medical management and, when feasible, the fitting of air-conduction amplification. The cases presented here illustrate some important factors to consider in the selection and fitting of bone-implant candidates.

Adult↗