Use of the Ling 7-Sound Test to monitor hearing in young children with Down syndrome.
Degree GrantorUniversity of Canterbury
Degree NameMaster of Audiology
Children with Down syndrome are at an increased risk of developing conductive hearing loss as a result of chronic/recurring otitis media with effusion (Barr, Dungworth, Hunter, McFarlane, & Kubba, 2011; Bernardi, Pires, Oliveira, & Nisihara, 2017) which may exacerbate their difficulties in speech and language development (Tharpe, 2016). Additionally, children with Down syndrome who experienced temporary or fluctuating hearing loss between 2-4 years of age have been found to demonstrate delayed speech and language development beyond the time of resolution of the hearing loss (Laws & Hall, 2014). The aim of this study was to evaluate the utility of using the Ling 7-Sound Test with four parents to monitor the hearing of their young children with Down syndrome on a daily basis over the period of one school term. Children’s responses to the Ling 7-Sound Test were compared to objective results obtained from tympanometry, performed weekly by the researcher at the early intervention centre the children attend. If the child was found to have otitis media with effusion, as evidenced by a type B low tympanogram, parents were encouraged to employ environmental modifications and communication strategies to mitigate the negative impacts of otitis media with effusion. Pure tone audiometry was used to confirm the hearing status when a child’s tympanometry results changed. The Parents’ Evaluation of Aural/Oral Performance of Children (PEACH) and Teachers’ Evaluation of Aural/Oral Performance of Children (TEACH) questionnaires (Ching & Hill, 2005) were completed by parents and early intervention educators to evaluate the child’s listening in the home and preschool environments. Following the study, parents completed a social validity questionnaire and participated in a semi-structured interview. All four families successfully incorporated the Ling 7-Sound Test into their daily routines and reported value in doing so. One child presented with binaural type B low tympanograms and a mild to moderate hearing loss, consistent with middle ear fluid during two weeks of the study. Three of the children completed the Ling 7-Sound Test with 45 dB A stimuli, while the fourth completed it with 40 dB A stimuli due to a different sensitivity in hearing. The qualitative nature of the comments provided by parents through the PEACH, Ling 7-Sound Test, questionnaires and interviews increased the holistic understanding of each child’s health, attention and listening behaviour in relation to their ear health and hearing during the 10 week study period.