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Dr Gooding had a week's study leave to visit
the Department of Developmental Paediatrics and
the Audiology Centre at the University of
Groningen in Holland.
Pre-School Screen Audiometry by Dorothy Barber,
Hearing Clinic Heston, Hounslow. Paper read at
meeting of the British Society of Audiology at
Southampton University.
'The value of school screening audiometry has
been proved. Numerous surveys from many
countries have confirmed the importance of this
method of detection of hearing loss in children,
although the proportion of detected cases varies
considerably, from 3% to 10% or more, according
to the criteria for the sample selected, methods of
testing and other variables. But there is no doubt
at all that a school health service without a
satisfactory system of school audiometry cannot be
considered as complete and that an important
group of children with a hearing impairment will
escape attention when there is no such service
available.
Many local authorities now run some kind of
screening programme in infant, junior and in
some areas, senior schools. However, this
screening programme may not come into operation
soon enough after the child's entry into school and
often not before the child reaches the age of six or
seven. Thus many children not only start their
schooling with a possibly handicapping condition,
but it may affect them for a considerable time
during the initial and critical stages of their
education. Also many difficulties a child with a
hearing loss may experience when starting school
could be prevented if his hearing loss was detected
beforehand.
With this problem in mind we decided to carry
out a small pilot scheme of screening children by
means of pure tone audiometry, before they
entered school. The aim was to find out what the
response would be, what difficulties would arise, if
any, and to gain information with a view to the
possible carrying out of a large-scale survey in the
future. This pilot scheme was carried out at the
Hearing Clinic, Heston, in August 1967. We
obtained the names of all the children due to be
admitted to three local primary schools in
42
September with the aim of calling them to the
clinic for testing during the month preceding their
entry to school.
The number of children called for this test was
164—only 2 failed to attend after 2 appointments
were offered (in many cases the second
appointment was only necessary because families
were away on holiday). Nearly all the mothers
were, in fact, very eager to attend—saying how
pleased they were and how necessary it was, they
thought, for this type of testing to be carried out.
Out of the 162 children who attended, 14 were
found to have a hearing defect, all previously
unsuspected and undiagnosed, i.e. 8.6%. All these
children who failed the screening test were then
called for a further test and were seen by a
medical officer. Of these 14 cases, 8 were unilateral
and 6 bilateral. Of the unilateral cases, 3 were
perceptive and 5 conductive. Of the bilateral cases
1 was perceptive and 5 conductive. Of the 14
cases, 3 now have normal hearing after treatment,
the remainder are still under treatment.
In two cases only it was not possible to carry
out the screening test because we were unable to
obtain the child's co-operation. One of these was
successfully screened on the second occasion, the
other was not, and because we learned from the
mother that this child had severely retarded speech
development, we decided to refer him directly to
the otologist. He was then found to have a
moderate conductive hearing loss, but was also
suspected of being of low mental ability and so
was referred for a full psychological assessment.
It is interesting to note that in the case of this
particular child, had it not been for the pre-school
screening test all this would probably have
remained undiagnosed for some time, as shortly
after the screening he was transferred to a small
private school which is not visited by the local
authority medical officers, or audiometricians.
We realise that a screening programme of this
nature is not easily carried out as it requires extra
staff and space, additional clerical work, i.e.
obtaining lists of new entrants to schools,
arranging appointments, etc. and is more time
consuming than the routine screening tests at
present carried out in schools. We also realise that
in some areas the attendance figures may not be