Affiliation:
1. Geisel School of Medicine at Dartmouth
2. Dartmouth Health Medical Center
3. Creare LLC, Hanover, New Hampshire
4. University of Montreal, Montreal, Canada.
5. Vivian Pellas Hospital, Medical Director, Mayflower Medical Outreach, Managua, Nicaragua
Abstract
Objective
Evaluate whether a portable, tablet-based central auditory processing (CAP) test system using native language training videos and administered by minimally trained community health workers can produce CAP results comparable to previously published norms. Our secondary aim was to determine subject parameters that influence test results.
Study Design
Cross-sectional study.
Setting
Community-based settings in Chontales, Nicaragua, New Hampshire, and Florida.
Patients
English- and/or Spanish-speaking children and adolescents (n = 245; average age, 12.20 yr; range, 6–18 yr)
Main Outcome Measures
Completion of the following tests with responses comparable to published norms: Pure-tone average (PTA), gap detection threshold (GDT), fixed-level frequency threshold, masking level difference (MLD), Hearing in Noise Test (HINT), Dichotic Digits Test (DDT), and Frequency Pattern Recognition (FPR) test.
Results
GDT, HINT, and DDT had comparable results to previously published normative values. MLD and FPR results differed compared with previously published normative values. Most CAP tests (MLD, GDT, HINT) results were independent of age and PTA (p = 0.1–0.9). However, DDT was associated with age and PTA (p < 0.0001)
Conclusions
Pediatric CAP testing can be successfully completed in remote low- and middle- income country environments using a tablet-based platform without the presence of an audiologist. Performance on DDT improved with age but deteriorated with hearing loss. Further investigation is warranted to assess the variability of FPR.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Neurology (clinical),Sensory Systems,Otorhinolaryngology