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Hearing Screening in Neurodevelopmental Research:Botswana

BACKGROUND: Hearing loss can impact results of neurodevelopmental assessments, but is often not screened for in studies of child development conducted in resource-limited countries due to expense and lack of trained personnel. METHODOLOGY: In a study of infants who were HIV-exposed (mother was HIV-positive) or HIV-unexposed (mother was HIV-negative), otoscopic view of the ear canal and OAE hearing screening were performed at two years of age, by nurses who had been trained by a pediatric audiologist in Botswana. Caregivers were asked if they had any concerns about their child’s hearing (Ten Questions Questionnaire). RESULTS: 75% (583) of the children in this part of study were available for otoscopic assessment. Of these children, OAE results were available for only 47% (272), due to significant problems with the equipment functioning and cooperation of the children. Of the children available for otoscopic assessment, 18% (108) were referred to an otolaryngology clinic due to failing the hearing screening, excessive wax or evidence of ear infection. There were few concerns about hearing noted by caregivers (.05%). There were no differences in ear health, audiological results, or referrals between the HIV-exposed and HIV-unexposed groups. CONCLUSION: Otoscopic and audiological screening showed evidence of a significant number of problems in this group of children and facilitated referrals for needed treatment. Given this incidence, hearing screenings would be a valuable part of research studies looking at child development, in part to rule out hearing loss as a contributor to poor performance. Ways to support improved functioning of equipment and strategies for gaining the cooperation of children unfamiliar with this type of procedure to increase the number of successful screenings will be discussed.

Betsy Kammerer (POC,Primary Presenter), Boston Childrens Hospital, betsy.kammerer@childrens.harvard.edu;
Dr. Kammerer is a clinical psychologist and neuropsychologist at Boston Childrens Hospital and Assistant Professor of Psychology at Harvard Medical School. She has worked in the Deaf and Hard of Hearing Program for over 30 years, with primary research interests in the neuropsychological and emotional development of children with hearing loss. She has also been involved in research with young children internationally, including in Botswana, Peru, Brazil, South Africa, and Thailand, and has lectured internationally.

ASHA DISCLOSURE:

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Nonfinancial -

Charlotte Mullen (Author,Co-Author), Boston Childrens Hospital, charlotte.mullen@childrens.harvard.edu;
Dr. Mullen is a pediatric audiologist at Boston Childrens Hospital.

Gloria Mayondi (Author,Co-Author), Botswana Harvard AIDS Institute Partnership, gmayondi@bhp.org.bw;
Gloria Mayondi is a project Director at Botswana Harvard Partnership.

Jean Leidner (Co-Author), Private Consultant, jeanleid@gmail.com;
Jean Leidner is a data analyst with Botswana Harvard Project and multiple other research projects connected with Harvard School of Public Health.

Modiegi Diseko (Author,Co-Author), Botswana Harvard AIDS Institute Partnership, mdisecko@bhp.org.bw;
Ms Disecko is a research nurse with Botswana Harvard Partnership

Maureen Sakoi (Author,Co-Author), Botswana Harvard AIDS Institute Partnership, msakoi@bhp.org.bw;
Ms Sakoi is a research nurse with Botswana Harvard Partnership

Juliana Manganella (Co-Author), Boston Childrens Hospital, juliana.manganella;
M. Manganella is a research assiatant in the Department of Otolarngology and Communication Enhancement at Boston Children's Hospital.

Gbolahan Ajibola (Author,Co-Author), Botswana Harvard AIDS Institute Partnership, gajibola@bhp.org.bw;
Dr. Ajibola is a research physician with Botswana Harvard Partnership

Derek Stiles (Co-Author), Boston Childrens Hospital, derek.stiles@childrens.harvard.edu;
Dr Stiles is Director of Diagnostic Audiology at Boston Childrens Hospital

Shahin Lockman (Author,Co-Author), Harvard School of Public Health, shahin.Lockman@gmail.com;
Dr. Lockman is a research physician at Harvard School of Public Health and Botswana Harvard Partnership and physician at Brigham and Women's Hospital in Boston.

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