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Objective: This study aims to compare levels of psychological distress and the quality of life in the hard of hearing with levels reported by the signing deaf, and the hearing population., Method: A total of 373 members of the Hard of Hearing Association completed the brief WHO's Quality of Life, 12-item General Health Questionnaire and Brief Symptom Inventory, and provided details about their initial and current deafness., Results: The hard of hearing have worse social relationships than the signing deaf, and are disadvantaged relative to the hearing in all areas measured. Quality of life is related to the level of satisfaction with the hearing achieved by hearing aids., Conclusion: General psychiatrists need to be aware that patients who are hard of hearing may be even more isolated than deaf people in a signing community. Hard of hearing patients with unsatisfactory hearing aids can be greatly assisted by cochlear implants.

The Survey of Income and Program Participation (SIPP) is one of a few national surveys that regularly collects data identifying the American population of persons with hearing loss or deafness. Estimates from the SIPP indicate that fewer than 1 in 20 Americans are currently deaf or hard of hearing. In round numbers, nearly 10,000,000 persons are hard of hearing and close to 1,000,000 are functionally deaf. More than half of all persons with hearing loss or deafness are 65 years or older and less than 4% are under 18 years of age. However, these findings are limited to those who report difficulty hearing "normal conversation" and do not include the larger population of persons with hearing loss for which only hearing outside the range and circumstances of normal conversation is affected. Policy makers, communications technology manufacturers, health and education service providers, researchers, and advocacy organizations have an interest in these results.

Objectives: Responders to questionnaire surveys, who are self-selecting, are generally accepted to be unrepresentative of the total available population, at least in demographic terms. Since demographic and other variables are known to be predictive of outcome, it is important to understand the extent of that unrepresentativeness when using survey data to report comparisons of outcome. This paper aims (i) to evaluate the extent to which a sample of hearing-impaired children surveyed by postal questionnaire was representative of the population of hearing-impaired children in the United Kingdom (UK), and (ii) to identify demographic differences between children with and without cochlear implants., Methods: Data from a previously reported total ascertainment of hearing-impaired children in the UK which identified 17,160 with permanent bilateral hearing impairment >40 dB HL were compared with data collected by postal questionnaire for a sample of 3224 children, including 527 with cochlear implants., Results: The sampled children were similar to the ascertained population in gender, age at onset of hearing impairment, and number of additional disabilities, but came from more recent birth cohorts and from more affluent families. Compared with profoundly impaired non-implanted children, implanted children had greater degrees of hearing loss, fewer additional disabilities, a later age of onset, were younger, came from more affluent families, were more likely to use spoken language at home, and to be taught using spoken language only., Conclusions: Comparisons of outcomes and generalisation of results require adjustment for relevant variables to avoid confounding estimates of the effectiveness of interventions including cochlear implantation.

Objectives: To assess associations between age-related vision and hearing impairments and whether combined sensory losses magnify effects on health-related quality of life., Methods: Seventy-five percent of survivors (n = 2334) were reexamined at Blue Mountains Eye Study 5-year examinations and 86.3% (2015) attended hearing assessments. Visual impairment was defined as visual acuity less than 20/40 (better eye), and hearing impairment as average pure-tone air conduction threshold greater than 25 dB (500-4000 Hz, better ear)., Results: Persons with visual impairment, compared with those without visual impairment, had lower mean audiometric thresholds across all frequencies (P< or =.05). For each 1-line (5-letter) reduction in best-corrected visual acuity and presenting visual acuity, hearing loss prevalence increased by 18% and 13%, respectively. Cataract and age-related maculopathy were also associated with hearing loss (respectively, multivariate-adjusted odds ratio, 1.3 and 1.6; 95% confidence interval, 1.0-1.7 and 1.1-3.1). The association between age-related maculopathy and hearing loss was stronger at younger ages (<70 years). Combined impairments were associated with poorer health-related quality of life than were single impairments (multivariate-adjusted 36-Item Short-Form Health Survey mean physical and mental component scores; Ptrend = .001 and <.001, respectively)., Conclusions: Older persons with visual impairment were also more likely to have hearing loss in this study, which suggests that these sensory impairments could share common risk factors or biologic aging markers. Combined sensory impairments also cumulatively affect health-related quality of life.

The study examined the prevalence of overweight cases in a sample of 151 deaf children aged 6-11 years. Participants were deaf students attending six elementary schools, both regular and special, in four states. Body mass index (BMI) was calculated using height and weight, plotted on the Center for Disease Control and Prevention (CDC) U.S. BMI-for-age growth charts, then compared to national values for same age and gender (CDC, 2006a, 2006b; National Center for Health Statistics, 2005). The results indicated that the prevalence of overweight deaf children aged 6-11 years was above the national percentage for same age and gender. A larger percentage of boys was overweight (24.7%) than girls (20.4%). After age 8 years, girls showed a consistent decrease in BMI with increasing age, a trend not demonstrated by boys. As a group, deaf children demonstrate a higher prevalence of overweight than national averages.

Objective: To determine the association between reported concurrent visual and hearing impairment and risk of mortality., Design, Setting, and Participants: Annual cross-sectional multistage area probability surveys of the US civilian noninstitutionalized population living at addressed dwellings were conducted by the National Center for Health Statistics, Hyattsville, Md. Mortality linkage with the National Death Index of participants from 1986 to 1994 was performed through 1997. Complete reported visual and hearing impairment data and survival status were available for 116 796 adults aged 18 years and older. A total of 3620 participants reported visual impairment only, 12 330 reported hearing impairment only, and 1461 reported concurrent visual and hearing impairment., Main Outcome Measure: Risk of mortality., Results: Mortality linkage identified 8949 deaths with an average follow-up of 7.0 years. After controlling for survey design, age, marital status, educational level, self-rated health, and number of nonocular and nonauditory conditions, white participants and "other-race" participants, but not African American participants, reporting concurrent visual and hearing impairment had significantly increased risk of mortality in comparison with their counterparts reporting no impairment (white participants: hazard ratio [HR] = 1.23, 95% confidence interval [CI], 1.04-1.46 for men and HR = 1.63, 95% CI, 1.37-1.93 for women; African American participants: HR = 1.50, 95% CI, 0.94-2.40 for men and HR = 0.92, 95% CI, 0.51-1.63 for women; participants of other races: HR = 2.47, 95% CI, 1.33-4.57 for men and HR = 2.23, 95% CI, 1.01-4.90 for women). Risk of mortality was generally greater for participants reporting concurrent impairment as compared with that for participants reporting either visual impairment alone or hearing impairment alone., Conclusions: In the United States, white persons and those of other races, but not African American persons, reporting concurrent visual and hearing impairment have an increased risk of mortality. Reported concurrent impairment is an independent predictor of mortality among white persons and those of other races for both men and women.

A lack of demographic information and data related to the achievement of short-term goals during substance abuse treatment among persons who are deaf or hard of hearing dictated the need for the study. New York State maintains a database on all individuals who participate in treatment. Within this database, 1.8% of persons in treatment for substance use disorder (SUD) were also deaf or hard of hearing. As hypothesized, members of the deaf and hard of hearing sample were older, likelier to be white, and likelier to be female, relative to the SUD-only group. For both groups, alcohol, heroin, and cocaine had the highest rates of reported use. Achievement of short-term goals in the areas of alcohol use, drug use, vocational/educational goals, and overall goals indicated no differences between the deaf and hard of hearing group and the SUD-only group. Implications of these findings are discussed.

Objective: To examine the association between the presence and severity of concurrent hearing and visual impairment (HI+VI) and morbidity., Methods: Data for adults 45 years and older were obtained from the National Health Interview Survey, 1986 to 1996 (n = 60,997). Covariate-adjusted logistic regression analyses were used to examine associations between HI+VI and five morbidity indicators: restricted activity days, bed rest days, doctor visits, hospitalizations and self-rated health., Results: Associations with morbidity indicators tended to be stronger in adults with HI+VI, and in particular, among adults with more severe HI+VI, relative to adults reporting no impairment. These associations were somewhat stronger in adults 45 to 64 years versus older adults., Discussion: HI+VI is associated with morbidity, although the strength of these associations varies across subgroups. Findings indicate that an increased focus on the provision of hearing and eye care services is required. Insurance coverage for these services should also be pursued by health policy makers.

The purpose of this study was to investigate alternative methods for evaluating deaf students' readiness to meet the English language and literacy demands of postsecondary educational programs. In the first part of the study, scores obtained by a large sample of deaf students on the ACT Assessment (ACT Composite score and scores on the ACT English and Reading tests) were compared to their scores on various measures of English language and literacy skills. In the second part of the study, the performance of a smaller sample of deaf students on the ESL Reading and ESL Grammar/Usage components of COMPASS/ESL was compared to their performance on a set of concurrent measures of English skills. The results of this investigation demonstrate that neither the ACT Assessment nor COMPASS/ESL are appropriate for the full range of deaf students seeking admission to postsecondary educational programs. However, the ACT Assessment is appropriate for deaf students seeking admission to transferable (BS and AAS) degree programs, and the ESL Reading and Grammar/Usage tests appear to be appropriate for deaf students seeking admission to nontransferable (AOS) degree programs. Taken together, the combination of the ACT Assessment and COMPASS/ESL appear able to provide a valid, reliable, and coherent approach to admissions screening assessment for the full range of deaf students seeking admission to postsecondary programs.

The study summarizes a database for the years 1994-1999 on deaf and hard of hearing students in Illinois with a diagnosis of emotional disturbance (N = 115). Data are reported on the group's demographic, domestic, etiologic, communication-related, and intervention-related characteristics. These dually diagnosed students differed from Illinois's general population of deaf and hard of hearing students in many ways, including higher incidences of prematurity, prenatal trauma, and perinatal trauma. They were more likely to have had a later onset of hearing loss, to live in single-parent homes, to belong to an ethnic minority, to live in an urban or suburban area, and to qualify for low-income health care. Many had histories of abuse, 50% were regularly medicated, and 15% were assigned to surrogate parents.

Purpose: To determine the frequency of sensory impairments among aged care clients., Methods: We examined 188 persons aged 65-99 years being evaluated for aged care services at a geriatric assessment center, west of Sydney, Australia. Visual acuity was measured using a LogMAR chart. Visual impairment was defined in the better eye: mild < 20/40 to > or = 20/80, moderate < 20/80 to > or = 20/200, and severe < 20/200. Hearing function was assessed by portable pure-tone air-conduction audiometry. Hearing loss was defined using average hearing thresholds in the better ear: mild > 25 to < or = 40 decibels (dB), moderate > 40 to < or = 60dB, and severe > 60dB., Results: Vision, hearing, or both were randomly tested in 96, 93, and 49 aged care clients, respectively. Vision impairment was found in 30.2% of clients. Distance vision could be improved with pinhole in 16.7% of 84 clients with presenting VA < 20/20. Moderate to severe hearing loss was present in 50.5%. Combined sensory impairment was detected in 22.5% of persons having both tests. The age-standardized proportions with vision impairment was 25.6%, higher than the rate (17.4%) found in the Blue Mountains Eye Study (BMES) community population, but lower than the 37.7% prevalence reported from the BMES nursing home sample. Hearing impairment was also more common in aged care clients (28.1% vs 17.5%)., Conclusions: This study suggests a high prevalence of sensory impairment among older persons transitioning from independent community living to institutionalized care.

In 2000, an estimated 4,420 children (33 per 1,000 births) were born with a disability in Pennsylvania. In addition, more than 1.8 million Medicare enrollees (age 65 and older) were residents of the state. Selected estimated costs were developed for these two populations at state and county levels.

The prevalence OF mental health problems among youth with hearing loss was assessed with an adjusted version of the Dutch rendition of the Youth Self Report, or YSR (Achenbach, 1991). The sample totaled 202 youth, aged 11-18 years, with auditory disabilities. The prevalence rates of externalizing problems, internalizing problems, and moderate to severe overall mental health problems were found to be 2-3 times higher than in a normative sample. Deaf participants scored significantly higher than hard of hearing participants in these areas. Main-streamed participants scored significantly lower than peers in schools for the deaf or for the hard of hearing. Participants with low IQ scores showed significantly more internalizing and social problems than those with moderate to high scores. The adjusted YSR is recommended for screening in schools and in mental health services for youth with hearing loss for prevention and early intervention.

Deaf persons' access to health-related information is limited by barriers to spoken or written language: they cannot overhear information; they have limited access to television, radio, and other channels for public information; and the average reading level of Deaf adults is at a 3rd to 4th grade level. However, literature searches revealed no published reports of community analysis focusing specifically on health education priorities for Deaf communities. A seven-step community analysis was conducted to learn the health education priorities in Arizona Deaf communities and to inform development of culturally relevant health education interventions in Deaf communities. The word "Deaf" is capitalized to reflect the cultural perspective of the Deaf community. A 14-member Deaf Health Committee collected data using multimethods that included review of state census data, review of national health priorities, key informant interviews, discussions with key community groups, a mail survey (n = 20), and semistructured interviews conducted in sign language with 111 Deaf adults. The community diagnosis with highest priority for health education was vulnerability to cardiovascular disease (CVD). Following completion of the community analysis, a heart-health education intervention (The Deaf Heart Health Intervention) was developed using a train-the-trainer, community health worker model. If this model proves to be effective in addressing vulnerability to CVD, then a similar protocol could be employed to address other health concerns identified in the Deaf community analysis.

It has been suggested that only 8% of postsecondary students in the United States who have a hearing loss have disclosed that hearing loss to their institutions. Consistent with this suggestion, two anonymous surveys of students enrolled in courses with the Open University in the United Kingdom suggested that there were roughly 9,000 students in the Open University itself and over 42,000 students in higher education across the United Kingdom as a whole who had a hearing loss that they had not disclosed to their institutions. These students tended to be older people with a relatively mild hearing loss that did not disrupt their communication with other students or their active engagement with learning activities. The impact of the students' hearing loss upon their approaches to studying seemed to be relatively slight, but it was associated with an increase in the students' perceived academic workload.

Unlabelled: Although hearing impairment is among the most common chronic ailments of older persons, the problem is even greater among those in nursing homes. It is estimated that 70% to 90% of elderly residents in long-term care facilities have some degree of hearing impairment. Despite this high prevalence, significant underuse of hearing aids or other assistive devices exists, especially among those with dementia., Objectives: The current study assessed rates of hearing impairment and hearing aid use among residents in a large, mid-Atlantic nursing home., Setting and Design: In a cross-sectional survey, interviews were conducted at a large, mid-Atlantic nonprofit nursing home., Participants: Reports were obtained from 279 resident-caregiver dyads, as well as from the Minimum Data Set (MDS) and research assistants performing the structured interviews., Measurements: Measures included the MDS and the Barriers to Hearing Aid Use Questionnaire, which was developed for this study., Results: Results show an inconsistency in reports of both hearing impairment and hearing aid use by multiple sources, as well as the underuse of hearing aids. These inconsistencies suggest that gross hearing impairment is undetected in clinical practice in over half of the residents., Conclusion: The findings highlight the need for regular hearing assessments in the nursing home population. They also suggest the need for evaluation of institutional-level policies regarding screening and hearing aid management, as well as the need for further information regarding potential barriers to effective hearing aid use. These issues are addressed in part 2 of this study following this report.

Objectives: This study assessed the prevalence of newborn hearing screening in Wisconsin between 1997 and 2001, and examined factors leading to establishment of programs and influencing the outcomes of universal newborn hearing screening (UNHS). The primary goal was to identify characteristics that might be important for states, provinces or countries that have not yet implemented UNHS programs and to examine some unique components of the Wisconsin UNHS program, that may provide direction to areas both with and without programs., Methods: The study consisted of two cross-sectional surveys administered at two separate time points (2000 and 2001). Additional data was provided by the Wisconsin Sound Beginnings Early Detection and Hearing Intervention database., Results: Between 1997 and 2001, the number of Wisconsin birthing hospitals with UNHS programs increased from two to 92 of a total of 103 and the percent of all Wisconsin newborns screened for hearing loss before 1-month of age increased from 10 to 90%. In 2001, 2.6% of screened newborns had an abnormal test requiring further audiologic evaluation, with a higher rate of referral in programs relying only on otoacoustic emission testing versus automatic auditory brainstem testing. As programs were being established, hospitals with greater number of deliveries more readily developed UNHS programs and hospitals with more deliveries were also significantly more likely to screen a greater percentage of delivered children once their programs were established. The Wisconsin Sound Beginnings program established a screening program for home birth infants in 2002 with a current screen rate of 79% for those midwives participating in this program., Conclusions: A vast majority of Wisconsin hospitals have voluntarily implemented UNHS programs. By 2001, greater than 90% of all Wisconsin newborns were screened through a UNHS program. With education, financial support and a statewide network dedicated to UNHS it is possible to establish programs even for infants born in a setting that should be considered high-risk to miss hearing screening, such as home births and hospitals that perform relatively few numbers of deliveries per year. UNHS programs need to develop coordinated systems for linking these programs to audiologic diagnostic services and early intervention programs.

Little is known about demographic, deafness-related, and diagnostic characteristics of deaf and partially hearing people with psychosocial or psychiatric problems. A study was conducted derived from data from intake assessment interviews of people with hearing loss treated at a Dutch ambulatory mental health center for the deaf between 1987 and 1999. Both sexes were equally represented. People who were postlingually deaf, hard of hearing, below age 22 years, or above age 65 years were less likely to ask for help than other groups in the study. Men presented more psychiatric disorders, and women more psychosocial problems, especially partially hearing women. The authors recommend stronger emphasis on mental health care for postlingually deaf people, severely hard of hearing people, adolescents, and retirement-age people. They also recommend development of skills for rational and emotional self-expression in the education and rearing of children with hearing loss.

Deafness affects many social interactions. The impact of deafness depends on several factors, e.g., the type of social environment in terms of the particular Deaf community a person lives in. The authors recorded the birthrate and the proportions of married and divorced people among deaf people in two Swedish counties: Narke, which had a strong Deaf community, and Varmland, whose Deaf community was weak. In both counties, the authors found that deafness was associated with low marriage rates and low birthrates. Further, in Narke, 99% of the people in the sample were married to another deaf person; only 10% were in Varmland. In Narke, the divorce rate among deaf people was about the same as that of the reference population (i.e., the county's marriage-age population). In Varmland, deaf people had a relatively low divorce rate. The findings are discussed from medical and social perspectives.

As part of a wider study aimed at establishing baseline information (for planning purposes), the pattern of disabilities in a Residential School for the handicap was determined. Information on demographic data, nature of handicap, age of enrollment, present class and length of stay in the school were obtained. The study involved 82 pupils (28 females) aged 5-30 years (mean 16.9 + 5.08 years). Seventy nine percent (65) were deaf, 13.6%(11) blind and 6.2% (5) had mental retardation. The mean age of enrollment was 10.6 + 4.12 years. Only two (2.5%) of the pupils/students stayed in the school beyond the regulation time. These findings show that deafness was the commonest disability and strongly suggest that none of the disabilities observed had major impact on learning ability in this school system.

Graduation patterns were examined for 905 deaf students (1990-1998) at the National Technical Institute for the Deaf. Students with higher reading and language skills had the best overall graduation percentage. Comparison of recipients of different degrees--bachelor of science (BS) versus fine arts (BFA); associate of applied science (AAS) versus occupational studies (AOS)--showed 92% of BS and 82% of AAS graduates reading at the 9th-grade level or above, versus 65% of BFA and 47% of AOS graduates. Interestingly, 80% of non-degree-earning students read at the 9th-12th grade levels; in absolute terms, they outnumbered graduates with similar reading skills in the AAS and BFA programs combined, and in the BS program. This indicates a need for improved counseling, placement, and retention strategies. Students performed similarly across degree categories, regardless of curriculum requirements and difficulty. Only non-degree-earning students had significantly lower grade averages.

Objective: To find out the prevalence and etiologies of middle ear disease among deaf children in a school for the deaf., Methods: A total of 162 students with hearing impairment attending a school for the deaf during the school year of 2001-2002 were admitted to this study. The range of age was from 6 to 20 years. The examination consisted of inspection of the auricle and external auditory canal, and otoscopic, audiometric and tympanometric evaluation. School performance was assessed using the results of end-of-year school examination and continuous assessments obtained from the school administration., Results: The demographic properties of the study group revealed that 81 (60.9%) of children were male and 52 (39.09%) were female. Most of the children (45%) were in the group of 9-13 years of age. On pure tone audiometric evaluation, sensorineural hearing loss (HL) was found in 99 (85.3%) and mixed type HL in 17 (14.6%) of 116 cases. Impacted wax was the most common pathology and was seen in 15 (39.4%) of children. Middle ear diseases were detected in 38 (28.5%) of children with otoscopic examination., Conclusion: This study shows that hearing impairment and preventable ear diseases are important health problems among the school children for the deaf. It is essential to start the school education early in time and to start using hearing aid before 2.5 year of age.

- The aim of this study was to determine the prevalence of traumatised permanent teeth among sensory (visual (VI) and hearing (HI)) impaired children attending special schools in Riyadh, Saudi Arabia. All the dental injuries involved incisor teeth, and trauma was noted in 33 (6.7%) children attending government schools (control group) compared to 7 (9%) VI children and 24 (11.4%) HI children. Differences in the dental trauma only reached statistical significance between the HI and control group (P < 0.05). Gender differences were only apparent in the HI group, with males having higher levels of traumatised teeth. In addition, HI children aged 11-12 years were more prone to trauma than children in the control group of the same age (P < 0.05). In conclusion, sensory impaired children do have a tendency for more dental trauma. However, this was only statistically significant for HI children. Whereas a gender difference was most noticeable for the HI group, with males having higher levels of trauma, this was noticeable by its absence among VI children.

Aims: To estimate the prevalence and the severity of malocclusion and treatment need for 329 handicapped individuals., Subjects and Setting: 329 handicapped individuals aged 11-30 years, attending eight different nonresidential special schools of South Canara, India., Method: Examination and recording using the Dental Aesthetic Index (DAI)., Results: 53% had a dental appearance which required no orthodontic treatment, 24% had a definite malocclusion, where treatment was 'elective' and treatment for a further 12% was considered to be 'highly desirable'. The remaining subjects (11%) had a handicapping malocclusion where treatment was considered mandatory., Conclusions: The prevalence of definite and severe malocclusions was higher in the mentally subnormal individuals when compared to other handicapping conditions. Orthodontic services for the handicapped have generally been neglected.

A descriptive study was conducted among a group of hearing-impaired individuals in Pondicherry to assess the dental caries prevalence and experience. A total 114 individuals were examined. The data was collected by direct clinical examination using appropriate indices and findings were recorded on the proforma sheets. The data were statistically processed and the results were obtained. Prevalence of dental caries in terms of DMFT is 42.98% and dft is 45%. Mean dft +/- s.d is 1.2 +/- 1.38 and Mean DMFT +/- s.d is 1.0 +/- 1.42. It was concluded that in both permanent and deciduous dentition and the females have high caries prevalence.

Objective: The aim of the study was to assess the caries experience of disabled children and young adults in Kuwait, to set baseline data, and to determine their treatment need., Method: Dental caries was scored by surface in accordance with WHO criteria. The study population comprised 832 disabled children and young adults (3-29 years; mean age 12.1 years) who were visually impaired, hearing impaired, had physical handicaps or developmental disorders, attending special needs schools., Results: The proportion of caries free subjects in the primary dentition (3-12-year-old children) was 11.2%. The mean dmft was 5.4, and dmfs 15.2, being highest in the Down's syndrome and lowest in the blind. The proportion of caries-free subjects in permanent dentition, over 5 years of age was 24.2%. The smallest percentage of caries-free subjects was found in the hearing impaired (16.4%) and highest percentage in the blind (35.5%). The mean DMFT was 4.5 and the DMFS 8.7, being highest in the Down's syndrome and lowest in the blind. Prevalence of untreated decay was highest in hearing impaired (86%). The caries experience of first permanent molars represented the largest proportion of the DMFT score (53.6%). In the permanent dentition increasing age, impaired hearing, and poor oral hygiene were significantly associated with caries risk., Conclusions: Caries experience among this disabled population was clearly higher than among the respective age groups in a previous national population survey. The study confirmed the need for strengthening organised preventive and restorative care for this population in Kuwait.

This project is an update of an earlier study on American and Canadian graduates of auditory-verbal programs. Survey research was conducted to obtain information on a variety of topics. Overall, the current results again indicated that the majority of respondents were integrated into "regular" or "typical" learning and living environments. In view of the earlier identification of hearing loss and the early fitting of sensory aids and availability of cochlear implant technology, coupled with intervention that emphasizes auditory learning, it is suggested that today's infants have the potential to become independent, participating, and contributing citizens in mainstream society.

The present study was carried out to determine the prevalence of malocclusion and traumatic injuries in disabled children and adolescents attending the special-needs schools in Kuwait. Included in the study were 818 children (438 males and 380 females), in the age groups of 3-20 years, who have visual impairment, hearing impairment, physical handicaps, or developmental disorders. The mean age of participants was 11.9 years. The survey was carried out according to the methods of WHO. The prevalence of severe malocclusion was 23.6%, and that of slight malocclusion was 37.0%. Children with Down syndrome (OR = 2.3; 95% CI = 1.51-3.52), those of increasing age (OR = 1.1; 95% CI = 1.01-1.10), and males (OR = 1.5; 95% CI = 1.05-2.07) had higher risk for the occurrence of severe malocclusion. Less than one-fifth of the subjects (16.9%) had traumatized anterior teeth. Severe malocclusion (OR = 1.8; 95% CI = 1.17-2.77) and increasing age (OR = 1.2; 95% CI = 1.13-1.26) were significant risk factors for the occurrence of traumatic injuries. We concluded that malocclusion and traumatic injuries are more prevalent among these subjects with disabilities than among the healthy population in Kuwait.

Objectives: The aim of the paper is to assess the significance of hearing disability as a public health problem through its association with multiple negative health outcomes: subjective health perception, mental health and social well-being., Methods: The data come from the participants of the 1997 national health survey in Belgium, who were 15 years and older (n = 8,560). The presence and severity of the hearing disability was estimated through self-reporting. The association of hearing disability with the studied health outcomes was assessed using logistic regression while controlling for confounding factors such as age, sex, co-morbidity and socio-economic status., Results: The prevalence of hearing disability is 7% in the population 15 years and older. The prevalence of subjective ill health (Odds Ratio (OR): 1.32), mental ill health (OR: 1.51), and a low appreciation of the social contacts (OR: 1.73) was higher in subjects with hearing disability. No association was found between hearing disability and the frequency of social contacts or with the functional content of the social contacts., Conclusions: Given the health and social consequences of hearing disability, increased public health attention, including both strategies for prevention, for identification and treatment, is warranted.

To collect parents' evaluation of support services in Denmark, questionnaires were distributed to parents of children who are deaf or hard of hearing. Some few results and conclusions are picked out in the article below. Parents' comments show some recurrent features: counselling must be offered and should be offered immediately after confirmed diagnosis, there is a need for psychological support at an early time, for qualified advisers, for written information to be distributed, and for co-operation between advisers of the family.

Purpose: To determine the frequency of Usher's syndrome and other ocular disease in students receiving special education services for the deaf in Oregon and to assess the amount of existing ophthalmologic surveillance of this population. A special emphasis was placed on screening for Usher's syndrome., Methods: From 1980-1990, a prospective two-center visual screening program of 231 deaf students in schools throughout Oregon was conducted using an ophthalmic questionnaire, complete eye examinations, and electroretinography. Students were between the ages of 10 and 21 years and participated on a volunteer basis. Findings for etiology and severity of visual loss and the scope of ophthalmologic surveillance within this population were analyzed., Results: Two hundred seventeen of the 231 students examined received electroretinograms. Significant ocular pathology was found in 111 (48%) of the students. The most common diagnoses were congenital rubella (21%), significant uncorrected ametropia (16%), and ocular hypertension (9%). Five students were diagnosed with Usher's syndrome. Of the students with significant ocular pathology, only 37% were actively followed by an ophthalmologist., Conclusion: Deaf students in Oregon's schools had a high frequency of eye disease. Early diagnosis and treatment of eye disease in this population could benefit the quality of life of these students. This study alerted the providers of special education services for the deaf and the ophthalmologic community in Oregon of the need for better eye care for these students.

Early identification of and intervention for all children who have hearing impairments remain unattained goals in the United States. Physicians typically are the first persons to obtain the medical and family history of infants and children and are the primary professionals confronted with parental concerns about hearing loss. Heightened awareness of the common causes of hearing loss in infants and children can facilitate prompt and appropriate referrals to audiologists when hearing loss is suspected. A strong and interactive relationship between physician and audiologist is needed to attain the common goals of providing the earliest and best possible diagnosis of and optimal management for hearing impaired pediatric patients.

Objective: To cross-culturally adapt the Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S) for use with older Spanish-speaking Mexican Americans., Subjects and Setting: Two different samples were used. First, a convenience sample of 100 older community-dwelling Mexican American men and women in San Antonio, Texas, was used to test technical equivalence of the Spanish and English language versions of the HHIE-S. Second, a neighborhood-based sample of older Mexican Americans was used to establish conceptual (n = 433) and criterion equivalence (n = 381) of the two HHIE-S language versions., Methods: Independent forward and back translations were done to create a Spanish language version of the HHIE-S. In the convenience sample, subjects were administered the English and Spanish HHIE-S in random order on separate days. In the neighborhood sample, the HHIE-S was given on one occasion in the language of the subject's preference. Depressive symptoms were assessed using the Geriatric Depression scale to see if the two language versions of the HHIE-S were similarly associated with depression (conceptual equivalence). Hearing impairment was assessed using the Welch-Allyn Audioscope to see if the two language versions were similarly associated with an audiometric measure for hearing loss (criterion equivalence)., Results: In the convenience sample, the overall mean (SD) Spanish and English HHIE-S scores were 6.2 (8.7) and 6.2 (9.3), respectively (P = 1.00). Total scores of the English and Spanish versions were highly correlated (r = .89), and regression analysis indicated that the two language versions gave nearly identical results. In the neighborhood-based sample, men had higher HHIE-S scores than women (OR 2.0, 95% CI = 1.3-3.5). Having depressive symptoms (OR 3.2, 95% CI = 1.9-5.5) or hearing impairment (OR 6.1, 95% CI = 3.5-10.5) was associated with higher HHIE-S scores. After adjustment for gender, depressive symptoms, and/or hearing impairment, the language of interview was not associated with HHIE-S score., Conclusion: We have developed and tested a Spanish translation of the HHIE-S that yields equivalent results to those obtained with the English version in bilingual Mexican Americans. The Spanish HHIE-S presented here is suitable for clinical use and research studies involving older Mexican Americans.