title: A video-based performance in noise test for measuring audio-visual disability in young school children: test development, with validation by trained teachers, parents and audiometry as relative standards for disability.
abstract: BACKGROUND
  impaired ability to detect target sounds in noisy surroundings is a particular feature of children with a history of otitis media with effusion (OME). Children with current OME are also likely to experience difficulty in speech reception in classrooms where a high level of background noise has been recorded. No tests are currently available which are feasible in primary care and which objectively measure school-related disabilities. The effects of speech in noise and the extent to which this is offset by speech reading contribute important dimensions to disability.
  
  
  METHODS
  a video-based speech reception test has been developed using the same principles in 227 English and 182 Danish 4-8 year-old children. Distribution data was collected for both language versions of the test. The test has been compared with audiometry and teacher and parents assessments to establish its validity.
  
  
  CONCLUSIONS
  there are no gold standards for audio-visual disability in current clinical use. The poor positive predictive value of audiometry for likely classroom functioning is a cause for concern, particularly in relation to inappropriate referral of children by primary care physicians.
authors.affiliation: Primary Medical Care Group, School of Medicine, Aldermoor Health Centre, University of Southampton, UK. igw@soton.ac.uk
authors.forename: I
authors.initials: I
authors.lastname: Williamson
authors.forename: C
authors.initials: C
authors.lastname: Sheridan
authors.forename: E
authors.initials: E
authors.lastname: Galker
authors.forename: J
authors.initials: J
authors.lastname: Lous
mesh_terms: D001299:Audiometry / Q000379:methods; D002648:Child; D002675:Child, Preschool; D006311:Hearing Disorders / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D009622:Noise; D010034:Otitis Media with Effusion / Q000150:complications; D010290:Parents; D011320:Primary Health Care; D015203:Reproducibility of Results; D013067:Speech Perception / Q000502:physiology*; D013663:Teaching; D014741:Video Recording; D014786:Vision Disorders / Q000175:diagnosis*