Emerging Issues

Research coupled with technologic progress is driving advancements in the evaluation and management of hearing impairment and deafness. Research is also contributing to the development of new tools and technologies for the evaluation and modification of intervention programs for deaf or hearing-impaired infants under 1 year of age.¹⁹ New methods to improve current techniques for fitting hearing aids to infants and children under 6 years of age are also being developed.

Research has allowed the Joint Committee on Infant Hearing Screening to issue new practice guidelines to supplement the training of pediatric audiologists involved in hearing screening, evaluation, and intervention programs for infants under 1 year of age. The committee comprises representatives from the American Academy of Audiology, American Academy of Otolaryngology—Head and Neck Surgery, American Academy of Pediatrics, American Speech-Language-Hearing Association, Council on Education of the Deaf, and directors of speech and hearing programs in State health and welfare departments.

Vaccine development for otitis media is a priority and offers the promise of greatly reducing this illness. The recent discovery of bacterial biofilms that remain in the middle-ear space long after the acute infection has been resolved is providing new insight into the pathogenesis of chronic otitis media infections with persistent effusion (fluid) and could lead to new treatment options.^{20, 21}

Regarding assistive listening devices, scientists have developed a new, shorter electrode to help persons who are unsuccessful hearing aid users. The short electrode is inserted into the base of the cochlea to restore hearing at the high frequencies, while preserving low-frequency residual hearing in the implanted ear.

Results from the NEI-sponsored Vision in Preschoolers (VIP) Study²² found that the 11 most commonly used vision screening tests vary widely in identifying children with symptoms of common childhood eye conditions. When highly skilled personnel in a controlled setting used specific tests to screen preschool children, approximately two-thirds of the children (under age 5 years and 5 years and older) with one or more of the targeted disorders were identified. These tests were able to detect 90 percent of the children with the most severe visual impairments. The VIP study will provide State and local agencies with data that will assist them in selecting the most effective vision screening tests for their programs.

Ongoing research continues to highlight clear areas of disparities in vision and hearing among select populations. For example, results from the Los Angeles Latino Eye Study,²³ sponsored by NEI, suggest that this population has some of the highest rates for visual impairment and blindness in the United States. The overall number of cases of visual impairment and blindness in this population increased with age, with women more frequently affected than men. From a socioeconomic perspective, persons of Latino origin who were unemployed, divorced or widowed, or less educated had increased rates for visual impairment and blindness. These data will provide additional information useful in designing interventions relevant to the vision objectives in Healthy People 2010.

Myopia occurs in approximately 25 percent of the U.S. population.²⁴ A clinical study of myopia in first- and second-generation Hispanic, white, Asian, and black immigrant students in this country has demonstrated that Asian immigrants have a significantly higher number of overall myopia cases. Increased cases of myopia among the Alaska Native population, as well as some American Indian tribes, have also been reported.²⁵

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