Distortion product otoacoustic emissions in children at school entry: A comparison with pure tone screening and tympanometry results

This study examined the test performance of distortion product otoacoustic emissions (DPOAEs) when used as a screening tool in the school setting. A total of 1003 children (mean age 6.2 years, SD = 0.4) were tested with pure-tone screening, tympanometry, and DPOAE assessment. Optimal DPOAE test performance was determined in comparison with pure-tone screening results using clinical decision analysis. The results showed hit rates of 0.86, 0.89, and 0.90, and false alarm rates of 0.52, 0.19, and 0.22 for criterion signal-to-noise ratio (SNR) values of 4, 5, and 11 dB at 1.1, 1.9, and 3.8 kHz respectively. DPOAE test performance was compromised at 1.1 kHz. In view of the different test performance characteristics across the frequencies, the use of a fixed SNR as a pass criterion for all frequencies in DPOAE assessments is not recommended. When compared to pure tone plus tympanometry results, the DPOAEs showed deterioration in test performance, suggesting that the use of DPOAEs alone might miss children with subtle middle ear dysfunction. However, when the results of a test protocol, which incorporates both DPOAEs and tympanometry, were used in comparison with the gold standard of pure-tone screening plus tympanometry, test performance was enhanced. In view of its high performance, the use of a protocol that includes both DPOAEs and tympanometry holds promise as a useful tool in the hearing screening of schoolchildren, including difficult-to-test children.

Two times three little pigs: Dysfluency, cognitive complexity and autism

This paper presents an analysis of dysfluencies in two oral tellings of a familiar children's story by a young boy with autism. Thurber & Tager-Flusberg (1993) postulate a lower degree of cognitive and communicative investment to explain a lower frequency of non-grammatical pauses observed in elicited narratives of children with autism in comparison to typically developing and intellectually disabled controls. we also found a very low frequency of non-grammatical pauses in our data, but indications of high engagement and cognitive and communicative investment. We point to a wider range of disfluencies as indicators of cognitive load, and show that the kind and location of dysfluencies produced may reveal which aspects of the narrative task are creating the greatest cognitive demand: here, mental state ascription, perspectivization, and adherence to story schema. This paper thus generates analytical options and hypotheses that can be explored further in a larger population of children with autism and typically developing controls.

Warehouse, PNG Coffee Industry Board Office and Warehouse, Goroka

View of exterior wall to warehouse.

Downpipes, PNG Coffee Industry Board Office and Warehouse, Goroka

Detailed view of downpipes and drainage grill.

PNG Coffee Industry Board Office and Warehouse, Goroka

View past tiered amphitheatre and offices above to air strip beyond.

View along western elevation, PNG Coffee Industry Board Office and Warehouse, Goroka

View past timber blinds to balcony and timber sunscreens.

Under construction, PNG Coffee Industry Board Office and Warehouse, Goroka

View of post being hoisted into position during construction.

Warehouse, PNG Coffee Industry Board Office and Warehouse, Goroka

View of warehouse exterior.

Pole detail, PNG Coffee Industry Board Office and Warehouse, Goroka

Detailed view of poles used in construction. Poles were spliced in their length with steel bars (like 3 pin plugs) and these joints were restrained from splitting with steel strap belts. The belts were tightened with opposing wedges like the old Greene & Greene wrought iron detail.

Warehouse, PNG Coffee Industry Board Office and Warehouse, Goroka

View of warehouse exterior.

Roof structure, internal, PNG Coffee Industry Board Office and Warehouse, Goroka

View to underside of roof with steel beam and insulation.

Post and beam connection, PNG Coffee Industry Board Office and Warehouse, Goroka

Detailed view of cast iron brackets connecting beams and posts.

Front elevation, PNG Coffee Industry Board Office and Warehouse, Goroka

View of front elevation with entrance from exterior.

Post and beam connection, PNG Coffee Industry Board Office and Warehouse, Goroka

Detailed view of cast iron brackets connecting beams and posts.