Sound localisation of low- and high-frequency sounds in cochlear implant users with single-sided deafness

OBJECTIVE

Localisation of low- and high-frequency sounds in single-sided deaf cochlear implant users was investigated using noise stimuli designed to mitigate monaural localisation cues.

DESIGN

Within subject design. Sound source localisation was tested in the horizontal plane using an array of seven loudspeakers along the azimuthal angle span from -90° to +90°. Stimuli were broadband noise and high- and low-frequency noise.

STUDY SAMPLE

Twelve adult subjects with single-sided deafness participated in the study. All had normal hearing in the healthy ear and were supplied with a cochlear implant (CI) in their deaf ear.

RESULTS

With broadband noise, the mean angular localisation error was 39° in aided condition as compared to a median angular error of 83.6° when the speech processor was not worn. For high-frequency noise, the median angular error was 30° and for low-frequency noise, it was 46° in the CI-aided condition.

CONCLUSIONS

Single-sided deaf CI users show the best sound localisation for high-frequency sounds. This supports the view that interaural level differences are dominant for sound localisation in these listeners. Nonetheless, a limited ability to localise low-frequency sounds was observed, which may be based on the supportive perception of interaural time differences.

Improved interaural timing of acoustic nerve stimulation affects sound localization in single-sided deaf cochlear implant users

The main impairment associated with single-sided deafness (SSD) is the loss of binaural hearing. Currently, the most effective treatment to compensate for this deficit is to supply patients suffering from SSD with a cochlear implant (CI) in the deaf ear. With this approach binaural hearing abilities can be restored to a certain extent, which is expressed in an improvement in such patients with regard to sound source localization and speech comprehension in noise after receipt of a CI. However, binaural performance of these listeners does not reach the level of normal-hearing listeners. One of the reasons for this might be that the electrical stimulation via CI and the physiological stimulation via the intact ear are not synchronized: the CI transmits the information to the auditory nerve with different timing than does the intact inner ear. As a result, there is a timing mismatch of the information transfer between the left and the right side, which may account for the limited binaural performance. The effective mismatch in timing depends on the CI system because of different stimulation strategies implemented in devices from different manufacturers. For the particular CI device used in this study (MED-EL Mi1000/Mi1200) electrical stimulation led to faster activation of the auditory nerve than natural for a wide frequency range. In particular, electrical stimulation was about 1 to up to 2 ms ahead of time for frequencies above 1.5 kHz. Hence, it was hypothesized that information transfer between the left and the right ear can be tuned by delaying the CI signal. The goal of the present study was to investigate whether such a delay in the CI signal affects binaural performance of CI users with SSD. For this purpose, sound source localization and speech perception in noise were tested in a sample of 12 CI users with SSD (mean age 51 ± 12 years). The tests were performed for four different delay times of the CI signal applied spontaneously (0.5, 1, 2 and 4 ms) and for the base line condition "no delay" in the CI signal (i.e. everyday use). It was found that delaying the signal had a significant impact on sound source localization. Speech perception in noise was affected, but less pronounced than was sound localization. Regarding sound source localization, a signal delay of 1 ms applied to this particular CI device produced the best performance in our patients. It is concluded that improving the synchronisation between the CI-transferred signal and the naturally transferred signal could increase binaural hearing performance in CI users with SSD.

Age of onset of recurrent respiratory papillomatosis: a distribution analysis

OBJECTIVE

Distribution of age of onset of recurrent respiratory papillomatosis (RRP) is generally described to be bimodal, with peaks at approximately 5 years and 30 years. This assumption has never been scientifically confirmed, and authors tend to refer to an article that does not describe distribution. Knowledge of the distribution of age of onset is important for virological and epidemiological comprehension. The objective of this study was to determine the distribution of age of onset of RRP in a large international sample.

DESIGN

Cross-sectional distribution analysis.

PARTICIPANTS

Laryngologists from 12 European hospitals provided information on date of birth and date of onset of all their RRP patients treated between 1998 and 2012. Centers that exclusively treated either patients with juvenile onset RRP or patients with adult onset RRP, or were less accessible for one of these groups, were excluded to prevent skewness.

MAIN OUTCOME MEASURES

A mixture model was implemented to describe distribution of age of onset. The best fitting model was selected using the Bayesian information criterion.

RESULTS

Six hundred and thirty-nine patients were included in the analysis. Age of onset was described by a three component mixture distribution with lognormally distributed components. Recurrent respiratory papillomatosis starts at three median ages 7, 35 and 64 years.

CONCLUSIONS

Distribution of age of onset of RRP shows three peaks. In addition to the already adopted idea of age peaks at paediatric and adult age, there is an additional peak around the age of 64.

Radiologic and functional evaluation of electrode dislocation from the scala tympani to the scala vestibuli in patients with cochlear implants

BACKGROUND AND PURPOSE

Localization of the electrode after cochlear implantation seems to have an impact on auditory outcome, and conebeam CT has emerged as a reliable method for visualizing the electrode array position within the cochlea. The aim of this retrospective study was to evaluate the frequency and clinical impact of scalar dislocation of various electrodes and surgical approaches and to evaluate its influence on auditory outcome.

MATERIALS AND METHODS

This retrospective single-center study analyzed a consecutive series of 63 cochlear implantations with various straight electrodes. The placement of the electrode array was evaluated by using multiplanar reconstructed conebeam CT images. For the auditory outcome, we compared the aided hearing thresholds and the charge units of maximum comfortable loudness level at weeks 6, 12, and 24 after implantation.

RESULTS

In 7.9% of the cases, the electrode array showed scalar dislocation. In all cases, the electrode array penetrated the basal membrane within 45° of the electrode insertion. All 3 cases of cochleostomy were dislocated in the first 45° segment. No hearing differences were noted, but the charge units of maximum comfortable loudness level seemed to increase with time in patients with dislocations.

CONCLUSIONS

The intracochlear dislocation rate of various straight electrodes detected by conebeam CT images is relatively low. Scalar dislocation may not negatively influence the hearing threshold but may require an increase of the necessary stimulus charge and should be reported by the radiologist.

Effect of wearing a ski helmet on perception and localization of sounds

Helmet use on ski slopes has steadily increased worldwide over the past years. A common reason reported for helmet non-use, however, is impaired hearing. Therefore, an intra-subject design study was conducted to compare hearing thresholds and sound source localization of 21 adults with normal hearing in an anechoic chamber when wearing a ski helmet and ski goggles or wearing a ski cap and ski goggles to the condition head bare. Hearing thresholds while wearing a ski helmet (6.8 ± 1.6 dB HL) and ski cap (5.5 ± 1.6 dB HL) were significantly different (p = 0.030, d = 0.44). Compared to head bare (2.5 ± 1.2 dB HL), a significant difference was found for the ski helmet only (p = 0.040, d = 1.57). Regarding sound source localization, correct scores in the condition head bare (90%) showed a highly significant difference compared with those of condition cap (65%) and helmet (58%), respectively (p < 0.001; d > 2.5). Compared to the ski cap, wearing the helmet significantly reduced correct scores (p = 0.020, d = 0.59) irrespective of the tested sound pressure levels. In conclusion, wearing a ski helmet impairs hearing to a small though significantly greater extent compared with a cap, the degree, however, being less than what is termed as a hearing impairment. Compared to the condition head bare, wearing a ski cap or a ski helmet significantly reduced one's ability of sound source localization.

Safety of intralesional cidofovir in patients with recurrent respiratory papillomatosis: an international retrospective study on 635 RRP patients

Intralesional use of cidofovir (Vistide(®)) has been one of the mainstays of adjuvant therapy in patients with recurrent respiratory papillomatosis (RRP) since 1998. In 2011, a communication provided by the producer of cidofovir addressed very serious side effects concerning its off-label use. As this was a general warning, it was inconclusive whether this would account for its use in RRP. The aim of this study is to determine whether nephrotoxic, neutropenic, or oncogenic side effects have occurred after intralesional use of cidofovir in patients with RRP. Update of recent developments in RRP, a multicentre questionnaire and a multicentre retrospective chart review. Sixteen hospitals from eleven countries worldwide submitted records of 635 RRP patients, of whom 275 were treated with cidofovir. RRP patients received a median of three intralesional injections (interquartile range 2-6). There were no statistical differences in occurrence of neutropenia or renal dysfunction before and after cidofovir. There was no statistical difference in occurrence of upper airway and tracheal malignancies between the cidofovir and the non-cidofovir group. In this retrospective patient chart review, no clinical evidence was found for more long-term nephrotoxicity, neutropenia or laryngeal malignancies after the administration of intralesional cidofovir in RRP patients.

[Results of hearing screenings in 14- to 15-year old adolescents]

BACKGROUND

A hearing screening among 14- to 15-year-old pupils was performed to estimate the number of hearing-impaired individuals in the adolescent population.

MATERIALS AND METHODS

A total of 1,298 pupils from 30 schools in Tyrol (Austria) participated in the screening. Hearing tests were performed in a silent room at the school. Sinus tones at frequencies 0.5/1/2/4/6 kHz and at levels of 25/20/20/20/20 dB HL, respectively, were delivered via headphones to either ear. Failure of screening was defined as not hearing one or more frequencies in one or both ears.

RESULTS

The screening was failed by 16.3% of the pupils. There was a small but not significant difference between males and females (17.0 vs. 15.2%). Most of the pupils failed at only one frequency (9.6%). Failing at two or more frequencies in the same ear occurred in 3.9% of the pupils, thereof in 1.1% bilaterally.

CONCLUSION

As the specificity of our screening is limited, false-positive results may result. Thus, the rate of hearing deficits in our sample is probably a bit lower than indicated by the figures above. Most of the adolescents who failed the screen failed at only one frequency. These subjects have a small elevation of their hearing threshold, not a hearing loss in the sense of a raised averaged threshold. A hearing loss in the latter sense is supposed to be present in only very few percent of adolescents, a bilateral hearing loss in perhaps less than 1%.

[Forced sterilisation of the hereditary deaf in the Third Reich : Its reflection in the scientific ENT literature.]

BACKGROUND: The Law for the Prevention of Genetically Diseased Offspring (enacted in Germany in 1934 and in Austria in 1940) allowed the forced sterilisation of people with hereditary disorders, including hereditary deafness. Doctors were required to register their patients who qualified under the Law and to cooperate in establishing the diagnosis. METHOD: This study investigated how the questions and problems related to this topic were discussed in three German-language scientific ENT journals published between 1934 and 1944. RESULTS AND DISCUSSION: A few ENT specialists appeared as "protagonists" of the eugenics programme and supported its implementation. Others seemed to be "sceptics" of the programme who, though not overtly objecting to it, warned against its uncritical application. The scientific discussion was nevertheless objective and not distorted by ideological motives. Apparently, the "sceptics" were influential enough to widely establish a restrictive practice of diagnosing hereditary deafness. Nevertheless, the physicians failed to comply with their professional obligation to advocate the welfare of the patient rather than that of "the nation".

[Development of a parent questionnaire for assessment of auditory behaviour of infants up to two years of age]

BACKGROUND

There is an increasing need for an instrument, which allows to quickly and reliably assess the auditory behaviour of infants and toddlers. SCIENTIFIC QUESTION AND OBJECTIVE: The objective of this study was to develop and validate the "LittlEARS Hearing Questionnaire", a tool for assessing auditory behaviour in children up to 24 months of age.

METHODS

Questionnaire construction followed the principles of classical test theory. The psychometric properties of 45 questions on infant auditory behaviour were examined in a sample of 218 parents of normal hearing infants up to age 24 months. Parental responses also served for computing normative values of the development of early auditory behaviour by regression analysis.

RESULTS

The final questionnaire contains 35 items, to be answered with either "yes" or "no". The sum of "yes"-answers yields an overall score, which can be compared to age-related normative values in order to appraise the age-appropriateness of the infant's auditory behaviour. The following scale characteristics have been found with the above sample: internal consistency: Cronbach's Alpha = 0.96; reliability: split-half r = 0.88; predictive accuracy: Guttman's Lambda = 0.96; correlation between overall score and age of the children: r = 0.91.

CONCLUSION

The "LittlEARS Hearing Questionnaire" is suitable for the quick assessment of a little child's hearing behaviour, e. g. at physical examinations, at the postnatal hearing screening, or when evaluating rehabilitative measures.

Führt eine Schallpegelabsenkung in Diskotheken zu einem Rückgang der Besucher?

BACKGROUND

This study investigated whether adolescents are likely to decrease their frequency of discotheque attendance if the sound levels are lowered moderately.

METHODS

A sample of 1,213 high school students aged between 13 and 20 years (mean: 15.8 years) were given a questionnaire and asked their views on the current sound levels at discotheques, and whether they would change their attendance if the levels were somewhat lower.

RESULTS

Some 53.7% of the respondents wished to keep the current sound levels, while only 2.5% preferred a raise, and 43.8% a decrease. In the case of a moderate decrease, 85% of respondents would not change their frequency of discotheque attendance, while 5% would reduce it, and 10% would increase it.

CONCLUSIONS

The results of this study contradict the fears of discotheque operators that adolescents would visit the discotheque less frequently if the sound levels are lowered moderately. To prove the effects of a sound level reduction, however, separate studies are needed.

Counselling vs. Gruppentherapie bei chronischem Tinnitus

BACKGROUND

Both counselling and group therapy have been recommended for supporting patients with chronic tinnitus. It is unclear which of these treatments is superior.

SCIENTIFIC QUESTION

This retrospective study aimed at comparing relief from tinnitus distress following counselling with that following cognitive group therapy. Distress relief was also compared to the distress level of the waiting group patients.

METHOD

Tinnitus distress was assessed through the Tinnitus Questionnaire (TQ, Goebel and Hiller) at three different times: before treatment (in waiting list patients: at initial contact) and at 3 and 6 months after initial assessment. Data from 21 patients per group were included in the analysis.

RESULTS

The initial tinnitus distress scores were similar in all groups (about 48 TQ points out of a maximum of 84). After 3 months, both counselling subjects and group therapy participants exhibited a significant distress reduction of 13 TQ points, which remained stable after 6 months. Patients on the waiting list experienced no distress relief over time.

CONCLUSION

Results from our data demonstrate the need for a future prospective study on the comparison of efficacy of counselling vs cognitive group therapy.

[Chronic tinnitus and allergies -- are they linked?]

BACKGROUND

Some neuro-otologic disorders are suspected to have a higher prevalence of allergies than is found in the population. This study aimed to determine the prevalence of allergies in patients with chronic tinnitus.

METHODS AND PATIENTS

102 tinnitus patients were mailed a survey containing a list of allergies, and asked to quote any allergy they were afflicted with. Additionally, they had to specify whether the diagnosis has been medically confirmed or not. Findings were compared to those from an age- and gender-matched control group.

RESULTS

32 % of tinnitus subjects (CI (95 %) = 42 - 24 %), but only 21 % of controls (CI (95 %) = 29 % - 13 %) had at least one medically diagnosed allergy. Regarding all (ie., diagnosed and non-diagnosed) allergies, 49 % of tinnitus subjects (CI (95 %) : 39 -59 %) versus 46 % (CI (95 %) : 37 -57 %) of controls stated to be afflicted with at least one allergy.

CONCLUSIONS

Our findings suggest that the frequency of allergies in tinnitus patients is essentially equal to the allergy prevalence in the population as revealed from recent epidemiologic studies. We conclude that there is no increased risk for allergies in chronic tinnitus. The lower rate of medically diagnosed allergies in non-tinnitus subjects probably indicates that mild allergies are less frequently diagnosed in the group of otherwise healthy persons.

[Effect of information about hearing damage caused by loud music. For adolescents the music in discoteques is too loud despite loudness limits]

BACKGROUND

Information campaigns are regarded useful to prevent adolescents from hearing-damage due to loud music. This study examined whether adolescents who are informed on the risk of a hearing-damage, exhibit preventive behavior when attending discotheques.

METHOD

253 pupils (age 14 to 19 years) were interviewed about their disco attending habits and about their information on the risk associated with listening to loud music.

RESULTS

About 85% of the sample were informed about the risk. Informed and uninformed pupils did not significantly differ in the frequency of disco attendance nor in the frequency of using ear-plugs. However, significantly more informed pupils experienced disco music as too loud (p < 0.05).

CONCLUSIONS

Information influences the subjective appraisal of loudness perception, but has little effect on preventive behavior. Instead, experimental forms of educational campaigns may be more effective. Additional provisions (lowering sound levels in discotheques) are necessary.

Epidemiology of permanent childhood hearing impairment in the Tyrol, 1980-94

In recent years the need for reliable data on permanent childhood hearing impairment (PCHI) has increased, owing to both scientific interest and practical aspects such as implementation of neonatal hearing screening. In order to obtain data about the epidemiology of PCHI in the Austrian state of Tyrol, the medical records of all hearing-impaired Tyrolean children born between 1980 and 1994 were researched. A total of 165 children with at least moderate hearing impairment in the better ear were registered, of whom 52.7% were found to be moderately hearing-impaired, 24.2% severely hearing-impaired and 23.0% profoundly hearing-impaired. Sensorineural hearing loss was observed in 87.3%, conductive hearing loss in 6.7% and mixed hearing loss in 6.1%. As for aetiology, non-syndromic hereditary hearing loss was diagnosed in 22% of the children and syndromic hearing loss in 8%. Congenital malformation of the ear was found in 3%. In 19% of the children, perinatal risk factors were seen, and in 10% a pre-, peri- or postnatal infection had occurred. Aetiology remained unknown in 36% of the children. The prevalence rate of newborn hearing impairment was 1.27/1000 newborns. The results are considered to fit well to the PCHI findings reported from other European regions.

Maternal concern about positive test results in universal newborn hearing screening

OBJECTIVE

A positive test result from universal newborn hearing screening (UNHS) has been suspected to cause maternal concern. However, findings so far are inconclusive. Against the background of a 2-stage UNHS protocol, we investigated the extent of maternal concern in 2 different situations: 1) mothers' immediate reactions after a positive result at the first-stage test and 2) maternal concern during a 1-month period while waiting for the infant's hearing assessment after the infant also failed the retest (ie, the screening). In addition, we checked whether mothers who are informed by an audiologist about the low predictive validity of positive test results in hearing screening are less concerned about a positive result than mothers who are not informed.

METHODS

A prospective study was conducted over a 1-year period, in which all mothers whose infants tested positive in the first stage or failed the screening were questioned about their level of concern attributable to the positive test result.

RESULTS

Of 85 mothers whose infants tested positive in the first-stage test (situation 1), 34 (40%) did not know the result. Of the remaining 51 mothers, 59% were not at all concerned and 27% were only slightly concerned about the result, whereas 14% stated that they were highly concerned. In an additional sample of 43 mothers whose infants failed the screening (situation 2), 42% reported not being worried and 37% only slightly worried, whereas 21% were highly concerned about the positive screening result. No effect of information about the low predictive validity of positive test results on the extent of maternal concern could be ascertained.

CONCLUSIONS

The results of this study contradict the findings of some previous surveys that reported considerably higher levels of maternal concern after a positive test in UNHS. The failure to demonstrate the impact of information on maternal concern might be attributable to the fact that the number of uninformed mothers was too small to affect our results perceptibly.

Improvement in early detection of congenital hearing impairment due to universal newborn hearing screening

OBJECTIVE

The aim of this study was to determine whether universal newborn hearing screening (UNHS) is effective in increasing the number of children whose hearing impairment is detected early, i.e. within the first 6 months of life. It also investigated whether UNHS contributes most to the early detection of moderately and severely hearing-impaired newborns, as suggested by a recently published report.

METHODS

The study consisted of a retrospective analysis of the data of all children born in Tyrol between 1980 and 1999 and having an at least moderate permanent hearing loss in the better ear.

RESULTS

The findings are that since UNHS was introduced in some newborn nurseries in 1995, a substantially higher number of hearing-impaired children has been detected early. For the whole sample, the increase of the early detection rate is 39.9%, with a 95% confidence interval of 33.2-46.8% (P<0.0001). For moderate hearing loss the increase is 49.2 with a 95% confidence intervall of 39.6-58.8% (P=0.000).

CONCLUSIONS

On the whole, our findings lend support to the view that UNHS is effective in early detection of congenital hearing impairment. We conclude that UNHS provides the greatest benefit for moderately hearing-impaired children who, otherwise, would have been detected last.

[Hospitalizations due to hepatitis A, B and C in Austria 1996-1998]

The aim of this study is to analyse the data of all Austrian in-patients who had been hospitalized between 1996 and 1998 with the main diagnosis "viral hepatitis" (according to ICD 9), in order to present data for epidemiological as well as health-economical considerations. The data used stem from the "Minimum Basic Data Set" (MBDS) which contains medical as well as demographical recordings of every in-patient treated in an Austrian public hospital. Hepatitis A: Values of the standardized hospitalization rate (SHR) ranged from 2.6/100,000 (1998) to 4.7/100,000 (1997). On age classes, the highest values regularly were observed in school-children (7-13/100,000 per year). Significant differences between males and females were not revealed. Among the Austrian federal states, Vienna was found to jut out (6.8/100,000 per year), probably due to its high proportion of immigrants from high-endemic regions. Hepatitis B: Values of SHR were found to be stable with about 3/100,000 per year. On age classes, rates increased rapidly in adolescents, reached the peak in young adults (aged 20 to 29 years: 5/100,000 per year) and, then, decreased slowly. Males were slightly, but not significantly, more affected than females. Interestingly, a respectable number of young children (aged 0 to 4 years) were hospitalized in 1997 and 1998 (1998: 4.4/100,000). Comparing the Austrian federal states, Vorarlberg (6.4/10,000 per year) and Vienna (4.5/100,000 per year) yielded the highest values of SHR. Hepatitis C: In the years observed, values of SHR were ascending successively from 6/100,000 (1996) to 9.7/100,000 (1998). On age classes, the highest risk of hospitalization was found for adults aged between 35 and 74 years (10-20/100,000 per year). Among the Austrian federal states, values of SHR differed considerably; Salzburg (15.1/10,000 per year) and Kärnten (Carinthia) (12.1/100,000 per year) were found to yield the highest values.

The impact of information on maternal attitudes towards universal neonatal hearing screening

In order to improve the acceptability of universal newborn hearing screening (UNHS) among parents, several authors have proposed that information about hearing screening be provided to them. The purpose of the present study was to test the hypothesis that mothers who are informed about their baby's hearing test are more likely to have a positive attitude towards hearing screening than are mothers who are not informed. Information given to mothers was assessed by three items concerning their involvement in their baby's hearing test. Subjects were 90 mothers who were interviewed during their stay at the maternity unit after delivery. Mothers' attitudes towards the screening were assessed through their answer to the following question: 'Should UNHS be performed despite the possibility that parents become worried by false-positive test results?' Mothers who answered 'Yes' were categorized as advocates of UNHS, whereas those who answered 'No' or 'Undecided' were categorized as sceptics. The great majority of mothers (84%) turned out to be advocates. In keeping with the hypothesis, among advocates a significantly higher proportion of mothers were well-informed about the hearing test (78% versus 50%; p = 0.016), were present at the hearing test (51% versus 14%; p<0.01) or knew the result of the hearing test (71% versus 29%; p<0.01). These findings support the view that providing information about the hearing test will positively affect parental attitude towards UNHS.

[Hepatitis B and C: incidence and regional distribution of hospitalizations in Austria]

The aim of this study was to describe the incidence as well as the geographical distribution of hospitalizations due to hepatitis B or C (according to ICD 9) in Austria between 1996 and 1998. The data were taken from the MBDS (Minimum Basic Data Set) which contains medical, demographical and administrative recordings of every in-patient treated in an Austrian hospital. Hepatitis B: The mean value of SHR (standardized hospitalization rate) amounted to 3.2/100.000 for the entire area of Austria. Among all Austrian provinces, Vorarlberg yielded the highest regional value (6.4/100.000), Burgenland the lowest one (1.9/100.000). Considerably high regional values of SHR were found in most districts of Vorarlberg, as well as in Vienna and the eastern districts of Lower Austria. Hepatitis C: The mean value of SHR amounted to 8.4/100.000 for the entire area of Austria. Regional SHR values in Austrian provinces ranged widely from 2.9/100.000 (Burgenland) to 15.1/100.000 (Salzburg), some provinces (Salzburg, Carinthia) showed a marked increase of hospitalizations within the observation period. The highest regional values of SHR were found in and around the districts of Salzburg, Villach, and Klagenfurt.

CONCLUSIONS

The differences observed in SHR values of Austrian districts cannot be accounted for by local differences of Hepatitis prevalence alone. They are supposedly also due to local differences of the health care system, as well as the clinical, diagnostical or documentational practices in hospitals in different regions. In order to evaluate MBDS-Data quality, a post-hoc comparison with external data stemming from three Austrian multicenter studies was performed. A remarkable correspondence in geographical distribution of hepatitis C patients was found between the two data sets. This is considered an argument in favour of the validity of MBDS-Data.

[Universal neonatal hearing screening--attitude and fears of mothers]

Maternal anxiety in the event of a false positive result is an argument against universal hearing screening in newborns. The aim of this study was to investigate the mothers' attitudes towards neonatal hearing screening and their anxiety in case of a positive result. The study comprises 75 mothers. Using a standardized interview 40 mothers were questioned, 38 of whom already knew about this type of health check. Despite the possibility of a false positive result 33 mothers consented to the general newborn hearing screening. The positive attitude towards screening was associated with knowledge about the test and presence during its performance. Of 20 additional mothers who were interviewed about their anxiety following a positive result their baby had received on the first test, only 2 declared to be very worried. Of 15 additional mothers whose babies had failed the screening, 4 mothers were worried, 2 of whom stated that they had not been well enough informed about the screening. Both scepticism towards neonatal hearing screening and anxiety following a positive result were associated with lack of information and absence during testing.

Children's theory of mind: Fodor's heuristics examined

The study reported in this manuscript examined Fodor's (1992) argument that standard false belief tasks used in developmental research seriously underestimate young children's understanding of false belief. The problem of these tasks according to Fodor is that always a unique, actual state of affairs (e.g., chocolate is now in cupboard B) is contrasted with a believed state of affairs (e.g., chocolate is still in cupboard A). Fodor argued that this uniqueness feature may be critical because young children with limited computational resources have to trade reliability of behavioral prediction for computational simplicity and, therefore, may rely on simple heuristics such as "Predict that the agent will act in a way that will satisfy his desires". In the standard false belief task such a heuristic will result in a unique, but incorrect (reality-based) prediction. Fodor's expectation is that when young children are not misled into applying such heuristics by the possibility of unique, reality-based prediction, then their true competence for belief-based reasoning will become evident. The present study contrasted for two different belief tasks a traditional unique version with a non-unique version, but found no support for Fodor's expectation as both 3- and 4-year-old children did not improve in the non-unique version.