The development of a test of speech reception disability for use in 5- to 8-year-old children with otitis media with effusion.

The study aims to develop a test of speech reception disability under simulated classroom conditions for use in young (5-8 year old) schoolchildren, to manage children with otitis media with effusion more effectively. A new video test, TADAST (Two Alternative Auditory Disability and Speech Reception Test), has been constructed in stages by extensively modifying the FADAST (Four Alternative) currently used to assess auditory disability in adults. Minimal word pair lists which were easily identifiable in picture form were developed and refined, and then formulated as a two alternative forced choice picture test. The distribution characteristics of the new test were defined in 89 schoolchildren with and without otitis media with effusion (OME) and compared with pure-tone audiometry performed at the same time. The test correlated highly with audiometry in older children. The distribution characteristics revealed a considerable proportion of children with bilateral OME with little functional disability who might otherwise be at risk of surgery. The test appeared to be sensitive to a 'history of OME' effect. Further refinements are needed to develop a final version which could also be used to evaluate hearing disability in 4-year-old children.