Browsing by Author "Jayasena, B.N."

Now showing 1 - 12 of 12

Audiovisual Segregation in Typically Developing Children
(Faculty of Medicine, University of Kelaniya, 2014) Jayasena, B.N.; Nanayakkara, S.; Illangasighe, C.; Jacob, J.
Learning in typical classrooms with high background noise is often difficult for children, where they may have to lipread the teacher to understand what is being said. In this scenario, it is assumed that a child should possess the ability to separate congruent information from incongruent information in an audiovisual signal. This study was aimed at investigating how well typically developing children can segregate visual information in the presence of auditory distracters, compared to young adults. 12 typically developing primary school children and 11 young adults with normal hearing and vision lipread 120 consonant-vowel-consonant-vowel (CVCV) nonsense syllable words presented in four conditions: (1) visual-only condition, (2) visual stimuli with a multi-talker babble, (3) visual stimuli with reversed speech sounds of the nonsense syllable words, (4) visual stimuli with non-altered speech sounds of the nonsense syllable words. Mean scores of children in all four conditions were lower than that of the adults, and also a significant difference for all the conditions between the two groups was noted. Results suggest that normal-like audiovisual segregation is difficult for young children because of maturation effects. The study findings can be used to encourage further research in audiovisual segregation. Also, if used constructively, these findings will be helpful in highlighting the importance of creating learner-friendly environments with minimal auditory distractions for children.
Central Auditory Processing Skills in children with a history of early-onset Otitis Media: A scoping review
(University of Kelaniya, Sri Lanka, 2022) Damayanthi, T.G.J.L.; Umesha, T.; de Silva, M.D.K.; Jayasena, B.N.
Background: Central auditory processing is characterized by the perception and processing of neural information related to the auditory inputs through the human ears and it is vital for speech perception, language skills, and complex learning functions. Auditory deprivation in the early years of life impacts neural maturation of the central auditory nervous system and lowers the ability to process neural information related to aural inputs. Otitis media is known to be the most frequent middle ear infection and a common reason for auditory deprivation among the paediatric population worldwide. Hence, this study focused on auditory deprivation due to otitis media during the early years of life. Many primary pieces of research have been conducted to assess the long-term influence of auditory deprivation due to otitis media on central auditory processing, which lasts over years even after the resolution of the middle ear condition. This study reviewed literature where the long-term effect of otitis media is assessed through behavioural and electrophysiological measures, in children with a history of otitis media within the first five years of their lives. Objectives: To summarize Audiological assessments used to evaluate central auditory processing and to describe central auditory processing skills in children with a history of early-onset otitis media. Methods: This review followed the methodological framework outlined by Arksey & O̕̕Mally (2005) and developed by Levac et al. (2010). Studies conducted from 2000-2020 involving human participants aged ≤18 years, belonging to any gender or geographical context, having a history of otitis media within the first 5 years of life, having normal hearing and normal middle ear condition by the time of study conducted, were included in the review. Studies involving participants with any type of hearing loss before the age of 05 years due to other reasons except otitis media, comment/text literature, and studies with no free accessibility to the full text, and an English translation were excluded. Literature was searched in PubMed, EBSCO host, and Scopus databases, and eligibility was assessed by two reviewers independently. Included studies were critically appraised using standard tools. Extracted data were reported following the systematic reviews and meta-analyses extension for scoping reviews checklist.Results: The review resulted in 13 eligible articles. Some have used behavioural measures only (08), and electrophysiological measures only (03) while 02 have used both. Poor auditory processing skills and alterations in electrophysiological measurements were reported in children with a history of otitis media within the first five years of their lives, compared to children without a history. Conclusion: As per the reviewed studies, there is a negative association between central auditory processing and the history of otitis media within the first five years of life, which persists beyond its resolution.
Designing a tool to monitor development of 2-5 year old children by preschool teachers in Sri Lanka: A preliminary report
(Sri Lanka Medical Association, 2018) Caldera, A.; Mendis, M.; Muttiah, N.; Wijesinghe, T.M.; Godamunne, P.K.S.; Chathurika, L.K.E.; Jayasena, B.N.; Wickremasinghe, A.R.; Perera, K.M.N.; Tilakarathne, N.; Peiris, M.K.R.R.; Sumanasena, S.P.
INTRODUCTION AND OBJECTIVES: Identifying neurodevelopmental impairments and providing early intervention positively impacts later academic and functional outcomes of children. Globally available child development screening tools are not readily accessible or validated for Sri Lanka. As a large proportion of Sri Lankan children aged 2-5 years attend preschools, teachers can complement developmental monitoring. The aim of this study was to design a tool to monitor the development of 2-5 year old children by preschool teachers. METHODS: Twelve local and global tools including the tool developed by Plan International and the Child Health Development Record (CHOR) were reviewed. All tools were mapped according to the domains and subdomains in the National Early Childhood Developmental Standards for Sri Lankan Children. A Delphi process was carried out by a panel of experts to include culture specific activities that assess all domains and subdomains across age groups. RESULTS: The existing tool developed by Plan International lacked indicators for health, daily living and social and emotional development. The CHOR was deficient in cognitive, receptive language, social and emotional indices. Several activities in some instruments were common to more than one age group. The domains incorporated into the proposed tool included motor, cognitive, language, social and emotional and self- help skills. Approximately 50 items per each age group were included in this tool CONCLUSION: A preliminary play-based tool for monitoring development of children 2-5 years of age across five main domains in natural settings for preschool children was developed. A pilot study is required to assess the validity of the tool.
Developing a tool to screen for disability among pre-school children: preliminary results
(Sri Lanka Medical Association, 2014) Perera, K.M.N.; Wijerathne, L.; Jayasinghe, C.; Kasturiratne, A.; Hettiarachchi, S.; Fonseka, R.; Jayasena, B.N.; Siriwardhena, D.; Godamunne, P.; Dahanayake, W.; Pathmeswaran, A.; Wickremasinghe, A.R.
INTRODUCTION AND OBJECTIVES: To develop and validate a tool that can be used by pre-school teachers to identify disabilities in the pre-school age group. METHODS: A multidisciplinary team was formed and the initial tool was developed^ Consensual validity was achieved by using nominal group technique and the tool was pre-tested in the Ragama MOH area. To assure criterion validity, the tool was used to screen all the children in the pre-school age group (2-5 years) in an MOH area randomly selected from the Anuradhapura District. The screened positives .were referred to an expert panel for confirmation of diagnosis and follow-up if required. RESULTS: Thousand nine hundred children were invited for screening and 1536 participated (478 2-3 years, 495 3-years, 560 > 4 years of age) and 267 (17.4%) were referred to the expert panel. Out of the referrals, majority (38.9%) had multiple disabilities. Hearing and speech difficulties were seen in (29.6%). Psycho social problems (11.6%), disabilities and other diseases (19.8%) accounted for the rest. The response rate for confirmation by experts was 64%. The predictive value of a positive test was 79.5%. The prevalence of disabilities among the screened pre-school age group was 88 per 1000 (95% Cl= 74 to 103). CONCLUSIONS: This tool can be used to screen children in the pre-school age for disabilities.
Development of a Dichotic Digits Test, Pitch Pattern Test and Duration Pattern Test for Sri Lankan Young Adults: Preliminary Findings
(International Postgraduate Research Conference 2019, Faculty of Graduate Studies, University of Kelaniya, Sri Lanka, 2019) Balasuriya, B.M.L.K.; Ekanayake, E.M.M.L.; Dayaratna, A.M.D.N.; Jayasena, B.N.
Dichotic Digits Test (DDT) involves listening to simultaneous digits presented bilaterally with different digits presented to each ear. Pitch Pattern Test (PPT) and Duration Pattern Test (DPT) are temporal processing tests that involve ordering auditory patterns in frequency and duration respectively. Dichotic listening and temporal processing are auditory processes that play a crucial role in everyday speech understanding. Poor performance shown in one or more of these auditory processes are an indication for Central Auditory Processing Disorder (CAPD). Research evidence suggest that performance scores are influenced by the language spoken by the population tested. Therefore, this study aimed to develop a DDT, PPT, and a DPT and establish norms for Sinhala speaking young adults. 25 single pair digits, 30 frequency patterns and 30 duration patterns were recorded using 6 bisyllabic Sinhala digits, 880 Hz and 1122 Hz, and 250ms and 500ms stimuli respectively. All tests were developed based on gold standards for CAPD test material construction. Initially, the stimuli were piloted on 20 participants who met the inclusion criteria, but not included in the main study. A sample of 128 right-handed normal hearing young adults aged 20 to 28 years were tested to establish cut-off scores, ear differences and gender differences in performances for all three tests. The participants were limited to young adults in order to minimize effects of aging on test performance. The DDT was performed under free recall, directed right and directed left listening conditions. Free recall involved repeating digits heard in both ears while directed recall involved repeating the digit in the monitored ear and ignoring the digit in the other ear. The cut-off scores for the DDT were 91.64% in the right ear and 85.96% in the left ear for the free recall and 69.15% in the right ear and 68.75% in the left ear for the directed recall listening condition. The PPT and DPT reported cut-off scores that were 27.82% in the right ear and 29.90% in the left ear, and 72.99% in the right ear and 73.33% in the left ear respectively. The right ear scores were significantly higher than the left ear scores (p < .001) in the DDT free recall listening condition, re-establishing the phenomena of right ear advantage. Interestingly, ear differences were not significant (p> .001) for PPT and DPT. No gender differences were noted for any of the tests. The study provide audiologists in Sri Lanka access to feasible tests and preliminary cut-off scores that would help diagnose CAPDs in young adults.
Effectiveness of vocal hygiene education among undergraduate music students with self-reported voice problems at University of Visual Performing Arts and University of Kelaniya
(University of Kelaniya, Sri Lanka, 2022) Nagahawatta, W.M.M.D.; Jayasena, B.N.
Background: Voice is the fundamental source of communication and plays an important role in daily life. Voice can indicate personal information such as the speaker’s social status, personal characteristics, and emotional state. Occupational voice users, such as singers, teachers, and lawyers are more likely than non-professionals to develop voice disorders. By abusing or misusing their voices, professional singers are more likely to acquire laryngeal signs and symptoms, as well as pathology. Objectives: To assess the Effectiveness of a Vocal Hygiene Program among undergraduate music students with self – reported voice problems in visual preforming university and Kelaniya University. This study aim was to determine the effectiveness of a virtual vocal hygiene education program on improving self-reported voice problems in undergraduate music students by comparing the Voice Handicap Index 10 score, Voice Related Quality of life score and acoustic parameters of voice before and after conducting the virtual vocal hygiene education program.Methods: This study included 30 undergraduate music students from the University of Visual and Performing Arts and the University of Kelaniya with self-reported vocal problems. The pre-scores were obtained after participants completed a self-administered voice case history, Voice Related Quality of Life, Voice Handicap Index -10, and voice samples. The study's participants were given a 30–45-minute vocal hygiene program that included basic voice production knowledge and 15 vocal hygiene tips. Participants in the study were required to follow the supplied vocal hygiene recommendations consistently for three weeks. At the end of the three weeks, all participants were given the Voice Handicap Index -10 and the Voice Related Quality of Life to collect post-test ratings, as well as voice samples to identify pre post results. Descriptive stats for demographic information of the participants mean and standard deviation of the pre and post voice handicap index -10, voice related quality of life and acoustic parameters. PRRAT software was used to analyse the voice samples. Inferential statistics for the mean difference in pre to post scores via paired t test was used to analyse the collected data.Results: There is a statistically significant difference between the pre- and post- tests (P < 0.05) suggesting a positive association between complying with a vocal hygiene program and the reduction of voice related symptoms. The jitter and the shimmer parameters were significantly lower in the post-test compared to the pre- test. Mean intensity, mean pitch and the HNR values were significantly higher in post- test compared to the pre -test.Conclusion: The conclusion of this study is that an effectively used vocal hygiene program can reduce the voice-related symptoms of undergraduate music students with self-reported voice problems.
Implementing Newborn Hearing Screening at the University Pediatric Unit of the North Colombo Teaching Hospital, Ragama
(Staff Development Center, University of Kelaniya, Sri Lanka, 2015) Chandrasekara, J.M.A.U.; Jayasena, B.N.; Illeperuma, D.; de Silva, D.; Chathurika, E.
Background and rationale:Hearing loss is a multifaceted condition with profound medical, social, and cultural implications (Smith et al., 2005). If hearing loss is not detected in infancy, it can lead to delayed speech and language acquisition, impaired social and emotional development and poor academic performance. Adverse consequences of late detection is minimized when hearing is screened by as early as 1 month of age. However, very few state sector hospitals in Sri Lanka implement hearing screening. Hence it is essential that newborn hearing screening programmes are implemented in a wider scale. Aim: This study aims to initiate a newborn hearing screening programme at the North Colombo Teaching Hospital, Ragama by identifying hearing impairment among all newborn well-babies and the Neonatal Intensive Care Unit (NICU) babies-University Pediatric Unit. Conceptual framework: The Joint Committee on Infant Hearing (JCIH) recommends a 1-3-6 benchmark on infant hearing. This includes screening hearing of all newborns no later than 1 month of age; those not passing screening to have a diagnostic hearing evaluation no later than 3 months of age; infants with confirmed hearing loss to receive appropriate intervention no later than 6 months of age(JCIH, 2007). Proposed Methodology: Hearing screening will be conducted using Otoacoustic Emission (OAE) for well-babies and a combination of OAE and Auditory brainstem Response (ABR) for babies admitted to the NICU. Those who fail the initial screenwill be rescreened at no later than 1 month of age. Those who fail the rescreen will be referred for detailed audiological evaluation by 3 months of age. The gathered data will be subjected to descriptive and inferential statistics. Expected outcomes: The proposed study will provide an initiative step towards including newborn hearing screening as a compulsory component to the hospital’s newborn care services.
Knowledge, Attitudes and Practices on Noise Induced Hearing Loss among Factory Workers of Two Dairy Product Manufacturing Factories in Gampaha District, Sri Lanka
(Faculty of Medicine, University of Kelaniya, 2014) Hansajie, S.T.K.; Jayasena, B.N.; Chathurika, L.K.E.
The main purpose of this study was to describe dairy product manufacturing factory workers’ knowledge, attitudes and practices on Noise Induced Hearing Loss. A cross-sectional study was conducted involving 187 factory workers in two factories in the Gamapaha District. A self-administered questionnaire was used to obtain information pertaining to knowledge, attitudes and practices related to Noise Induced Hearing Loss. In the study, it was found out that knowledge on risk factors of NIHL (23.5%) and symptoms of NIHL (38%) was weak. Even though most of the workers (76.5%) perceive noise as a usual phenomenon in the working area, 77% of the workers were willing to seek medical attention if the hearing starts to deteriorate. The overall practice level was not satisfactory. 80.2% of the workers have never used hearing protection devices (HPD) while working. 98.9% of the workers have never undergone a hearing evaluation and 99.5% of the workers have never attended to a hearing conservation program. 95% of the workers reported that the occurrence of hearing deterioration due to high level of noise was worrying. Only 0.5% of the workers reported wearing HPD while working. 80.2% of the workers never used HPD during work. There was a significant association between aspects of work experience and HPD usage (2= 5.193, p= 0.02). In conclusion, it was discovered that there is a need to have a hearing conservation program that stresses on the use of hearing protective devices to prevent the occupational noise induced hearing loss in the particular setting.
Prevalence of External and Middle Ear Pathologies among Students with Hearing Impairment in School Settings
(Faculty of Medicine, University of Kelaniya, 2014) Perera, N.C.S.; Chandrasekara, J.M.A.U.; Jayasena, B.N.
Hearing impairment is a major health problem in children. The incidence of external and middle ear diseases is greater for children with severe to profound hearing impairment. This study was aimed at determining the prevalence of external and middle ear pathologies among students with hearing impairment in school settings. A descriptive cross sectional study was carried out in two selected schools for children with hearing impairment (6-9, 10-13 and 14-16 years). A total of 195 participants were selected using two stage stratified sampling method. Otoscopy and Tympanometry were performed. Intact tympanic membranes were found in 316 ears (81 %), which was high in the age group of 14 -16 years. 74 (19 %) reported non occluded ear cerumen, occluded ear cerumen, tympanic membrane perforation, bulging tympanic membrane, external ear infection, foreign bodies and discharge. Most common pathology was non occluded ear cerumen in 49 (12.6 %), and high in 10 -13 age group. Only 383 ears were examined by Tympanometry due to occluded ear cerumen, presence of foreign bodies and external ear infection in 7 ears. Type “A” tympanograms were found in 282 ears (74%) and those were normal middle ears. Remaining 101 ears (26%) were pathological middle ears. Type “As” (47 ears; 12%) and type “Ad” (23 ears; 12%) were the most frequent pathological tympanograms, which was high in the 14 -16 group. There is a noticeable prevalence of external and middle ear pathologies among students with hearing impairment. The study findings highlight importance of regular ear examinations and promoting hearing hygiene in children with hearing impairment.
REACh for the preschoolers; a developmental assessment tool for 2-5 year old children in Sri Lanka
(BioMed Central, 2023) Caldera, A.V.; Wickremasinghe, A.R.; Muttiah, N.; Godamunne, P.K.S.; Jayasena, B.N.; Chathurika, L.K.E.; Perera, K.M.N.; Mendis, M.; Tilakarathne, D.; Peiris, M.K.R.R.; Wijesinghe, T.; Senarathna, N.E.; Saubhagya, W.D.L.; Chandraratne, M.; Sumanasena, S.P.
BACKGROUND: Preschool children in low resource settings are at higher risk of missing developmental potential due to the lack of standardized and validated methods for the timely detection of children with developmental delays or neurodevelopmental disorders. The preschool teacher is a non-specialist resourceful link within the community to detect and offer interventions early. This paper discusses the preliminary iteration of designing and testing the psychometric properties of a developmental assessment for children aged 24 to 60 months in Sri Lanka. This assessment is designed to be conducted by preschool teachers in their preschool setting. METHODS: Three processes followed: 1. Designing and development of the Ragama Early Assessment for Children (REACh) complete preschool developmental assessment and a tool kit 2. Testing and training teachers on conducting the REACh assessment 3. Preliminary assessment of the psychometric properties including content validity, internal consistency, interrater reliability and concurrent validity. RESULTS: A literature search identified 11 assessments and 542 items representing cognitive, social-emotional and adaptive, language and motor domains. Content validity was assessed to select and adapt items. A complete assessment tool was designed to be administered in four settings within the preschool. This was further improved during pre and pilot testing and teacher training. Cronbach's alpha measuring internal consistency was > 0.70 for cognitive, language, social-emotional and adaptive domains across all three age groups in 1809 children. Interrater reliability was > 65% for age groups 36-47 and 47- 60 months. Concurrent validity using a clinical gold standard demonstrated sensitivity of more than 0.75 for all age groups with variable specificities (24-35 months: 0.71, 36- 47 months: 0.43 and 48-60 months: 0.67) assessed in 75 children. CONCLUSIONS: This culturally and linguistically adapted tool was tested nationally in Sri Lanka. The inte-rrater reliability between teachers and research assistants was higher than 65% for all domains in children more than 36 months. The preliminary iteration confirms it as an acceptable screening assessment for all age groups but with significantly lower specificity in the 36-47 month age group. Further improvement in certain domains together with intense teacher training is likely to enhance the validity and reliability of the assessment.
Subjective Measures of Hearing Aid Outcome in Hearing Impaired School Children
(Faculty of Medicine, University of Kelaniya, 2014) Rupasinghe, W.B.S.R.; Chandrasekara, J.M.A.U.; Jayasena, B.N.
It is imperative to ensure that hearing aids provide maximum benefit to the wearer, especially in case of children with prelingual hearing impairment. The current study aimed at exploring the status of hearing aid use among children in two schools for the hearing impaired in and around Colombo, and to measure whether the students are benefitted from their hearing aids. 104 hearing aid users in school setting for the hearing impaired in the age range of 6-16 years were tested during the study. Otoscopic examination, Pure tone Audiometry, Aided audiogram, Speech Identification Score (SIS) and Ling’s six sounds test were performed. Subjective measures of hearing aid outcome were measured using the aided performance for SIS and Ling’s six sounds test. The relative benefit was measured using the difference between the aided and unaided scores of respective tests. Only 17.31% (n=18) participants from the whole study population receive at least ≥50% benefit from the hearing aids and only 41.34% (n= 43) participants had demonstrated at least ≥50% aided performance score at SIS. Aided performances were better for those with Pure Tone Average (PTA) <90dBHL compared to participants with PTA ≥90dBHL, indicating that there is an association between the degree of hearing loss in the ear with amplification and the aided performance. Results suggest that the benefit provided by the hearing aids used by students with hearing impairment in Sri Lankan school setting is not satisfactory as the speech identification and sounds detection and identification ability with those hearing aids were very poor even at quiet condition and will be more affected in real life listening conditions with challenging signal-to-noise ratios. Potential factors that may have contributed to the results were identified as unaidable hearing loss, inconsistent use, inadequate aural rehabilitation, improper fitting and programming of hearing aids and less compliance for hearing aid use due to use of sign language.
A Survey on current knowledge and practices of teleaudiology among audiology professionals in Sri Lanka
(University of Kelaniya, Sri Lanka, 2022) Prabodani, G.V.; Jayasena, B.N.
Background: With the advancement of technology and resources, telehealth is becoming a prominent method of filling the gaps in conventional audiology services across the world. Teleaudiology services in Sri Lanka are evolving and still is an under addressed area of local literature compared to other telehealth applications in the medical sector. Objectives: To describe the current knowledge and practices of teleaudiology and factors affecting planning and implementation of teleaudiology services in Sri Lanka. Methods: This is a descriptive cross-sectional study conducted among 104 (n=104) audiology professionals employed in public and private audiology work setups across the country. Objectives of the study were evaluated through an online self-administered questionnaire, which was configured as a Google form. Results: The study yielded a response rate of 83.87% and a majority (75.0%) of the participants were female and the age distribution of participants was between 25 and 45 years. A majority (79.8%) of the practitioners reported awareness on teleaudiology while 32.7% of them were utilizing teleaudiology in practice. Initiation of teleaudiology was influenced by the COVID-19 pandemic for the majority. Audiology practitioners reported the use of telepractice predominantly in counselling, education, training, hearing aid related rehabilitation, and prevention of hearing and balance related conditions as individual or group sessions, utilizing a hybrid telehealth model. More than 75.0% of the services were centralized within the Western province in private centres and the teen to adult age range was served through telepractice predominantly. Despite practices, several factors and challenges were reported to influence teleaudiology practices, including the lack of facilities and resources as the major challenge while reporting several benefits of practice also. Conclusions: The findings of the study indicate that teleaudiology services are currently available in Sri Lanka, but it is centralized within a narrow geographic area and primarily restricted only to certain services. No information can be derived on the trend of teleaudiology in Sri Lanka due to the lack of evidence in the existing literature. This study sheds a light on current knowledge and practices of teleaudiology with an emphasis on factors affecting it, which will assist in improving services further.