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Hearing Loss, Tinnitus Among Special Olympic Athletes

Stevens, Wendy

doi: 10.1097/01.HJ.0000559499.67179.bc
Special Olympics
Free

Ms. Stevens is an audiologist with 32 years of experience and a senior lecturer at De Montfort University in Leicester, U.K. She has been volunteering at the Special Olympics since 2009 and served as the event's clinical director since 2013. She was also named “Audiologist of the Year” by the British Academy of Audiology in 2017.

The daily impact of hearing loss can lead to adverse consequences, including frustration, loneliness, and behavioral changes.1 Hearing loss also affects a person's ability to learn and socialize, which are particularly important for someone with a learning disability (LD). Previous research within the United Kingdom found that 30 to 40 percent of adults with a learning disability has hearing loss, and that hearing loss in this population goes largely untested.2-4 People with LD are often unaware that they have a hearing loss and therefore do not self-report. More recent studies5,6 also found that people with LD are more likely to have hearing loss compared with the general population but are less likely to have their hearing problem diagnosed or managed. Screening for hearing loss is not included in the annual health check offered by a general physician to patients over the age of 14.

Table

Table

Figure 1.

Figure 1.

Figure 2.

Figure 2.

To date, there has been little or no research in the field of tinnitus in adults with LD. The consequences of tinnitus with regard to behavior can include depression, mood swings, isolation, and sleep disturbances.7 Tinnitus can also affect their socialization, which adds another challenge in addition to their learning disability. A recommended procedure is available for assessing children with tinnitus. However, no assessment tool or recommended procedure is available for adults with LD.

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SPECIAL OLYMPICS

The Special Olympics is the world's largest sports organization for adults and children with LD. Approximately 5 million athletes compete every year in over 172 countries.8 The Special Olympics in Great Britain began in 1978 and are held every four years. As the games started to grow, it became evident that many athletes had untreated health problems, and in 1997, the Special Olympics Healthy Athletes, a health screening and education program for athletes with LD, was launched. To date, this initiative has provided over 1,400,000 free health exams to athletes and trained more than 120,000 health care professionals across the globe. At the 40th anniversary games in 2018 held at Stirling, Scotland, the Special Olympic athletes were invited to have their hearing checked, including screening for tinnitus. When hearing loss or an otological problem (e.g., ear infection) was identified, the participant was made aware and advised to get further consultation.

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EVALUATING THE ATHLETES

The athletes were screened using an international protocol defined by the Special Olympics (Table). They were asked the following questions regarding their tinnitus:

  1. Do you have any noises in your ears?
  2. Is it a quiet or loud sound?
  3. Does it bother you?

The athletes responded by pointing to a relevant face icon (Fig. 1). A total of 108 athletes were screened over three days. Overall, 72 percent had attended the Special Olympics previously, but only 28 percent had been screened at least once. Results suggested that 33 percent had hearing loss. This notably compares with the current statistic that one in six people in the United Kingdom has hearing loss.9 The difference in prevalence could be due to the fact that people with LD will have other related health conditions like Down syndrome. About 7.5 percent of participants were found to have conditions that needed an ENT referral.

Of the total number of athletes screened, 86 percent responded to the tinnitus questions. Of this, 39.8 percent reported hearing noises in their ears. Responses to the third tinnitus-related question were limited. However, 18 percent reported that the noise they hear wasn't bothersome, and 17 percent said it was. In comparison, the prevalence of tinnitus among the adult U.K. population is 10 percent, a rate that can increase with age and level of hearing loss.10 In sum, we found increased prevalence rates for both hearing loss (2:1) and tinnitus (4:1) in Special Olympic athletes compared with normal control data in the United Kingdom.

The results of the screenings indicated that an assessment tool must be developed to more accurately determine the prevalence of hearing loss and tinnitus in people with LD, and that this tool must be integrated into audiology practice. The results also indicated the need for hearing screening to be part of the annual health evaluation of people with LD to improve their quality of life. Finally, overall results also showed that the screenings benefited not only the Special Olympic athletes but also the student volunteers from De Montfort University's BSc Healthcare Science program, who helped conduct the hearing screenings. Attending these screenings offered the students an opportunity to develop their clinical skills in this field, and anecdotal evidence has suggested that students become more clinically confident after volunteering at these events.

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REFERENCES

1. Ciorba A Bianchini C Pelucchi, S Pastore. The impact of hearing loss on the quality of life of elderly adults. A Clin Interv Aging. 2012;7:159-63. doi: 10.2147/CIA.S26059. Epub 2012 Jun 15.
2. Yeates, S. The incidence and importance of hearing loss in people with severe learning disability: the evolution of a service. Brit J Learn Dis. 1995;23(2):79. https://doi.org/10.1111/j.1468-3156.1995.tb00169.x
3. Lavis D., Cullen P. & Roy A. Identification of hearing impairment in people with a learning disability: from questionnaire to testing. Brit J Learn Dis. 1997; 25(3)100-105. https://doi.org/10.1111/j.1468-3156.1997.tb00020.x
4. Turner S Moss S (1996) The Health Needs of Adults with Learning Disabilities. J Intellect Disabil Res. 1996 Oct;40 ( Pt 5):438-50.
5. McShea, Lynzee. Hearing loss in people with learning disabilities. British Journal of Healthcare Assistants 2014; 7(12).
6. Sarah Bent, Siobhan Brennan Lynzee McShea, Hearing Impairment, Physical Health of Adults with Intellectual and Developmental Disabilities, 10.1007/978-3-319-90083-4_9, (169-185), (2018).
7. American Association of Tinnitus, 2018/ Impact of Tinnitus. https://www.ata.org/understanding-facts/impact-tinnitus. Accessed 01/02/19.
8. Special Olympics https://www.specialolympics.org/. Accessed 01/02/19.
9. Action Hearing Loss Facts and Figures.
10. British Tinnitus Association, 2019. All About Tinnitus. https://www.tinnitus.org.uk/all-about-tinnitus
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