The screening and epidemiology of middle-ear disease in a population of primary school entrants

The purpose of this paper is to demonstrate that the epidemiology of middle-ear pathology in primary school entrants is such that any screening procedure based upon a "once and for all' test on a single cohort of children is unlikely to identify those children most in need of intervention and likely to lead to unnecessary over referrals both to a Community Audiology Clinic or a Specialist Unit. Further evidence is produced to show the value of serial tympanometry as a screening tool generally and the use of the tympanometer 85AR specifically. Agreement is also measured between three variables in middle-ear pathology, namely clinical appearance and mobility of the tympanic membrane and the associated Tympanogram Type. The relative merits of clinical examination as a screen are discussed. A population of children from three primary schools was studied on four separate occasions during 1980. 553 five-year-old children were tested overall.