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EBP Compendium: Summary of Clinical Practice Guideline

National Health Care for the Homeless Council, Inc.
Adapting Your Practice: Treatment and Recommendations for Homeless Children with Otitis Media

Bernie, K., Creaven, B. K., et al. (2008).
Nashville (TN): Health Care for the Homeless Clinicians' Network, National Health Care for the Homeless Council, Inc., 29 pages.

AGREE Rating: Highly Recommended


This guideline provides recommendations for the treatment of homeless children with otitis media. The primary audience for these guidelines is primary care clinicians, however several recommendations are relevant to the fields of speech-language pathology or audiology.


  • Screening/Assessment
    • Assessment Instruments
      • Audiometric Screening - "Perform routine audiometric screening at every visit. If hearing loss is suspected, refer to audiologist" (p. vi).
      • Pneumatic Otoscopy - Pneumatic otoscopy is "recommended as the primary diagnostic method.., is cost-effective, accurate, available at every office, and easy to bring to outreach" (p. 8).
      • Tympanometry - Tympanometry is "helpful in children over 4 months of age if the examiner is unsure of the middle ear status by otoscopic evaluation alone; however given the higher cost for equipment and testing, this method may not be available to many clinicians who provide care for homeless children" (p. 8).
      • Acoustic Reflectometry - Reflectometry "can be used as an alternative to tympanometry to confirm an otoscopic diagnosis of middle ear effusion in children aged 2 years and older" (p. 8). It "offers the advantage of easy portability but may not be available to all clinicians serving homeless children." (p. 8).
  • Management
    • Speech, Language & Hearing
      • Clinicians should "explain risks to hearing, speech, emotional development, and school performance from chronic, serious ear infections" (p. vi).
      • Clinicians should also "refer to audiologist/speech pathologist if there is hearing loss, balance problem, speech delay...or if speech/hearing milestones are unclear" (p. vii).

Keywords: Otitis Media

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Added to Compendium: October 2011

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