Parents' reactions and recommendations after diagnosis and hearing aid fitting

Increasing Pediatric Hearing Aid Use: Considerations for Clinical Practice

PURPOSE

Hearing aid use can be variable for young children, and inconsistent wear time can undermine spoken language development. This study explored the effectiveness of hearing aid data logging (DL) awareness and coaching sessions on increasing hours of hearing aid use. We also collected qualitative data on challenges participants experienced managing hearing aid use.

METHOD

We used a single-subject design that included three conditions, during a 6-week period, in the same order for each participant. Condition A was baseline, Condition B was DL monitoring alone, and Condition C was remote coaching calls plus DL monitoring.

RESULTS

Hours of hearing aid use increased for each child from baseline to the end of the study, ranging from 1.19 to 4.4 hr. Mothers reported that the coaching calls were beneficial and helped them identify and problem-solve issues.

CONCLUSIONS

Parents were able to increase hours of hearing aid use with DL awareness and coaching support. Tele-audiology offers an opportunity to provide parents with more frequent support that can be individualized based on their situation, challenges, and family needs.

What Are Parents' Experiences With Their Child's Hearing Aid Use in the First 5 Years?

OBJECTIVES

Parents are required to make informed choices for their children regarding the use of hearing amplification after hearing loss has been diagnosed. If parents choose a listening and spoken language approach for their child where the development of age appropriate spoken language is the parents' goal, then the early fitting and frequent use of hearing aids is crucial. Within the framework of family centered care, parents have the ultimate responsibility for supporting their child's hearing aid use. However, few studies have focused on parents' insights regarding the aspects that shape hearing aid use in the early years. Thus the aim of this study was to explore parents' firsthand experiences with their child's hearing aid use in the first 5 years. Understanding parents' insights will help improve service provision to optimize outcomes for children with hearing loss.

DESIGN

The study utilized a prospective qualitative design to explore parents' firsthand experiences with their child's hearing aid use. Purposive sampling was used to recruit 12 parents who participated in semi-structured interviews. Parents' responses were analyzed using thematic analysis.

RESULTS

Three overarching themes were conceptualized, namely: (a) towards hearing aids - journey into the wilderness; (b) adjusting to hearing aids - it's the journey, not the destination; and (c) support for my child's hearing aid use - it's not where you are going, it's who you have beside you. Each theme was further divided into categories and subcategories.

CONCLUSIONS

This study identified that parents have much to contribute to service providers' understanding regarding the aspects that shape consistent hearing aid use in young children. Parents shared many insights such as the emotionally daunting nature of the first few months post hearing loss confirmation, the influence of family support, and the importance of building connections and understanding about hearing loss and hearing aid use within their social networks. Based on these insights, the authors provide recommendations for clinical best practice that draw upon key principles of family centered care. They consist of practical suggestions including strategic support to overcome less optimal hearing aid use and ways to facilitate parent support within their familial and communal networks.

Intervention Research to Increase Pediatric Hearing Device Use: A Scoping Review

PURPOSE

This study is a scoping review examining interventions to increase hearing device use for children.

METHOD

Online databases were used to identify peer-reviewed journal articles published prior to November 1, 2021, yielding 1,288 after duplications were removed. Four articles met the inclusion criteria after articles were screened by title name and abstract and subsequent full-text screening of six articles. A qualitative analysis was conducted to identify features of the intervention studies related to the participants, design, intervention, key findings, and limitations.

RESULTS

The included studies were published between 1982 and 2021, and in all four studies, the children used hearing aids. All four of the studies used a longitudinal design to address hearing aid use problems, with the timeframe ranging from approximately 1 month to 6 months and had variable success in increasing use time. None of the studies included a protocol, such as counseling skills, for addressing internal challenges that interfere with hearing aid use.

CONCLUSIONS

Review of the limited research in this area found variable effectiveness for the interventions studied. There is an urgent need for research in this area to inform clinical practice and provide evidence-based interventions to address malleable factors that interfere with audibility for children who use hearing devices.

Children with Conductive Hearing Loss Fitted with Hearing Aids: Outcomes and Caregiver Experiences in South Africa

Introduction  Hearing aids are a frequent management option for children with conductive hearing loss (CHL) and it is necessary to determine the efficacy of outcomes. Limited information regarding caregivers' perceptions and experiences are available to examine outcomes in this population. Objectives  To describe hearing aid outcomes and caregivers' experiences for children with CHL who wear behind-the-ear (BTE) hearing aids. Methods  Retrospective review of clinical data from 19 children between 0 and 13 years of age with CHL, who were fitted with BTE hearing aids between January 2017 and March 2020. Hearing aid outcomes were documented at one month post-hearing aid fitting, via average daily use and caregiver and teacher reports obtained through the Parents' Evaluation of Aural/oral performance of Children (PEACH) and the Teachers' Evaluation of Aural/oral performance of Children (TEACH). Telephonic surveys were conducted with 13 caregivers to explore their experiences. Qualitative data from open-ended questions were analyzed thematically. Results  The average hearing aid use was 6.5 hours/day (2.0 standard deviation, SD; range 4.1-10.3) for bilateral hearing aid users. Questionnaire results indicated that most children (PEACH - 83.3% and TEACH - 92.3%) used their hearing aids more than 75% of the time. Participants performed better in quiet environments with limited sensitivity to loud sounds at home and at school. Reported challenges included stigma and device compliance. Conclusions  Children with CHL used their hearing aids for comparable hours (5-8 hours/day), as reported for children with sensorineural hearing loss, but less than the recommended 10 hours/day required for adequate language development. Caregivers reported benefits equivalent to expectations, with challenges similar to those reported in high-income countries.

eHealth Education and Support for Pediatric Hearing Aid Management: Parent Goals, Questions, and Challenges

PURPOSE

The purpose of this study was to investigate parent goals, questions, and challenges that emerged during coaching phone calls in an eHealth program designed to provide education and support for hearing aid management.

METHOD

Coaching phone calls were audio-recorded, transcribed, and qualitatively analyzed for emergent themes within the categories of goals, questions, and challenges.

RESULTS

Emergent themes revealed that parent goals were focused on self-efficacy, routines, device care, and child development. Emergent themes for questions revealed that parents asked questions related to the device care, audiology appointments, confirmation of learning, and child development. For challenges, emergent themes revealed parents' own struggles (e.g., with emotions), issues related to working with their audiologist, child factors, and anticipated challenges.

CONCLUSIONS

The eHealth intervention allowed parents to raise questions and discuss their challenges in a supportive environment. Supportive accountability helped participants identify and address barriers to hearing aid management based on their priorities and current challenges. Providing supplemental learning support, in addition to routine audiology visits, can help parents develop more effective hearing aid management routines.

Identifying the Factors that Affect Consistent Hearing Aid Use in Young Children With Early Identified Hearing Loss: A Scoping Review

OBJECTIVES

This study is a scoping review examining factors that affect consistent hearing aid use in young children with early identified hearing loss (HL).

DESIGN

Online databases were used to identify journal articles published between 2009 and 2019, yielding over 1800 citations. The citations were uploaded into an online software product called Covidence that enables scoping/systematic review management. After duplicates were removed, 857 articles were screened by abstract and title name, 93 of which were put through for full-text screening. Twenty-five articles met predetermined inclusion and exclusion criteria. Appraisal tools were utilized to establish the quality of the studies included. Numerical summaries were used to synthesize and describe the data set. Thematic analysis was utilized to identify global and subthemes within the data set.

RESULTS

Numerical summaries revealed that over half of the studies in the data set used a quantitative design. Thematic analysis of the data identified four global themes namely, "each child is an individual," "parents are key," "parents require support," and "professionals make a difference." Each global theme was further divided into subthemes, most of which centered around the parents of children with HL. Each subtheme was categorized as a malleable or a fixed factor that impacts on hearing aid use in young children with HL.

CONCLUSION

This scoping review identified malleable and fixed factors that impact on hearing aid use in young children with HL. These factors centered around the individual characteristics of children with HL, the key responsibility their parents have, and the important contribution that professionals can make. Irrespective of whether factors are malleable or fixed, parents and professionals working with children with HL can have a positive impact on hearing aid use. This is likely to have a flow on, positive impact on their overall communication and learning outcomes.

Best ear hearing level, time factors and language outcome in Swedish children with mild and moderate hearing loss with hearing aids

AIM

The risk for language disorder is high in children with all levels of hearing loss (HL). Early identification and intervention should be as important for children with mild HL as for those with more severe HL. Despite new-born hearing screening, a recent survey of speech language therapist services in southern Sweden indicates that children with mild and moderate HL are severely neglected when it comes to language assessment and language intervention. In this study we explore associations between Best Ear Hearing Level (BEHL), time factors and language skills in Swedish children with HL with hearing aids (HA).

METHOD

Participants were 19 children with mild HL (BEHL 23-39) and 22 children with moderate HL (BEHL 40-70) aged 5-15 years. Information on age at diagnosis and at HA fitting were collected. The children performed a nonword repetition and a sentence comprehension task.

RESULTS

The time elapsed between diagnosis and fitting with HA was longer for the children with mild HL.Participants with mild HL received their HA significantly later than children with moderate HL. No association between BEHL and the two language measures was found, and language skills were not better in children with mild than moderate HL. 17% of participants performed below cut-off for language disorder on both language measures.

CONCLUSION

Given the risk for long-term academic and social consequences of even mild HL delayed HA intervention for children with HLleads to serious concerns by families, clinicians, and pedagogues.

Delivery of audiological diagnoses for infants: a linguistic analysis of clinical communication

OBJECTIVE

To describe and analyse the linguistic structure of audiological diagnoses for infants, to determine ways to optimise the delivery of diagnostic information to parents during this typically emotive time.

DESIGN

This study analysed the linguistic structure of audio-recorded infant diagnostic appointments.

STUDY SAMPLE

Nine appointments conducted by four experienced paediatric audiologists were analysed.

RESULTS

Diagnoses of normal hearing were delivered explicitly and in a straightforward manner. Positive aspects of this outcome were highlighted, and audiologists used the pronoun "we," conveying a feeling of teamwork. In contrast, when a hearing loss was diagnosed, the diagnosis included disfluencies and the use of hedging, although positive aspects were also emphasised. In these cases, audiologists used the pronoun "I," thereby taking ownership of the results. Differences in the topics raised by audiologists and parents highlighted a mis-match between the information provided and the information requested. Topics addressed by audiologists were primarily medical and procedural, whereas parents were concerned with causes, treatments and experiential information.

CONCLUSIONS

The use of the above linguistic strategies may serve to minimise the significance and impact of the diagnosis. Whilst the data are unable to be generalised to other contexts, the study has generated in-depth and nuanced information about diagnosis delivery.

Family-Centered Care in the Transition to Early Hearing Intervention

This study aimed to explore and compare families' and professionals' perspectives on the implementation of family-centered care (FCC) (Moeller, Carr, Seaver, Stredler-Brown, & Holzinger, 2013) during the period between diagnosis of hearing loss (HL) and enrollment in early intervention (EI). A convergent mixed-methods study incorporating self-report questionnaires and semistructured in-depth interviews was used. Seventeen family members of children with HL and the 11 professionals who support these families participated in this study. The results suggested that the services engaged during the transition period partially adhered to the principles of FCC, including the provision of timely access to EI services and provision of emotional and social support. However, areas for improvement identified include strengthening family/professional partnerships, shared decision-making processes, collaborative teamwork, program monitoring, and consistency in the provision of information and support. Qualitative and quantitative research findings also indicated a lack of consistency in service provision during the transition period.

Exploring factors influencing the use of an eHealth intervention for families of children with hearing loss: An application of the COM-B model

BACKGROUND

Prior to developing a successful eHealth intervention, it is important that we explore stakeholders' capacity to adapt to eHealth.

OBJECTIVE

To explore what factors influence the use eHealth services from the perspectives of families of children with hearing loss and professionals who support families as they transition into early intervention.

METHODS

A qualitative study incorporating semi-structured in-depth interviews was conducted with families (n = 17) and professionals (n = 11). Interview topic guides were developed based on the COM-B model of behaviour change to explore barriers and facilitators related to capability, opportunity, and motivation.

RESULTS

The COM-B model captured several factors that may influence the use eHealth interventions for families of children with hearing loss. The capability factors included computer literacy and familiarity with social media. The opportunity factors were access to online resources, reliable Internet, and affordable equipment. Professionals' and families' preferences and a culture of face-to-face services were also identified as barriers for using eHealth. The motivation factors included families' and professionals' confidence in using technology and beliefs that there were benefits (e.g., saving travel) associated with using eHealth services. In contrast, beliefs that eHealth may be difficult to set up and not able to replace in-person communication identified as barriers to families and professionals adopting eHealth interventions.

CONCLUSION

Findings of this study indicated that implementation of an eHealth intervention could be facilitated by addressing the barriers in stakeholders' capabilities, opportunities (e.g., equipment and social support), and motivation (e.g., negative beliefs about eHealth) before developing eHealth services.

Maternal Perception of Self-Efficacy and Involvement in Young Children with Prelingual Hearing Loss

Appropriate intervention needs to support families and consider them as a part of rehabilitation program. Parents who have high self-efficacy are more likely to put their knowledge and skills into action and have positive interactions with their children. In addition, there has been a positive relation between parental involvement and child educational success. The aim of present study was evaluating maternal perception of both self-efficacy and involvement between mothers of children with hearing aid and cochlear implant via Scale of Parental Involvement and Self Efficacy (SPISE) and exploring relationship between maternal self-efficacy and parental involvement and child factors. 100 mothers of children with hearing loss were available. 49 mothers participated in study, filled SPISE, and return it on time. SPISE consisted of three sections (1) demographic information, (2) maternal self-efficacy, (3) parental involvement. All cases had received at least 6 months auditory training and speech therapy. Participants included 30 (61.2%) mothers of children with hearing aid, 19 (38.8%) mothers of children with cochlear implant. ANOVA analysis showed that there is no significant difference between hearing aid (HA) and cochlear implant (CI) groups in term of self-efficacy and parent-involvement except for question 21 (comfortable in participating in individualized program) that score in HA group was significantly higher than CI group. Results of present study has practical implications for early interventionists working with families. Every early intervention program should consider families to reach maximum outcome. Early interventionists can use SPISE to evaluate parental selfefficacy and involvement and work on parents with low score to achieve the best results.

The First Step to Early Intervention Following Diagnosis: Communication in Pediatric Hearing Aid Orientation Sessions

PURPOSE

This preliminary study aimed to explore communication processes and information exchange in pediatric hearing aid orientation (HAO) sessions. Effective information exchange in such sessions is crucial to support appropriate hearing aid use.

METHOD

Using a qualitative sociolinguistic framework, we recorded and analyzed 5 HAO sessions between 2 audiologists and 5 caregivers of children who had just been fitted with hearing aids. We also conducted semistructured interviews with the audiologists and caregivers and analyzed these using content analysis.

RESULTS

By necessity, audiologists provide a significant amount of information about hearing aids to caregivers in HAO sessions. Although caregivers in our study recalled and understood certain points such as the importance of not getting the hearing aids wet, crucial information about insertion and cleaning was often not recalled. Some caregivers misunderstood how the hearing aids would assist their child.

CONCLUSIONS

Caregivers need time to practice and absorb the information given, particularly given the emotional aspects associated with the diagnosis and "switch-on." There is a need to revisit approaches to information giving, which align with the ongoing early intervention process. We offer some suggestions for improving HAO sessions and information giving about hearing aids.

Role of Cortical Auditory Evoked Potentials in Reducing the Age at Hearing Aid Fitting in Children With Hearing Loss Identified by Newborn Hearing Screening

Recording of free-field cortical auditory evoked potential (CAEP) responses to speech tokens was introduced into the audiology management for infants with a permanent childhood hearing impairment (PCHI) during 2011-2015 at a U.K. service. Children with bilateral PCHI were studied from two sequential cohorts. Thirty-four children had followed an audiology pathway prior to CAEP introduction, and 44 children followed a pathway after the introduction of CAEP and were tested with unaided and aided CAEP responses. Data analysis explored the age of diagnosis, hearing aid fitting, and referral for cochlear implant (CI) assessment for each of these groups. CAEP offered a novel educative process for the parents and audiologists supporting decision-making for hearing aid fitting and CI referral. Delays in hearing aid fitting and CI referral were categorized as being due to the audiologist's recommendation or parental choice. Results showed that the median age of hearing aid fitting prior to CAEP introduction was 9.2 months. After the inclusion of CAEP recording in the infant pathways, it was 3.9 months. This reduction was attributable to earlier fitting of hearing aids for children with mild and moderate hearing losses, for which the median age fell from 19 to 5 months. Children with profound hearing loss were referred for CI assessment at a significantly earlier age following the introduction of CAEP. Although there has also been a national trend for earlier hearing aid fitting in children, the current study demonstrates that the inclusion of CAEP recording in the pathway facilitated earlier hearing aid fitting for milder impairments.

When expectation meets experience: parents' recollections of and experiences with a child diagnosed with hearing loss soon after birth

OBJECTIVE

To examine parents' recollections of and their experiences with bringing up a child diagnosed with hearing loss at a very young age.

DESIGN

Based on the analysis of informal parent discussion groups, four open-ended questions were formulated to solicit information about parents' expectations following diagnosis, as well as experiences and challenges when raising a child with a hearing loss.

STUDY SAMPLE

Forty parents of children, aged between three to five years, who were diagnosed with hearing loss before the age of three years.

RESULTS

Parents' responses revealed strong support for early intervention, high expectations for their child's development, and desire for information tailored to individual needs. Parents also reported anxiety relating to their perceptions of the significance of consistent device usage on their child's development. Further concerns arose from their observations of the difficulties experienced by their child in real-world environments despite consistent device usage, and their perception of their child's language delay despite early intervention.

CONCLUSIONS

The findings point to a need to support parents to form realistic expectations based on current knowledge. Implications for clinicians to provide improved management of children with hearing loss are discussed.

Qualitative analysis of parents' experience with receiving the news of the detection of their child's hearing loss

OBJECTIVE

Despite the fact that clinicians are responsible for delivering bad news, they have been shown to lack both confidence and skill in performing this basic task. The time immediately after the detection of childhood hearing loss is perceived as stressful. We conducted a qualitative study to assess parents' experiences with receiving the bad news of the detection of their child's hearing loss.

STUDY DESIGN

Semi-structured interviews were conducted with families of children with hearing loss identified during early childhood.

SETTING

A rehabilitation center treating pre-school children in the north of Israel.

PATIENTS

14 families/parents of children diagnosed prior to the implementation of a universal screening program.

MAIN OUTCOME MEASURE

Parents' perceptions of the manner in which the information regarding the detection of their child's hearing loss was given, and what their feelings were at the time.

RESULTS

50% of parents expressed dissatisfaction with the process of the breaking of the bad news. ABR is perceived by parents and health professionals alike as the definitive moment of diagnosis. The emotions experienced by parents at the moment of the breaking of the bad news were predominantly shock and upset. The meaning of the news was perceived differently under different circumstances. Information given bluntly, without empathy, was a frequent complaint. Parents repeatedly stated the importance of the formulation of a plan for the future.

CONCLUSIONS

Qualitative enquiry provided valuable information. Effective strategies for the breaking of bad news should become an integral part of universal neonatal screening programs.

Infant hearing loss in South Africa: age of intervention and parental needs for support

Hearing loss is referred to as the silent, overlooked epidemic in developing countries, and data reporting the mean age of diagnosis and intervention is virtually non-existent due to limited systematic or routine screening programs. The objective of this paper is to present findings of recent practice in early diagnosis and intervention services in an urban South African context, with specific reference to parental needs for support. Data was collected by means of questionnaire surveys for 54 parents of children with congenital or early-onset hearing loss, followed by focus group discussions conducted with 10 parents. The results of this study indicate the mean age of diagnosis to be 23 months (+/-18 SD), the mean age of initial hearing-aid fitting to be 28 months (+/-19 SD), and the mean age of enrollment into an early intervention program to be 31 months (+/-19 SD). In addition, results signify that this diverse and challenging population of parents of young hearing-impaired children largely depends on the ongoing support, guidance, and commitment of the pediatric audiologist.

Consistency of hearing aid use in infants with early-identified hearing loss

PURPOSE

To examine the consistency of hearing aid use by infants. A goal was to identify maternal, child, and situational factors that affected consistency of device use.

METHOD

Maternal interviews were conducted using a nonvalidated structured interview (Amplification in Daily Life Questionnaire) that included 5-point Likert scale items and open-ended questions. Participants were mothers of 7 infants with mild to moderately severe hearing loss who were enrolled in a longitudinal study. Data were collected at 4 intervals (10.5-12, 16.5, 22.5, and 28.5 months old).

RESULTS

Consistency of amplification use was variable at early ages but improved with age. By age 28.5 months, toddlers used amplification regularly in most settings. Selected daily situations (e.g., in car or outdoors) were more challenging for maintaining device use than contexts where the child was closely monitored. Only 2 families established early, consistent full-time use across all contexts examined. Qualitative results were used to identify familial, developmental, and situational variables that influenced the consistency of infant/toddler device use.

CONCLUSION

Families may benefit from audiologic counseling that acknowledges the multifaceted challenges that arise. Audiologists can work in partnership with families to promote consistent device use across a variety of daily situations.

Newborn hearing screening follow-up: factors affecting hearing aid fitting by 6 months of age

PURPOSE

To determine the extent to which the goal of hearing aid fitting by 6 months of age is being achieved and to identify barriers to achieving that goal.

METHOD

Screening and follow-up records from 114,121 infants born at 6 hospitals were collected over a 6-year period. Infants diagnosed with permanent hearing loss requiring amplification were categorized as fit on time, fit late, or lost to follow-up. Seven factors were empirically identified as potential barriers to timely intervention.

RESULTS

Ninety-one percent of referred infants returned for follow-up evaluation. Hearing aids were fit on 107 of the 192 infants requiring amplification. Thirty-nine percent were fit on time, and 61% were fit late or lost to follow-up. Unilateral hearing loss and late diagnosis were statistically significant (p < .0001) predictors for late fitting and loss to follow-up. Conductive hearing loss and coverage by Medicaid were also statistically significant (p < .0001) predictors for loss to follow-up.

CONCLUSION

High return rate for follow-up does not ensure hearing aid fitting by 6 months of age. Infants with unilateral hearing loss are at particular risk of being lost to follow-up.

Parental Narratives of Genetic Testing for Hearing Loss: Audiologic Implications for Clinical Work With Children and Families

Purpose

Few studies have examined how parents personalize the possibility of genetic hearing loss in their children and whether they actually intend to pursue testing for their child. This article addresses the audiologist’s important role in the genetic testing referral and follow-up processes.

Method

Twenty-four parents whose children were referred to genetic testing for hearing loss were interviewed in depth. Parents were selected to include a diverse range of races, ethnicities, and socioeconomic levels. Interviews were coded and analyzed using qualitative methods.

Results

Parental associations with genetic testing included feeling personally responsible, feeling relief, and considering metaphysical attributions for their child’s hearing loss. Parental attitudes were related to perceptions and experiences with deafness. Many misconceptions about genetics were also found.

Conclusions

Audiologists need to be sensitized to parents' personal and sociocultural contexts when discussing genetic testing and should tailor informational and emotional support to parents' requirements when confronting the possibility of their child having a genetic hearing loss.

Pinnaplasty: reshaping ears to improve hearing aid retention

The hearing aid is extremely important to the deaf. A small number have difficulty in retaining the device because the ear is prominent or cup-shaped. This report describes 11 children whose ear shape was modified to improve hearing aid retention and one adult in whom an over set back ear was released to allow fitment of a postaural device. In eight of the 11 children treated, conservative measures such as double-sided tape and retention bands (Huggies) had been tried previously without success. The creation of an antihelical fold in a misshapen ear lacking such a fold provides a reinforcing strut which is useful to support a hearing aid. In patients whose ear had been excessively tethered by previous surgery, projection was restored by inserting a cartilage block behind the ear. In one child with ears tethered by previous surgery, costal cartilage was used not only to release both ears, but also to reconstruct a new helical rim on one side. Surgery enabled a normal postaural hearing aid to be worn in 17 of the 19 ears treated. The two failures deserve special mention. In one patient with a unilateral deformity and severe mental retardation, the dressings were pulled off immediately after surgery. In another patient with a bilateral problem, the appearance and hearing aid retention was improved, but there was not enough room in the postauricular sulcus on one side for the battery component to fit comfortably and an in-the-ear device is now used on that side. Pinnaplasty is a helpful strategy to improve hearing aid retention. Care must be taken not to overdo the set back so that enough room is left to retain the hearing device.

The ages of suspicion, identification, amplification and intervention in children with hearing loss

OBJECTIVE

The aim of this study was to determine the ages of suspicion, identification, amplification and intervention in children with hearing loss.

METHODS

In the first stage of the study, we determined the ages of parental suspicion, identification, amplification and intervention in children with hearing loss who were referred to our center between years 1999 and 2004. The data of 199 children with severe to profound hearing loss was analyzed retrospectively. Based on these data, the intervals of suspicion and identification, identification and amplification and amplification and intervention were calculated. In the second stage of study, the data obtained from 156 children with severe to profound hearing loss, who were followed at our center between years 1991 and 1994, was compared to the data obtained in the first stage of study. Data were collected from family questionnaire-based interviews and hospital records.

RESULTS

In the first stage of the study, parents reported that hearing loss was suspected at a mean age of 12.5 months. The average ages of identification, amplification and intervention were 19.4; 26.5 and 33.0 months, respectively. The results obtained from the second stage of this study revealed that, ages of suspicion, identification and intervention were significantly smaller for the period of 1999-2004, compared to the period of 1991-1994.

CONCLUSIONS

The results of this study clearly demonstrate that, in Turkey, there are significant improvements in the ages of suspicion, identification and intervention of hearing loss. Even though these improvements are remarkable, the ages of suspicion, identification, amplification and intervention of hearing loss are still far beyond the suggested ages by the Joint Committee on Infant Hearing.