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Hung YC, Ho PH, Chen PH, Tsai YS, Li YJ, Lin HC. Impact of Hearing Aids on Language Outcomes in Preschool Children With Mild Bilateral Hearing Loss. Trends Hear 2024; 28:23312165241256721. [PMID: 38773778 PMCID: PMC11113073 DOI: 10.1177/23312165241256721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 04/19/2024] [Accepted: 05/07/2024] [Indexed: 05/24/2024] Open
Abstract
This study aimed to investigate the role of hearing aid (HA) usage in language outcomes among preschool children aged 3-5 years with mild bilateral hearing loss (MBHL). The data were retrieved from a total of 52 children with MBHL and 30 children with normal hearing (NH). The association between demographical, audiological factors and language outcomes was examined. Analyses of variance were conducted to compare the language abilities of HA users, non-HA users, and their NH peers. Furthermore, regression analyses were performed to identify significant predictors of language outcomes. Aided better ear pure-tone average (BEPTA) was significantly correlated with language comprehension scores. Among children with MBHL, those who used HA outperformed the ones who did not use HA across all linguistic domains. The language skills of children with MBHL were comparable to those of their peers with NH. The degree of improvement in audibility in terms of aided BEPTA was a significant predictor of language comprehension. It is noteworthy that 50% of the parents expressed reluctance regarding HA use for their children with MBHL. The findings highlight the positive impact of HA usage on language development in this population. Professionals may therefore consider HAs as a viable treatment option for children with MBHL, especially when there is a potential risk of language delay due to hearing loss. It was observed that 25% of the children with MBHL had late-onset hearing loss. Consequently, the implementation of preschool screening or a listening performance checklist is recommended to facilitate early detection.
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Affiliation(s)
- Yu-Chen Hung
- Speech and Hearing Science Research Institute, Children's Hearing Foundation, Taipei, Taiwan
- Department of Special Education, Chung Yuan Christian University, Taoyuan City, Taiwan
| | - Pei-Hsuan Ho
- Department of Otolaryngology-Head and Neck Surgery, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Audiology and Speech-Language Pathology, MacKay Medical College, New Taipei City, Taiwan
| | - Pei-Hua Chen
- Speech and Hearing Science Research Institute, Children's Hearing Foundation, Taipei, Taiwan
- Department of Audiology and Speech-Language Pathology, MacKay Medical College, New Taipei City, Taiwan
| | - Yi-Shin Tsai
- Speech and Hearing Science Research Institute, Children's Hearing Foundation, Taipei, Taiwan
| | - Yi-Jui Li
- Speech and Hearing Science Research Institute, Children's Hearing Foundation, Taipei, Taiwan
| | - Hung-Ching Lin
- Department of Otolaryngology-Head and Neck Surgery, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Audiology and Speech-Language Pathology, MacKay Medical College, New Taipei City, Taiwan
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Zhang AL, Kosoko-Thoroddsen TSF, Thomas DA, Lieu JEC. Use of Socioeconomic Demographic Data in Studies on Pediatric Unilateral Hearing Loss: A Scoping Review. Ear Hear 2024; 45:10-22. [PMID: 37607013 DOI: 10.1097/aud.0000000000001417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
OBJECTIVES Social determinants of health (SDOH) (healthcare access and quality, education access and quality, socioeconomic status, social and cultural context, neighborhood and built environment) ( Healthy People 2030 ) have been shown to impact a wide range of health-related outcomes and access to care. Given the medical and nonmedical costs associated with children with unilateral hearing loss (UHL), the varied insurance coverage for hearing healthcare services, and the differences in hearing aid utilization rates between children of different sociodemographic classes, the sociodemographic information of children with UHL enrolled in research studies should be collected to ensure the generalizability of hearing healthcare interventions. Therefore, the objective of this scoping review is to assess the reporting of SDOH data for participants in studies of pediatric UHL and its comparison to population trends. DESIGN Two searches of published literature were conducted by a qualified medical librarian. Two reviewers then evaluated all candidate articles. Study inclusion parameters were from 2010 to present, peer-reviewed studies with prospective study design, and participant population including children (age 0 to 18 years old) with UHL. RESULTS Two literature searches using PubMed Medline and Embase found 442 and 3058 studies each for review. After abstract and paper review, 87 studies were included in final qualitative review, with 22 of these studies reporting race distribution of participants, 15 reporting insurance status or family income, and 12 reporting the maternal education level. CONCLUSIONS Sociodemographic data are not commonly reported in research studies of children with UHL. In reported samples, research participants are more likely to have private insurance and higher family income compared with overall population distribution. These demographic biases may affect the generalizability of study results to all children with UHL. Further evaluation is warranted to evaluate whether participant recruitment affects outcomes that reflect the overall population.
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Affiliation(s)
- Amy L Zhang
- Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
- These are co-first authors/contributed equally to this work
| | - Tinna-Sólveig F Kosoko-Thoroddsen
- Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
- These are co-first authors/contributed equally to this work
| | - Deborah A Thomas
- Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Judith E C Lieu
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
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Zhang VW, Hou S, Wong A, Flynn C, Oliver J, Weiss M, Milner S, Ching TYC. Audiological characteristics of children with congenital unilateral hearing loss: insights into Age of reliable behavioural audiogram acquisition and change of hearing loss. Front Pediatr 2023; 11:1279673. [PMID: 38027307 PMCID: PMC10663346 DOI: 10.3389/fped.2023.1279673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives The aims of this study were to report the audiological characteristics of children with congenital unilateral hearing loss (UHL), examine the age at which the first reliable behavioural audiograms can be obtained, and investigate hearing changes from diagnosis at birth to the first reliable behavioural audiogram. Method This study included a sample of 91 children who were diagnosed with UHL via newborn hearing screening and had reliable behavioural audiograms before 7 years of age. Information about diagnosis, audiological characteristics and etiology were extracted from clinical reports. Regression analysis was used to explore the potential reasons influencing the age at which first reliable behavioural audiograms were obtained. Correlation and ANOVA analyses were conducted to examine changes in hearing at octave frequencies between 0.5 and 4 kHz. The proportions of hearing loss change, as well as the clinical characteristics of children with and without progressive hearing loss, were described according to two adopted definitions: Definition 1: criterion (1): a decrease in 10 dB or greater at two or more adjacent frequencies between 0.5 and 4 kHz, or criterion (2): a decrease in 15 dB or greater at one octave frequency in the same frequency range. Definition 2: a change of ≥20 dB in the average of pure-tone thresholds at 0.5, 1, and 2 kHz. Results The study revealed that 48 children (52.7% of the sample of 91 children) had their first reliable behavioural audiogram by 3 years of age. The mean age at the first reliable behavioural audiogram was 3.0 years (SD 1.4; IQR: 1.8, 4.1). We found a significant association between children's behaviour and the presence or absence of ongoing middle ear issues in relation to the delay in obtaining a reliable behavioural audiogram. When comparing the hearing thresholds at diagnosis with the first reliable behavioural audiogram across different frequencies, it was observed that the majority of children experienced deterioration rather than improvement in the initial impaired ear at each frequency. Notably, there were more instances of hearing changes (either deterioration or improvement), in the 500 Hz and 1,000 Hz frequency ranges compared to the 2,000 Hz and 4,000 Hz ranges. Seventy-eight percent (n = 71) of children had hearing deterioration between the diagnosis and the first behavioural audiogram at one or more frequencies between 0.5 and 4 kHz, with a high proportion of them (52 out of the 71, 73.2%) developing severe to profound hearing loss. When using the averaged three frequency thresholds (i.e., definition 2), only 26.4% of children (n = 24) in the sample were identified as having hearing deterioration. Applying definition 2 therefore underestimates the proportion of children that experienced hearing changes. The study also reported diverse characteristics of children with or without hearing deterioration. Conclusion The finding that 78% of children diagnosed with UHL at birth had a decrease in hearing loss between the hearing levels at first diagnosis and their first behavioural audiogram highlights the importance of monitoring hearing threshold levels after diagnosis, so that appropriate intervention can be implemented in a timely manner. For clinical management, deterioration of 15 dB at one or more frequencies that does not recover warrants action.
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Affiliation(s)
- Vicky W. Zhang
- Audiological Science Department, National Acoustic Laboratories, Sydney, NSW, Australia
- Department of Linguistics, Macquarie University, Sydney, NSW, Australia
| | - Sanna Hou
- Audiological Science Department, National Acoustic Laboratories, Sydney, NSW, Australia
| | - Angela Wong
- Audiological Science Department, National Acoustic Laboratories, Sydney, NSW, Australia
| | - Christopher Flynn
- Audiological Science Department, National Acoustic Laboratories, Sydney, NSW, Australia
- Lutwyche centre, Hearing Australia, Brisbane, QLD, Australia
| | - Jane Oliver
- Audiological Science Department, National Acoustic Laboratories, Sydney, NSW, Australia
- Upper Mt Gravatt centre, Hearing Australia, Brisbane, QLD, Australia
| | - Michelle Weiss
- Audiological Science Department, National Acoustic Laboratories, Sydney, NSW, Australia
- Dandenong centre, Hearing Australia, Melbourne, VIC, Australia
| | - Stacey Milner
- Audiological Science Department, National Acoustic Laboratories, Sydney, NSW, Australia
- Cheltenham centre, Hearing Australia, Melbourne, VIC, Australia
| | - Teresa Y. C. Ching
- Audiological Science Department, National Acoustic Laboratories, Sydney, NSW, Australia
- NextSense Institute, Macquarie Park, Sydney, NSW, Australia
- Macquarie School of Education, Macquarie University, Sydney, NSW, Australia
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, QLD, Australia
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Impact of unilateral hearing loss in early development. Curr Opin Otolaryngol Head Neck Surg 2022; 30:344-350. [PMID: 36004776 DOI: 10.1097/moo.0000000000000848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to provide an update on current literature as it relates to the impact of unilateral hearing loss for the pediatric population. RECENT FINDINGS Current studies further corroborate past research findings which reveal the potential consequences of unilateral hearing loss on spatial hearing, language, and neurocognitive functioning. Deficits among children with unilateral hearing loss may parallel those seen in children with bilateral hearing loss, further challenging historic views that hearing in one ear in childhood is sufficient for normal development. The potential deficiencies seen in children with unilateral hearing loss can be subtler than those seen with bilateral hearing loss, but may nonetheless also impact school performance, patient fatigue, parental stress, and quality of life. Early interventions within a sensitive period of development of the central auditory system may circumvent potential barriers in cognitive, academic, and psychosocial development. SUMMARY This review synthesizes the latest research on the impact of unilateral hearing loss in childhood and the role for possible interventions. The summarized information may serve to support the development of new guidelines for the evaluation and treatment of children with unilateral hearing loss.
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Hung YC, Chen PH, Lin TH, Lim TZ. Children With Unilateral Hearing Loss After Newborn Hearing Screening in Taiwan. Am J Audiol 2022; 31:646-655. [PMID: 35728040 DOI: 10.1044/2022_aja-22-00019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE We explored the intervention characteristics and language outcomes of children with unilateral hearing loss (UHL) in Taiwan after the implementation of universal newborn hearing screening (UNHS) to highlight changes in attitudes and actions toward hearing-related treatments. METHOD Data of 132 children with UHL in birth cohorts from 2012 to 2019 were included. This retrospective study examined differences in age at identification, hearing aid (HA) fitting, and seeking supportive services. Commonly requested attributes of services, reasons for HA rejection, and children's language performance were investigated. RESULTS The age at identification decreased from 50.3 months in 2012 to 2.6 months in 2019. Similar trends of declining age were obtained for the age at HA fitting and age at first service contact. In addition, 40% of the parents did not seek support until the child became older (M = 30.5 months) and showed more noticeable behaviors related to hearing loss, and only 64% of the children were consistent HA users. Children with UHL enrolled in the intervention programs approximated the average language performance of the assessment norm; however, they showed depressed language levels when compared to the norm group at the 75th percentile. CONCLUSIONS UNHS had a positive impact on early identification and intervention in children with UHL. Compared to parents of children with all types of hearing loss, parents of children with UHL seemed to be more uncertain about aural habilitation at the early stage.
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Affiliation(s)
- Yu-Chen Hung
- Speech and Hearing Science Research Institute, Children's Hearing Foundation, Taipei, Taiwan.,Department of Special Education, Chung Yuan Christian University, Taoyuan, Taiwan
| | - Pei-Hua Chen
- Speech and Hearing Science Research Institute, Children's Hearing Foundation, Taipei, Taiwan
| | - Tzu-Hui Lin
- Speech and Hearing Science Research Institute, Children's Hearing Foundation, Taipei, Taiwan
| | - Tang Zhi Lim
- Speech and Hearing Science Research Institute, Children's Hearing Foundation, Taipei, Taiwan
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Laugen NJ, Erixon E, Huttunen K, Mäki-Torkko E, Löfkvist U. Newborn Hearing Screening and Intervention in Children with Unilateral Hearing Impairment: Clinical Practices in Three Nordic Countries. J Clin Med 2021; 10:jcm10215152. [PMID: 34768671 PMCID: PMC8584845 DOI: 10.3390/jcm10215152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/26/2021] [Accepted: 10/28/2021] [Indexed: 12/20/2022] Open
Abstract
Studies have limitedly considered children with early-identified unilateral hearing impairment (UHI), and clinical practices regarding screening, diagnostics and habilitation in this group are rarely documented. In this study, routines for newborns with UHI from screening to diagnostics and habilitation were explored in Norway, Sweden and Finland. An online survey was sent to hospitals responsible for the hearing diagnostics of children requesting information about their practices regarding congenital UHI. Responses covered 95% of the children born in the three included countries. The results revealed large variations in ways of organising healthcare and in clinical decisions regarding hearing screening, diagnostics and habilitation of children with congenital UHI. Finally, implications for policy making and research are also discussed.
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Affiliation(s)
- Nina Jakhelln Laugen
- Department of Psychology, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
- Correspondence:
| | - Elsa Erixon
- Department of Surgical Sciences, Uppsala University, 75185 Uppsala, Sweden;
| | - Kerttu Huttunen
- Research Unit of Logopedics and Child Language Research Center, Faculty of Humanities, University of Oulu, 90014 Oulu, Finland;
- Department of Otorhinolaryngology, Head and Neck Surgery, Oulu University Hospital, 90220 Oulu, Finland
- Medical Research Center Oulu, University of Oulu, 90014 Oulu, Finland
| | - Elina Mäki-Torkko
- Audiological Research Centre, Faculty of Medicine and Health, 70182 Örebro, Sweden;
- School of Medical Sciences, Faculty of Medicine and Health, 70182 Örebro, Sweden
| | - Ulrika Löfkvist
- Department of Public Health and Caring Sciences, Uppsala University, 75122 Uppsala, Sweden;
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, 17177 Stockholm, Sweden
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Porter A, Sheeran N, Hood M, Creed P. Decision-making following identification of an infant's unilateral hearing loss: Parent and professional perspectives. Int J Pediatr Otorhinolaryngol 2021; 148:110822. [PMID: 34225081 DOI: 10.1016/j.ijporl.2021.110822] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 06/27/2021] [Accepted: 06/29/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Parents of infants identified with unilateral hearing loss (UHL) make decisions about managing their infant's hearing loss based on limited evidence and before knowing whether their infant will require additional support. OBJECTIVES The decision-making processes of parents and clinicians regarding the management of UHL following newborn hearing screening were examined. PROCEDURE Two convenience samples were recruited: 15 parents of children with permanent UHL aged under 4 years, and 14 clinicians. Applied thematic analysis of the semi-structured interviews elicited insight into the complexities surrounding decision-making from a parent and clinician perspective. RESULTS Three main themes captured the decision-making process: motivation for decision-making, limited evidence creates uncertainty, and available evidence builds certainty. The diverse experiences and opinions of parents and clinicians highlight the complexity of decision-making when there are contested opinions and no clear best management option. CONCLUSIONS The choices parents make about the management of their child's UHL can have lifelong implications for their child. Many questions need answering before parents can effectively evaluate the short- and long-term consequences of their options and whether the advantages outweigh the disadvantages in the long-term. This uncertainty is challenging for professionals and parents and risks cognitive biases influencing clinical and parental decision-making.
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Affiliation(s)
- Ann Porter
- School of Applied Psychology, Griffith University, Parklands Drive, Southport, QLD, 4222, Australia.
| | - Nicola Sheeran
- School of Applied Psychology, Griffith University, Parklands Drive, Southport, QLD, 4222, Australia.
| | - Michelle Hood
- School of Applied Psychology, Griffith University, Parklands Drive, Southport, QLD, 4222, Australia.
| | - Peter Creed
- School of Applied Psychology, Griffith University, Parklands Drive, Southport, QLD, 4222, Australia.
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