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Kriukelis R, Gabbett MT, Beswick R, McInerney-Leo AM, Driscoll C, Liddle K. The congenital hearing phenotype in GJB2 in Queensland, Australia: V37I and mild hearing loss predominates. Eur J Hum Genet 2024:10.1038/s41431-024-01584-0. [PMID: 38486023 DOI: 10.1038/s41431-024-01584-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/12/2024] [Accepted: 02/27/2024] [Indexed: 03/17/2024] Open
Abstract
GJB2 was originally identified in severe, non-syndromic sensorineural hearing loss (SNHL), but was subsequently associated with mild and moderate SNHL. Given the increasing utilisation of genetic testing pre-conceptually, prenatally, and neonatally, it is crucial to understand genotype-phenotype correlations. This study evaluated the nature and frequency of GJB2 variants in an Australian paediatric population with varying degrees of SNHL ascertained through newborn hearing screening. Audiograms from individuals with GJB2 variants and/or a GJB6 deletion (GJB6-D13S11830) were retrospectively reviewed (n = 127). Two-thirds were biallelic (homozygous/compound heterozygous) for pathogenic/likely pathogenic variants of GJB2 and/or GJB6 (n = 80). The most frequent variant was c.109 G > A, followed by c.35delG and c.101 T > C. Compared to biallelic carriage of other GJB2 variants, c.109 G > A positive individuals (homozygous/compound heterozygous) were more likely to have mild HL at their initial and latest audiograms (p = 0.0004). Biallelic carriage of c.35delG was associated with moderately-severe or greater SNHL at both initial and latest audiograms (p = 0.007). The c.101 T > C variant presented with milder SNHL and U-shaped audiograms (p = 0.02). In this agnostically identified cohort, mild SNHL predominated in GJB2/GJB6 carriers in contrast to previous studies targeting individuals with significant loss. Consequently, c.109 G > A, associated with milder phenotypes, was the most frequent. This study provides valuable data to support prognostic confidence in genetic counselling.
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Affiliation(s)
| | - Michael T Gabbett
- Centre for Genomics and Personalised Health, School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Rachael Beswick
- University of Queensland Centre for Children's Health Research, South Brisbane, QLD, Australia
- Healthy Hearing Program, Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Aideen M McInerney-Leo
- Frazer Institute, University of Queensland, Dermatology Research Centre, Brisbane, QLD, Australia
| | - Carlie Driscoll
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Karen Liddle
- Queensland Children's Hospital, South Brisbane, QLD, Australia.
- University of Queensland Centre for Children's Health Research, South Brisbane, QLD, Australia.
- Frazer Institute, University of Queensland, Dermatology Research Centre, Brisbane, QLD, Australia.
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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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Carew P, Shepherd DA, Smith L, Soh QR, Sung V. Language and health-related quality of life outcomes of children early-detected with unilateral and mild bilateral hearing loss. Front Pediatr 2023; 11:1210282. [PMID: 37645035 PMCID: PMC10461396 DOI: 10.3389/fped.2023.1210282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 07/31/2023] [Indexed: 08/31/2023] Open
Abstract
Introduction We aimed to describe the language and health-related quality of life (HRQoL) outcomes of children early-identified with unilateral or mild bilateral permanent hearing loss. This was a cross-sectional community-based study of children with mild bilateral or unilateral permanent hearing loss (including unilateral auditory neuropathy spectrum disorder (ANSD)), drawn from a population-based databank in Victoria, Australia. Methods Enrolment in this databank is independent of early intervention and amplification approaches. Language and caregiver-reported HRQoL outcomes are described by type and degree of loss at three timepoints across child development: at age 2 years (n = 255), 5-7 years (n = 173) and 9-12 years (n = 45). Results Across all age groups, average language outcomes were poorer than population normative scores by between a half to two thirds of a standard deviation. Children with mild bilateral hearing loss demonstrated poorer average language outcomes than children with unilateral hearing loss, particularly at younger ages. Children with unilateral ANSD showed language outcomes comparable to their peers with unilateral profound hearing loss. Children had poorer HRQoL psychosocial scores compared to physical scores, without obvious patterns of outcomes linked to degree or type of hearing loss. Discussion This study demonstrates children with early-identified unilateral or mild bilateral hearing loss have average language and HRQoL outcomes poorer than population normative expectations from an early age. These outcomes are observed at later ages across childhood. These findings provide a contemporary description of language and quality of life outcomes for children identified but not targeted by universal newborn hearing screening and raise questions of how to provide better support for these populations of children and their families.
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Affiliation(s)
- Peter Carew
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
- Department of Audiology and Speech Pathology, The University of Melbourne, Parkville, VIC, Australia
| | - Daisy A. Shepherd
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Libby Smith
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
| | - Qi Rui Soh
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
| | - Valerie Sung
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Centre for Community Child Health, Royal Children's Hospital, Parkville, VIC, Australia
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Sung V, Ching TYC, Smith L, Marnane V, Saetre-Turner M, King A, Beswick R, Iseli CE, Carew P. Mild matters: trial learnings and importance of community engagement in research for early identified bilateral mild hearing loss. Front Pediatr 2023; 11:1197739. [PMID: 37614905 PMCID: PMC10442842 DOI: 10.3389/fped.2023.1197739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/14/2023] [Indexed: 08/25/2023] Open
Abstract
Introduction Early identification of mild hearing loss has resulted in early hearing amplification without adequate evidence of effectiveness. This paper describes learnings from a pilot trial, combined with a qualitative study, to highlight the importance of community engagement in designing research studies to determine whether early amplification benefits young children with bilateral mild hearing loss. Methods PART 1 of the study is a proof-of-concept non-blinded multi-centre randomised controlled trial (RCT) of hearing device fitting vs. no fitting aimed to gather preliminary data and determine its acceptability/feasibility in children <2 years old with bilateral mild hearing loss. Results PART 2 is a qualitative study to understand the barriers/enablers to RCT participation. Of 40 potentially eligible families, nine (23%) declined, three were uncontactable (7%), 26 (65%) ineligible: of these, nine (35%) did not meet hearing threshold inclusion criteria, 11 (42%) were already fitted or had made decisions on fitting hearing device, two (7%) had conductive loss and four (16%) were ineligible for other reasons. Two of 11 (18%) eligible families were randomised. With the limited sample size, outcome measures were not compared between groups. Both participants completed the trial, reported the RCT to be acceptable, and neither changed group post-enrolment. Discussion Whilst recruitment uptake could potentially be increased by altering the eligibility criteria, better communication with and reimbursement of clinicians as recruiters, and improving awareness of the study amongst external stakeholders, the RCT methodology does not conform to family-centred practice, and potentially raises ethical concerns regarding potential adverse consequences of not offering early amplification. Parental perception of losing control over choice of management due to randomisation is not an easily modifiable factor. Alternative methodological approaches without randomisation are required to determine whether hearing amplification benefits infants with mild hearing loss.Clinical Trial Registration: identifier [ACTRN12618001608257].
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Affiliation(s)
- Valerie Sung
- Prevention Innovation, Population Health, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Centre for Community Child Health, Royal Children’s Hospital, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Teresa Y. C. Ching
- NextSense, NextSense Institute, Sydney, NSW, Australia
- Macquarie School of Education, Macquarie University, Sydney, NSW, Australia
- School of Health & Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Libby Smith
- Prevention Innovation, Population Health, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Centre for Community Child Health, Royal Children’s Hospital, Parkville, VIC, Australia
| | | | | | - Alison King
- Hearing Australia, Doncaster, VIC, Australia
| | - Rachael Beswick
- Children’s Health Queensland Hospital and Health Service, South Brisbane, QLD, Australia
| | - Claire E. Iseli
- Otolaryngology Department, Royal Children’s Hospital, Parkville, VIC, Australia
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia
| | - Peter Carew
- Prevention Innovation, Population Health, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Department of Audiology and Speech Pathology, University of Melbourne, Parkville, VIC, Australia
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