Schoolchildren with unilateral or mild to moderate bilateral sensorineural hearing loss should be screened for neurodevelopmental problems

Use of Socioeconomic Demographic Data in Studies on Pediatric Unilateral Hearing Loss: A Scoping Review

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.

Hearing aid use in 11-year-old children with mild bilateral hearing loss: Associations between parent and child ratings and datalogging

OBJECTIVE

This study examined the hearing aid use in older school-aged children with mild bilateral hearing loss. More specifically, it investigated children's and parents' estimation of use in comparison to datalogging as well as explored the situations children used their hearing aids.

METHODS AND MATERIALS

Sixteen children with mild bilateral hearing loss and their parents participated. Of those, 14 children used hearing aids. Children and parents completed a questionnaire on hours of hearing aid use and situations hearing aids were used. Datalogging of the hearing aids was recorded and compared to the outcome of the questionnaires.

RESULTS

Datalogging indicated average hearing aid use time was 6.6 h. Children significantly overestimated their use of their hearing aids while approximately half the parents overestimated their child's use. Children used their hearing aids most often at school and in the car.

CONCLUSION

Children with mild bilateral hearing loss overestimate the amount of time they are wearing their hearing aids. This may impact counselling and intervention on the use of hearing aids. Therefore, school-aged children should be included in the discussions around potentially increasing use of hearing aids.

Neurodevelopmental problems and quality of life in 6-year-olds with a history of developmental language disorder

AIM

To explore family-reported neurodevelopmental functioning and quality of life in 6-year-olds who had screened positive for developmental language disorder at age 2.5 years.

METHODS

Parents of 85 6-year-old children completed questionnaires about child neurodevelopmental difficulties and quality of life. The children were interviewed regarding quality of life, and their language was assessed by speech and language pathologists. Test results at 6 years identified three subgroups: children with developmental language disorder (n = 68) or speech sound disorder (n = 6) and children with no current language disorder (n = 11).

RESULTS

Out of the 68 children with developmental language disorder, 33 (48%) had significant parent-rated problems with language, executive functions 17 (25%), perception 15 (22%) and/or motor skills 15 (22%). Four (67%) of the children with speech sound disorder had significant problems with language. Significant problems were reported with language in five (45%) and with perception in four (36%) children with no current language disorder. The parents reported no impaired quality of life, whereas the children themselves reported impairment mainly with school functioning.

CONCLUSIONS

Overlap between language difficulties and other neurodevelopmental problems was higher in 6-year-olds who had screened positive for developmental language disorder about 3 years earlier, than in the general population. The parent and child reports of quality of life were not consistent.

Youth with hearing loss: Emotional and behavioral problems and quality of life

OBJECTIVES

To compare parent- and self-reported emotional and behavioral problems and quality of life (QoL) among youth with hearing loss (HL) to norms, and to investigate possible associations between emotional and behavioral problems and QoL among youth with HL.

METHODS

We used the Strengths and Difficulties questionnaire (SDQ) and the Inventory of Life Quality in Children and Adolescents (ILC) to measure emotional and behavioral problems and QoL in youth with HL (n = 317, ages 6-18), where 78% had bilateral HL, 22% unilateral HL, 16% had cochlear implants, and 59% conventional hearing aids.

RESULTS

The youth with HL had significantly more parent-reported (but not self-reported) emotional and behavioral problems and poorer parent- and self-reported QoL than hearing youth. SDQ and ILC total scores were significantly correlated (-0.47 to -0.63). Conclusion Emotional and behavioral problems and poor QoL appear closely related in youth with HL, suggesting that attending to these problems may improve QoL.

What Can a Child Do With One Normal-Hearing Ear? Speech Perception and Word Learning in Children With Unilateral and Bilateral Hearing Losses Relative to Peers With Normal Hearing

OBJECTIVES

To examine the effects of unilateral hearing loss on children's ability to perceive familiar words and to learn and retain new words. Because children with unilateral hearing loss receive full auditory input in one ear, their performance was expected to be consistent with that of children with normal hearing rather than that of children with moderate bilateral hearing loss.

DESIGN

Participants were 36 school-age children with normal hearing bilaterally, 11 children with moderate bilateral hearing loss, and 11 children with mild-to-profound unilateral hearing loss (six right and five left). Half of the normally hearing children and two-thirds of the children with unilateral hearing loss were from bilingual Spanish/English-speaking homes. One of the 11 children with bilateral hearing loss was from a bilingual Spanish/English-speaking home. All children completed a word recognition test in English and in Spanish, a word-learning task comprised of nonsense words constructed using the phonotactic rules of English, Spanish, and Arabic, and a next-day word-retention test.

RESULTS

Word recognition did not differ across groups in English or Spanish. Learning and retention of nonsense words was highest for the children with normal hearing in all three languages. The children with unilateral and bilateral losses learned and recalled the English nonsense words as well as their normally hearing peers, but performance for the Spanish and Arabic nonsense words was significantly and similarly reduced by hearing loss in either ear.

CONCLUSIONS

Failure to learn and retain new words given a full auditory representation in one ear suggests that children with unilateral and bilateral hearing losses may share a unifying feature of impairment at the level of the central auditory system.