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Yoshinaga-Itano C, Carr G, Davis A, Ching TYC, Chung K, Clark J, Harkus S, Kuan ML, Garg S, Balen SA, O'Leary S. Coalition for Global Hearing Health Hearing Care Pathways Working Group: Guidelines for Clinical Guidance for Readiness and Development of Evidence-Based Early Hearing Detection and Intervention Programs. Ear Hear 2024:00003446-990000000-00281. [PMID: 38783422 DOI: 10.1097/aud.0000000000001501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Editor's Note: The following article discusses the timely topic Clinical Guidance in the areas of Evidence-Based Early Hearing Detection and Intervention Programs. This article aims to discuss areas of services needed, guidance to countries/organizations attempting to initiate early hearing detection and intervention systems. Expert consensus and systematic/scoping reviews were combined to produce recommendations for evidence-based clinical practice. In Ear and Hearing, our long-term goal for the Point of View article is to stimulate the field's interest in and to enhance the appreciation of the author's area of expertise. Hearing is an important sense for children to develop cognitive, speech, language, and psychosocial skills. The goal of universal newborn hearing screening is to enable the detection of hearing loss in infants so that timely health and educational/therapeutic intervention can be provided as early as possible to improve outcomes. While many countries have implemented universal newborn hearing screening programs, many others are yet to start. As hearing screening is only the first step to identify children with hearing loss, many follow-up services are needed to help them thrive. However, not all of these services are universally available, even in high-income countries. The purposes of this article are (1) to discuss the areas of services needed in an integrated care system to support children with hearing loss and their families; (2) to provide guidance to countries/organizations attempting to initiate early hearing detection and intervention systems with the goal of meeting measurable benchmarks to assure quality; and (3) to help established programs expand and improve their services to support children with hearing loss to develop their full potential. Multiple databases were interrogated including PubMed, Medline (OVIDSP), Cochrane library, Google Scholar, Web of Science and One Search, ERIC, PsychInfo. Expert consensus and systematic/scoping reviews were combined to produce recommendations for evidence-based clinical practice. Eight essential areas were identified to be central to the integrated care: (1) hearing screening, (2) audiologic diagnosis and management, (3) amplification, (4) medical evaluation and management, (5) early intervention services, (6) family-to-family support, (7) D/deaf/hard of hearing leadership, and (8) data management. Checklists are provided to support the assessment of a country/organization's readiness and development in each area as well as to suggest alternative strategies for situations with limited resources. A three-tiered system (i.e., Basic, Intermediate, and Advanced) is proposed to help countries/organizations at all resource levels assess their readiness to provide the needed services and to improve their integrated care system. Future directions and policy implications are also discussed.
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Affiliation(s)
- Christine Yoshinaga-Itano
- University of Colorado, Boulder, Colorado, USA
- University of Witwatersrand, Johannesburg, South Africa
| | - Gwen Carr
- UCL Ear Institute London, London, United Kingdom
| | - Adrian Davis
- UCL Ear Institute London, London, United Kingdom
- London School of Economics, London, United Kingdom
- Imperial College London, London, United Kingdom
- Anglia Ruskin University, Cambridge, United Kingdom
| | - Teresa Y C Ching
- Macquarie University, Sydney, New South Wales, Australia
- NextSense Institute, Sydney, New South Wales, Australia
- University of Queensland, Brisbane, Queensland, Australia
| | - King Chung
- MGH Institute of Health Professions, Department of Communication Sciences and Disorders, Charlestown, Massachusetts, United States
| | | | | | - Meei-Ling Kuan
- National Women's League Hearing Health Foundation, Taipei, Taiwan
| | | | - Sheila Andreoli Balen
- Speech, Language and Hearing Department, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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Trottenberg G, Funnell WRJ, Motallebzadeh H. Newborn Hearing Screening in Québec, Canada. Am J Audiol 2023:1-7. [PMID: 37988681 DOI: 10.1044/2023_aja-23-00041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023] Open
Abstract
PURPOSE This study discusses the history and current state of the newborn hearing screening program in Québec and aims to assess general challenges associated with establishing universal newborn hearing screening (UNHS) programs. METHOD We reviewed the statistics of the occurrence and long-term effects of congenital hearing loss and the immediate and long-term benefits of UNHS and its limitations. The resources for this study included financial reports related to establishing UNHS in different health care systems; Canadian provincial, territorial, and federal regulations and publications; local and nationwide media; and interviews health care staff and program managers. RESULTS Because of its benefits and its cost-effectiveness, UNHS programs have been implemented in many health care systems around the world. Despite Canada's success in offering a wide array of health care services to its citizens, certain provinces trail behind others in developing UNHS programs. Although there have been recent improvements in the screening rate of the province of Québec, nearly half of all Québec newborns continue to not be screened for hearing loss. The reasons for the current low screening rate include delays in implementation, information-technology complications, operating costs, and lack of public awareness. CONCLUSIONS For UNHS to be implemented in a timely fashion, those involved in the process should first understand what challenges may arise. Québec's experience with this process may provide useful lessons for other health care systems.
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Affiliation(s)
- Gabriel Trottenberg
- Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | - W Robert J Funnell
- Department of BioMedical Engineering, McGill University, Montréal, QC, Canada
- Department of Otolaryngology-Head & Neck Surgery, McGill University, Montréal, QC, Canada
- Department of Pediatric Surgery, McGill University, Montréal, QC, Canada
| | - Hamid Motallebzadeh
- Department of BioMedical Engineering, McGill University, Montréal, QC, Canada
- Department of Communication Sciences & Disorders, California State University, Sacramento
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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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Carew P, Shepherd DA, Smith L, Howell T, Lin M, Bavin EL, Reilly S, Wake M, Sung V. Spoken Expressive Vocabulary in 2-Year-Old Children with Hearing Loss: A Community Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1223. [PMID: 37508720 PMCID: PMC10377817 DOI: 10.3390/children10071223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/30/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023]
Abstract
Through a cross-sectional community study of 2044 children aged 2 years, we (1) examine the impact of hearing loss on early spoken expressive vocabulary outcomes and (2) investigate how early intervention-related factors impact expressive vocabulary outcomes in children with hearing loss predominantly identified through universal newborn hearing screening. We used validated parent/caregiver-reported checklists from two longitudinal cohorts (302 children with unilateral or bilateral hearing loss, 1742 children without hearing loss) representing the same population in Victoria, Australia. The impact of hearing loss and amplification-related factors on vocabulary was estimated using g-computation and multivariable linear regression. Children with versus without hearing loss had poorer expressive vocabulary scores, with mean scores for bilateral loss 0.5 (mild loss) to 0.9 (profound loss) standard deviations lower and for unilateral loss marginally (0.1 to 0.3 standard deviations) lower. For children with hearing loss, early intervention and amplification by 3 months, rather than by 6 months or older, resulted in higher expressive vocabulary scores. Children with hearing loss demonstrated delayed spoken expressive vocabulary despite whole-state systems of early detection and intervention. Our findings align with calls to achieve a 1-2-3 month timeline for early hearing detection and intervention benchmarks for screening, identification, and intervention.
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Affiliation(s)
- Peter Carew
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC 3052, Australia
- Department of Audiology and Speech Pathology, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Daisy A Shepherd
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC 3052, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Libby Smith
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC 3052, Australia
| | - Tegan Howell
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC 3052, Australia
| | - Michelle Lin
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC 3052, Australia
- Department of Audiology and Speech Pathology, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Edith L Bavin
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC 3052, Australia
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC 3086, Australia
| | - Sheena Reilly
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC 3052, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC 3010, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4222, Australia
| | - Melissa Wake
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC 3052, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC 3010, Australia
- Liggins Institute, University of Auckland, Auckland 1023, New Zealand
| | - Valerie Sung
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC 3052, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC 3010, Australia
- Centre for Community Child Health, Royal Children's Hospital, Parkville, VIC 3052, Australia
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Jafarzadeh S, Khajedaluee M, Khajedaluee AR, Khakzadi M, Esmailzadeh M, Firozbakht M. Early Hearing Detection and Intervention Results in Northeastern of Iran from 2005 to 2019: A Repeated Cross-Sectional Study. Int J Prev Med 2023; 14:8. [PMID: 36942040 PMCID: PMC10023843 DOI: 10.4103/ijpvm.ijpvm_396_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 06/15/2022] [Indexed: 01/26/2023] Open
Abstract
Background Hearing loss is one of the most common congenital disorders. The Early Diagnosis and Intervention Process is designed for the early diagnosis and intervention of hearing loss in infants. The present study aimed to examine the results of Early Hearing Detection and Intervention (EHDI) in northeastern Iran from 2005 to 2019. Setting Northeastern Iran. Methods In most cases, the two-stage protocol (otoacoustic emissions [OAE] and automated auditory brainstem response [AABR]) has been used. Infant assessment methods included the use of OAE, ABR, auditory steady-state response, high-frequency tympanometry, and behavioral audiometry. Interventions included medical interventions, hearing rehabilitation, hearing aids, and cochlear implants. Results 1,162,821 infants were screened. The screening coverage increased from less than 1% in 2005 to about 99% in 2018. The referral rate has been about 1%. 2.17 out of every 1000 infants are hearing impaired, and the most common cases are bilateral hearing loss and mild to moderate hearing loss. Conclusions During 2005 to 2019 the coverage rate reached to more than 95% of live births. To improve the EHDI process in this population, better follow-up of diagnosed neonates and expansion of diagnostic and intervention services are needed.
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Affiliation(s)
- Sadegh Jafarzadeh
- Department of Audiology, School of Paramedical Sciences, Sinus and Surgical Endoscopic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Khajedaluee
- Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Address for correspondence: Dr. Mohammad Khajedaluee, Department of Community Medicine, Faculty of Medicine, Campus of Mashhad University of Medical Sciences, Park Square, Mashhad, Iran. E-mail:
| | | | - Masoomeh Khakzadi
- Supervisor of Hearing Screening, State Welfare Organization of Khorasan Razavi, Mashhad, Iran
| | - Mansoor Esmailzadeh
- Expert of Social Welfare Studies, State Welfare Organization of Iran, Tehran, Iran
| | - Mohsen Firozbakht
- Chairman of Hearing Screening Program, State Welfare Organization of Iran, Tehran, Iran
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Harris AB, Seeliger E, Hess C, Sedey AL, Kristensen K, Lee Y, Chung W. Early Identification of Hearing Loss and Language Development at 32 Months of Age. JOURNAL OF OTORHINOLARYNGOLOGY, HEARING AND BALANCE MEDICINE 2022; 3:10.3390/ohbm3040008. [PMID: 37193373 PMCID: PMC10174220 DOI: 10.3390/ohbm3040008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
This study examines the relationship between the early identification of hearing loss and language outcomes for deaf/hard of hearing (D/HH) children, with bilateral or unilateral hearing loss and with or without additional disabilities. It was hypothesized that hearing loss identified by 3 months of age would be associated with better language outcomes. Using a prospective, longitudinal design, 86 families completed developmental instruments at two time points: at an average age of 14.8 months and an average age of 32.1 months. Multiple regression examined how hearing loss identified by 3 months of age contributed to later language outcomes while controlling for developmental level at the first time point. Hearing loss identified by 3 months of age was positively associated with better language outcomes for D/HH children at 32 months of age; however, D/HH children still exhibited language delays, compared to normative scores for same-aged hearing peers for reported measures. Language outcomes of children with unilateral hearing loss were not better than those of children with mild-to-moderate bilateral hearing loss. Children with additional disabilities and more severe bilateral hearing loss had lower language scores than those without.
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Affiliation(s)
- Anne B. Harris
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA
| | | | - Christi Hess
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Allison L. Sedey
- Speech, Language, and Hearing Sciences, University of Colorado-Boulder, Boulder, CO 80309, USA
- Colorado School for the Deaf and the Blind, Colorado Springs, CO 80903, USA
| | - Kayla Kristensen
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Yen Lee
- Edgewood College, Madison, WI 53711, USA
| | - Winnie Chung
- Veterans Healthcare System of the Ozark, Fort Smith, AR 72917, USA
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
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Edmond K, Chadha S, Hunnicutt C, Strobel N, Manchaiah V, Yoshinga-Itano C. Effectiveness of universal newborn hearing screening: A systematic review and meta-analysis. J Glob Health 2022; 12:12006. [PMID: 36259421 PMCID: PMC9579831 DOI: 10.7189/jogh.12.12006] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background Permanent bilateral hearing loss (PBHL) is a serious condition in newborns, with a prevalence of at least one per 1000 live births. However, there has been no recent systematic review and meta-analysis of the effectiveness of universal newborn hearing screening programs (UNHS). Methods We registered our study protocol on PROSPERO CRD42020175451. Primary outcomes were any identification of PBHL (ie, PBHL diagnosed at any time), age of identification of PBHL, and neurodevelopment. Two reviewers searched standard databases to March 2022 and extracted data. We used fixed and random effects meta-analysis to pool data and graded the certainty of evidence using standard methods. Results The search retrieved 2834 records. We identified five studies reporting on the effects of UNHS vs no UNHS in 1 023 610 newborns. The relative risk of being identified with PBHL before nine months in infants with UNHS compared to infants without UNHS was 3.28 (95% confidence interval (95% CI) = 1.84, 5.85, one study, 1 023 497 newborns, low certainty evidence). The mean difference in the age of identification of PBHL in infants with UNHS compared to infants without UNHS was 13.2 months earlier (95% CI = -26.3, -0.01, two studies, 197 newborns, very low certainty evidence). The relative risk of infants eventually being identified with PBHL in infants with UNHS compared to infants without UNHS was 1.01 (95% CI = 0.89, 1.14, three studies, 1 023 497 newborns, low certainty evidence). At the latest follow-up at 3-8 years, the standardised mean difference (SMD) in receptive language development between infants with UNHS compared to infants without UNHS was 0.60 z scores (95% CI = 0.07, 1.13, one study, 101 children, low certainty evidence) and the mean difference in developmental quotients was 7.72 (95% CI = -0.03, 15.47, three studies, 334 children, very low certainty evidence). The SMD in expressive language development was 0.39 z scores (95% CI = -0.20, 0.97, one study, 87 children, low certainty evidence) and the mean difference in developmental quotients was 10.10 scores (95% CI = 1.47, 18.73, 3 studies, 334 children, very low certainty evidence). Conclusions UNHS programs result in earlier identification of PBHL and may improve neurodevelopment. UNHS should be implemented across high-, middle-, and low-income countries. Registration PROSPERO (CRD42020175451).
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Affiliation(s)
| | | | | | | | - Vinaya Manchaiah
- University of Colorado Anschutz Medical Campus, Colorado, USA,University of Colorado Hospital, Colorado, USA,University of Pretoria, Gauteng, South Africa,Manipal Academy of Higher Education, Manipal, India
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Colin E, Grinand M, Alshawareb F, Gazzano E, Tort C, Roman S. Hearing aid benefits in children with mild bilateral hearing loss: AUDIO-INFANS study. Int J Pediatr Otorhinolaryngol 2022; 160:111244. [PMID: 35853402 DOI: 10.1016/j.ijporl.2022.111244] [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: 03/31/2022] [Revised: 06/23/2022] [Accepted: 07/11/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVES There is a lack of consensus regarding the definition, consequences, and management of mild bilateral hearing loss in children. The objective of this study is to analyze the benefit of hearing aids in children with mild bilateral hearing loss by evaluating their functional hearing. METHODS This retrospective study included 57 children with mild bilateral hearing loss between 20 dB HL and 40 dB HL. Pure tone and speech audiometry thresholds were assessed with and without hearing aids. Two groups were subsequently formed: group E with an effective use of hearing aids (>10 h/day), and group IE whose use of hearing aids was deemed ineffective (<10 h/day). RESULTS Without hearing aids, the initial median of hearing level was 35 dB HL and 36 dB HL in the right and left ears, respectively, compared to 23 dB HL and 25 dB HL with hearing aids. The Lafon test performed on 25 children at 55 dB HL and 65 dB HL showed results ranging from 0% to 100% without hearing aids and from 90% to 100% with hearing aids. Scores obtained with hearing aids were significantly higher than those without them at an average speech level. Median age at diagnosis and at prescription were found to significantly influence the daily use of hearing aids. CONCLUSIONS Our results show that in the case of mild bilateral hearing loss, hearing aids have positive effects on the functional hearing of children and help them to no longer be disadvantaged. This study highlights the need to provide regular support to these children to ensure their optimal care in the event of hearing-related problems. Coordination between the different professionals working with these children is also necessary for their follow-up and appropriate management.
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Affiliation(s)
- Elisabeth Colin
- Department of ENT, Avignon General Hospital, 305 rue Raoul Follereau, 84000, Avignon, France.
| | - Marilyne Grinand
- Department of Clinical Research, Avignon General Hospital, 305 rue Raoul Follereau, 84000, Avignon, France.
| | - Fadi Alshawareb
- Department of ENT, Avignon General Hospital, 305 rue Raoul Follereau, 84000, Avignon, France.
| | - Elise Gazzano
- Department of ENT, Avignon General Hospital, 305 rue Raoul Follereau, 84000, Avignon, France.
| | - Christian Tort
- Department of ENT, Avignon General Hospital, 305 rue Raoul Follereau, 84000, Avignon, France.
| | - Stéphane Roman
- Department of Pediatric Otolaryngology, La Timone Children's Hospital, Aix-Marseille University, 264 rue Saint Pierre, 13005, Marseille, France.
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Kapadia M, Vaid N, Vaze V. UNHS: A Decade Long Feasibility and Sustenance Study from a Tertiary Care Hospital in India. Indian J Otolaryngol Head Neck Surg 2022; 74:624-630. [PMID: 36032914 PMCID: PMC9411340 DOI: 10.1007/s12070-021-02435-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 02/02/2021] [Indexed: 11/30/2022] Open
Abstract
Objective The aim of this study is to estimate the incidence of hearing loss in neonates at a tertiary referral center, to assess the associated risk factors in those identified with hearing loss and to explore the challenges of starting and continuing a universal neonatal hearing screening programme in a tertiary care hospital over a decade. Materials and Methods It is a cohort prospective observational study conducted from January 2008 to January 2018. Five thousand five hundred and forty neonates underwent screening for hearing loss, of which 2688 were well babies and 2854 babies had one or more risk factors causing hearing loss. Otoacoustic emissions (OAE) is employed as the first level of screening within one month of birth. Brainstem evoked response audiometry (BERA) is done at 3 months of gestational age for all the well babies who were referred on OAE testing and all the high risk babies irrespective of the result of the OAE screening. The High risk criteria are based on the set criteria by the Joint Committee on Infant Hearing (2007) and American Academy of Pediatrics (1994). Results In our study the incidence of hearing impairment is 5.41 per 1000 neonates screened. In well babies and at risk babies it is 1.49 and 9.11 per 1000 respectively.The common neonatal risk factors associated with hearing loss in our study are babies admitted to neonatal intensive care units (NICU), intrauterine growth retardation (IUGR), birth weight less than 1500 g, respiratory distress syndrome (RDS) and hyperbilirubinemia. Conclusion The incidence of hearing loss in our study is comparable to that reported in literature (Bachmann KR, ArvedsonJC (1998) Early identification and intervention for children who are hearing impaired. Pediatr Rev. 1998 May; Vol. 19. No.5. pp. 155-165. http://www.ncbi.nlm.nih.gov/pubmed/9584525 Accessed from May 1998, Nagapoornima P, Ramesh A, Srilakshmi, Rao S, Patricia PL, Gore M, et al. Universal hearing screening. Indian J Pediatr. 2007 Jun 18; 74(6):545-9., Augustine AM, Jana AK, Kuruvilla KA, Danda S, Lepcha A, Ebenezer J, et al. (2014) Neonatal hearing screening-experience from a tertiary care hospital in southern India. Indian Pediatr. Vol. 51. No.3. pp 179-183. http://www.ncbi.nlm.nih.gov/pubmed/24277966 Accessed from Mar 2014). Hearing loss is more common in those babies with risk factors as reported in literature (Nagapoornima P, Ramesh A, Srilakshmi, Rao S, Patricia PL, Gore M, et al. Universal hearing screening. Indian J Pediatr. 2007 Jun 18; 74(6):545-9. http://www.ncbi.nlm.nih.gov/pubmed/21654001 Paul AK (2011) Early identification of hearing loss and centralized newborn hearing screening facility-the Cochin experience. Indian Pediatr. Vol. 48. No. 5. pp 355-359. Accessed from May 2011). Implementation of neonatal hearing screening program at a tertiary care hospital using a two tier system with OAE and BERA is a feasible but challenging service.
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Neumann K, Mathmann P, Chadha S, Euler HA, White KR. Newborn Hearing Screening Benefits Children, but Global Disparities Persist. J Clin Med 2022; 11:271. [PMID: 35012010 PMCID: PMC8746089 DOI: 10.3390/jcm11010271] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/27/2021] [Accepted: 12/29/2021] [Indexed: 12/23/2022] Open
Abstract
There is substantial evidence that newborn hearing screening (NHS) reduces the negative sequelae of permanent childhood hearing loss (PCHL) if performed in programs that aim to screen all newborns in a region or nation (often referred to as Universal Newborn Hearing Screening or UNHS). The World Health Organization (WHO) has called in two resolutions for the implementation of such programs and for the collection of large-scale data. To assess the global status of NHS programs we surveyed individuals potentially involved with newborn and infant hearing screening (NIHS) in 196 countries/territories (in the following text referred to as countries). Replies were returned from 158 countries. The results indicated that 38% of the world's newborns and infants had no or minimal hearing screening and 33% screened at least 85% of the babies (hereafter referred to as UNHS). Hearing screening programs varied considerably in quality, data acquisition, and accessibility of services for children with PCHL. In this article, we summarize the main results of the survey in the context of several recent WHO publications, particularly the World Report on Hearing, which defined advances in the implementation of NHS programs in the Member States as one of three key indicators of worldwide progress in ear and hearing care (EHC).
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Affiliation(s)
- Katrin Neumann
- Department of Phoniatrics and Pedaudiology, University Hospital Münster, 48149 Münster, Germany; (P.M.); (H.A.E.)
| | - Philipp Mathmann
- Department of Phoniatrics and Pedaudiology, University Hospital Münster, 48149 Münster, Germany; (P.M.); (H.A.E.)
| | - Shelly Chadha
- Blindness Deafness Prevention, Disability and Rehabilitation Unit, Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, World Health Organization, 1211 Geneva, Switzerland;
| | - Harald A. Euler
- Department of Phoniatrics and Pedaudiology, University Hospital Münster, 48149 Münster, Germany; (P.M.); (H.A.E.)
| | - Karl R. White
- National Center for Hearing Assessment and Management, Utah State University, Logan, UT 84322, USA;
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12
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Ferreira MDS, Levy CCADC, Löfkvist U. Home language environment in relation to language outcome in Brazilian toddlers who are hard of hearing and controls with typical hearing - a pilot study including reliability analyses of the LENA recording system. Codas 2022; 35:e20210250. [PMID: 36287421 PMCID: PMC10010425 DOI: 10.1590/2317-1782/20212021250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 03/02/2022] [Indexed: 11/06/2022] Open
Abstract
PURPOSE The purpose of this pilot study was to explore the home language environment and language outcome of Brazilian toddlers who were hard of hearing, (HH) and controls with typical hearing (TH), and investigate the reliability of using the LENA recording system within a Brazilian Portuguese context. METHODS Fourteen families participated in the study (seven children who were HH and seven controls with TH. Each family contributed with one all-day recording. A smaller portion of the recordings of the typically hearing toddlers were manually transcribed by two transcribers. An interrater agreement was conducted, and then the human transcript results were compared against the LENA-generated data for three measures: Adult Words (AW), Child Vocalizations (CV) and Conversational Turns (CT). RESULTS Data analyses revealed a moderate to strong interrater agreement for CV and AW. Weak to moderate agreement was found between the LENA estimates and the means of the human counts for CV and AW. Seemingly, LENA overestimated human counts for AW and underestimated numbers of CV. Comparative analysis suggested similarities in the language and listening environment of the two groups (TH vs. HoH). Children's language development was supported by higher numbers of parent-child interactions (CT). CONCLUSION The findings imply that LENA may contribute as an ecologically valid tool in preventive family-centered intervention programs for Brazilian toddlers who are hard of hearing and their families, although further validation studies are needed.
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Affiliation(s)
| | | | - Ulrika Löfkvist
- Department of Special Needs Education, University of Oslo - Oslo, Norway.,Department of CLINTEC, Cochlear Implant Section, Karolinska Institute - Stockholm, Sweden.,Department of Public Health and Caring Sciences, Uppsala University - Uppsala, Sweden
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13
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An Economic Evaluation of Australia's Newborn Hearing Screening Program: A Within-Study Cost-Effectiveness Analysis. Ear Hear 2021; 43:972-983. [PMID: 34772837 PMCID: PMC9275830 DOI: 10.1097/aud.0000000000001153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Hearing loss is one of the most prevalent congenital disorders among children. Many countries have implemented universal newborn hearing screening (UNHS) for the early diagnosis and treatment of hearing loss. Despite widespread implementation, the value for money of UNHS is unclear due to lack of cost and outcomes data from rigorous study designs. The objective of this research is to conduct a within-study cost-effectiveness analysis of UNHS compared with targeted screening (targeting children with risk factors of hearing loss) from the Australian healthcare system perspective. This evaluation is the first economic evaluation to assess the cost-effectiveness of UNHS compared to targeted screening using real-world data from a natural experiment. DESIGN The evaluation assumed the Australian healthcare system perspective and considered a time horizon of 5 years. Utilities were estimated using responses to the Health Utilities Index Mark III. Screening costs were estimated based on the Victorian Infant Hearing Screening Program. Ongoing costs were estimated based on administrative data, while external data sources were used to estimate costs related to hearing services. Missing data were handled using the multiple imputation method. Outcome measures included quality-adjusted life years (QALYs) and four language and communication-related outcomes: Peabody Picture Vocabulary Test, Wechsler Nonverbal Scale of Ability, Progressive Achievement Test, and comprehensive, expressive, and total language scores based on the Preschool Language Scale. RESULTS On average, the UNHS cost an extra Australian dollar (A$)22,000 per diagnosed child and was associated with 0.45 more QALYs per diagnosed child compared with targeted screening to 5 years, resulting in an incremental cost-effectiveness ratio (ICER) of A$48,000 per QALY gained. The ICERs for language outcomes lay between A$3,900 (for expressive language score) and A$83,500 per one-point improvement in language score (for Wechsler Nonverbal Scale of Ability). UNHS had a 69% probability of being more cost-effective compared to targeted screening at a willingness to pay threshold of A$60,000 per QALY gained. ICERs were most sensitive to the screening costs. CONCLUSIONS The evaluation demonstrated the usefulness of a within-study economic evaluation to understand the value for money of the UNHS program in the Australian context. Findings from this evaluation suggested that screening costs were the key driver of cost-effectiveness results. Most outcomes were not significantly different between UNHS and targeted screening groups. The ICER may be overestimated due to the short follow-up period. Further research is warranted to include long-term resource use and outcome data, late diagnosis, transition and remission between severity levels, and timing of diagnosis and treatment.
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Yoshinaga-Itano C, Mason CA, Wiggin M, Grosse SD, Gaffney M, Gilley PM. Reading Proficiency Trends Following Newborn Hearing Screening Implementation. Pediatrics 2021; 148:e2020048702. [PMID: 34552002 PMCID: PMC9109733 DOI: 10.1542/peds.2020-048702] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/16/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To investigate trends in population-level school-aged reading scores among students with hearing loss in an urban Colorado school district after implementation of universal newborn hearing screening (UNHS) and Early Hearing Detection and Intervention. METHODS The final sample included 1422 assessments conducted during the 2000-2001 through 2013-2014 school years for 321 children with hearing loss in grades 3 through 10. Longitudinal hierarchical linear modeling analyses were used to examine reading proficiency (controlling for birth year, grade in school, free and reduced lunch status, additional disability services, and English not spoken in the home). The Colorado Student Assessment Program was administered to students in third through 10th grades throughout the state. The test years chosen included children born before and after implementation of UNHS. RESULTS After implementation of UNHS, significant longitudinal reading proficiency improvements were observed by birth year and grade overall and for all subgroups. However, gains in reading proficiency were substantially less for children eligible for free and reduced lunch and those with moderate-severe to profound hearing loss. With each succeeding birth cohort and grade, increased numbers of children participated in testing because of improved language skills, with higher proportions identified as proficient or advanced readers. CONCLUSIONS Notable improvements in reading proficiency after Early Hearing Detection and Intervention implementation were demonstrated, as all groups of children with hearing loss became more likely to achieve proficient and advanced reading levels. On the other hand, some disparities increased, with greater improvements in reading proficiency for children in economically advantaged families.
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Affiliation(s)
- Christine Yoshinaga-Itano
- Institute of Cognitive Science, University of Colorado Boulder, Boulder, Colorado
- University of the Witwatersrand, Johannesburg, Johannesburg, South Africa
| | - Craig A Mason
- School of Learning and Teaching, The University of Maine, Orono, Maine
| | - Mallene Wiggin
- Institute of Cognitive Science, University of Colorado Boulder, Boulder, Colorado
| | - Scott D Grosse
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Marcus Gaffney
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Phillip M Gilley
- Institute of Cognitive Science, University of Colorado Boulder, Boulder, Colorado
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15
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Lin JJ, Gillam L, Smith L, Carew P, King A, Ching TYC, Sung V. Mild matters: parental insights into the conundrums of managing mild congenital hearing loss. Int J Audiol 2021; 61:500-506. [PMID: 34346279 DOI: 10.1080/14992027.2021.1954248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To explore and describe parental experiences related to the management of mild bilateral congenital hearing loss in children. DESIGN Using qualitative methods, we conducted semi-structured interviews with parents/caregivers until saturation of themes was achieved. We analysed transcripts using inductive content analysis. STUDY SAMPLE Caregivers of children under 3-years-old with mild bilateral sensorineural hearing loss. RESULTS We interviewed 12 parents. Parental perception of advice regarding hearing aid fitting was varied; almost all children were offered hearing aids. Perceived positives related to hearing aids: feeling empowered that action has been taken; improvements in the child's hearing perception and; facilitation of behavioural management. Perceived negatives of hearing aid use: difficulties with compliance resulting in parental frustration and guilt, damage/loss of equipment, discomfort, parental discord, altered quality of natural sound and potential bullying/stigma. Some parents were ambivalent about the effect of the hearing aids. Where hearing aids were offered and not fitted, there was significant ongoing uncertainty, and the family carried the burden of their decision. CONCLUSIONS There was a wide variation in perceived advice regarding early hearing aid fitting in children with mild bilateral hearing loss. We identified parental perceptions of positive/negative impacts of hearing aid fitting and potential perceived harms from not fitting.
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Affiliation(s)
| | - Lynn Gillam
- The Royal Children's Hospital, Melbourne, Australia.,The University of Melbourne, Melbourne, Australia
| | - Libby Smith
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Peter Carew
- Murdoch Children's Research Institute, Melbourne, Australia
| | | | | | - Valerie Sung
- The Royal Children's Hospital, Melbourne, Australia.,The University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
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Yoshinaga-Itano C, Manchaiah V, Hunnicutt C. Outcomes of Universal Newborn Screening Programs: Systematic Review. J Clin Med 2021; 10:2784. [PMID: 34202909 PMCID: PMC8268039 DOI: 10.3390/jcm10132784] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/08/2021] [Accepted: 06/10/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This systematic review examined the outcomes (age of identification and intervention, developmental outcomes, cost-effectiveness, and adverse effects on parents) of universal newborn hearing screening (UNHS) for children with permanent congenital hearing loss (PCHL). MATERIALS AND METHODS Multiple electronic databases were interrogated in March and April 2020 with further reports identified from article citations and unpublished literature. UNHS reports in English with comparisons of outcomes of infants who were not screened, and infants identified through other hearing screening programs. RESULTS 30 eligible reports from 14 populations with 7,325,138 infants screened through UNHS from 1616 non-duplicate references were included. UNHS results in a lower age of identification, amplification, and the initiation of early intervention services and better language/literacy development. Better speech perception/production were shown in younger, but not in older, children with early identification after UNHS. No significant findings were found for behavior problems and quality of life. UNHS was found to be cost-effective in terms of savings to society. In addition, no significant parental harm was noted as a result of UNHS. CONCLUSIONS In highly developed countries, significantly better outcomes were found for children identified early through UNHS programs. Early language development predicts later literacy and language development.
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Affiliation(s)
| | - Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX 77710, USA;
| | - Cynthia Hunnicutt
- Institute of Cognitive Science, University of Colorado Boulder, UCB 594, Boulder, CO 80309, USA;
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Todorov M, Galvin K, Klieve S, Rickards F. Engagement of Children who are Deaf or Hard-of-Hearing Attending Mainstream Schools. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2021; 26:395-404. [PMID: 33866369 DOI: 10.1093/deafed/enab003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 01/26/2021] [Accepted: 01/28/2021] [Indexed: 06/12/2023]
Abstract
This study compared the observed and the self-reported engagement of 16 students who are Deaf or hard-of-hearing (DHH) attending mainstream schools to that of matched controls with typical hearing. Observed engagement was measured through observations in the classroom setting using the Mainstream Version of the Code for Instructional Structure and Student Academic Reponses. Self-reported engagement was measured using the Classroom Participation Questionnaire. The results revealed no significant differences for either observed or self-reported engagement between the DHH and the control groups; however, three individual DHH participants had lower levels of observed engagement compared to their matched controls. As such, including engagement in the evaluation of students who are DHH may be important for some individuals to provide a better understanding of the daily challenges they experience at school. Where needs are identified, the support that students who are DHH receive should include a specific focus on engagement to assist with their successful inclusion.
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Affiliation(s)
- Michelle Todorov
- Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, Victoria 3053, Australia
| | - Karyn Galvin
- Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, Victoria 3053, Australia
| | - Sharon Klieve
- Melbourne Graduate School of Education, The University of Melbourne, Carlton, Victoria 3053, Australia
| | - Field Rickards
- Melbourne School of Government, The University of Melbourne, Carlton, Victoria 3053, Australia
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18
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刘 梦, 张 天. [A review of diagnosis and treatment of syndromic hearing loss]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2021; 35:285-288. [PMID: 33794621 PMCID: PMC10128230 DOI: 10.13201/j.issn.2096-7993.2021.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Indexed: 06/08/2023]
Abstract
Hereditary deafness is divided into syndromic hearing loss and non-syndromic hearing loss according to whether it is accompanied by other system dysfunction. The early identification and diagnosis of syndromic hearing loss is very important, including clinical and molecular diagnosis. Early diagnosis can predict the progress of hearing loss, other systemic disorders and guide treatment. Thus otolaryngologists are likely to become the first doctors to treat children with syndromic hearing loss, it is more necessary to master the clinical and molecular diagnosis methods of common syndromic hearing loss, and cooperate with doctors of other relevant departments for early intervention and treatment. Therefore, this article reviewed the common features, molecular diagnostic methods and treatment strategies for syndromic hearing loss.
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Affiliation(s)
- 梦婷 刘
- 哈尔滨医科大学附属第一医院耳鼻咽喉头颈外科(哈尔滨,150001)
| | - 天虹 张
- 哈尔滨医科大学附属第一医院耳鼻咽喉头颈外科(哈尔滨,150001)
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St John M, Columbus G, Brignell A, Carew P, Skeat J, Reilly S, Morgan AT. Predicting speech-sound disorder outcomes in school-age children with hearing loss: The VicCHILD experience. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2020; 55:537-546. [PMID: 32374456 DOI: 10.1111/1460-6984.12536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 03/09/2020] [Accepted: 03/14/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Congenital hearing loss is the most common birth anomaly, typically influencing speech and language development, with potential for later academic, social and employment impacts. Yet, surprisingly, the nuances of how speech is affected have not been well examined with regards to the subtypes of speech-sound disorder (SSD). Nor have the predictors of speech outcome been investigated within a sizeable population cohort. AIMS (1) To describe the subtypes and prevalence of SSD in children with hearing loss. (2) To determine which characteristics of hearing loss predict the presence of SSD. METHODS & PROCEDURES A total of 90 children (5-12 years of age) with permanent hearing loss were recruited from an Australian population cohort. Children completed a standardized speech assessment to determine the presence and subtype of SSD. Logistic regression was used to determine the predictors of speech outcome. Demographic, developmental and hearing-related predictors were examined. OUTCOMES & RESULTS The prevalence of speech disorder overall was 58%, with the most common subtype being phonological delay in 49% of the sample. Factors most predictive of speech disorder were being male, younger and a bimodal user (i.e., using both a hearing aid and a cochlear implant). CONCLUSIONS & IMPLICATIONS This is the first study, in a sizeable cohort, to describe the prevalence and predictive factors for SSD associated with hearing loss. Clinically, it could be beneficial to implement earlier targeted phonological interventions for children with hearing loss. What this paper adds What is already known on this subject Speech issues are common in children with hearing loss; however, the breakdown of subtypes of SSD (e.g., articulation versus phonological disorder) have not been previously described in a population cohort. This distinction is relevant, as each subtype calls for specific targeted intervention. Studies examining factors predictive of speech outcomes, across a range of hearing levels, are also lacking in a population cohort. What this paper adds to existing knowledge Data suggest the most common type of SSD in children with hearing loss is phonological delay. Males, younger children, and bimodal users were at greater risk of having a subtype of SSD. What are the potential or actual clinical implications of this work? The results are clinically pertinent as the speech diagnosis determines the targeted treatment. Phonological delay is responsive to treatment, and early targeted intervention may improve prognosis for speech outcomes for children with hearing loss.
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Affiliation(s)
- Miya St John
- Murdoch Children's Research Institute, Parkville, Melbourne, VIC, Australia
- University of Melbourne, Parkville, Melbourne, VIC, Australia
| | - Georgie Columbus
- Murdoch Children's Research Institute, Parkville, Melbourne, VIC, Australia
| | - Amanda Brignell
- Murdoch Children's Research Institute, Parkville, Melbourne, VIC, Australia
- University of Melbourne, Parkville, Melbourne, VIC, Australia
| | - Peter Carew
- Murdoch Children's Research Institute, Parkville, Melbourne, VIC, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Jemma Skeat
- University of Melbourne, Parkville, Melbourne, VIC, Australia
| | - Sheena Reilly
- Murdoch Children's Research Institute, Parkville, Melbourne, VIC, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Angela T Morgan
- Murdoch Children's Research Institute, Parkville, Melbourne, VIC, Australia
- University of Melbourne, Parkville, Melbourne, VIC, Australia
- Royal Children's Hospital, Parkville, Melbourne, VIC, Australia
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20
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Le HND, Petersen S, Mensah F, Gold L, Wake M, Reilly S. Health-Related Quality of Life in Children With Low Language or Congenital Hearing Loss, as Measured by the PedsQL and Health Utility Index Mark 3. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2020; 23:164-170. [PMID: 32113621 DOI: 10.1016/j.jval.2019.07.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 05/08/2019] [Accepted: 07/29/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To examine health-related quality of life (HRQoL) in young children with low language or congenital hearing loss and to explore the value of assessing HRQoL by concurrently administering 2 HRQoL instruments in populations of children. METHODS Data were from 2 Australian community-based studies: Language for Learning (children with typical and low language at age 4 years, n = 1012) and the Statewide Comparison of Outcomes study (children with hearing loss, n = 108). HRQoL was measured using the parent-reported Health Utilities Index Mark 3 (HUI3) and the Pediatrics Quality of Life Inventory 4.0 (PedsQL) generic core scale. Agreement between the HRQoL instruments was assessed using intraclass correlation and Bland-Altman plots. RESULTS Children with low language and with hearing loss had lower HRQoL than children with normal language; the worst HRQoL was experienced by children with both. The lower HRQoL was mainly due to impaired school functioning (PedsQL) and speech and cognition (HUI3). Children with hearing loss also had impaired physical and social functioning (PedsQL), vision, hearing, dexterity, and ambulation (HUI3). Correlations between instruments were poor to moderate, with low agreement. CONCLUSIONS Children with low language and congenital hearing loss might benefit from interventions targeting overall health and well-being, not just their impairments. The HUI3 and PedsQL each seemed to provide unique information and thus may supplement each other in assessing HRQoL of young children, including those with low language or congenital hearing loss.
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Affiliation(s)
- Ha N D Le
- Deakin Health Economics, Deakin University, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Parkville, Melbourne, Australia.
| | - Solveig Petersen
- Deakin Health Economics, Deakin University, Geelong, Victoria, Australia; Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Fiona Mensah
- Murdoch Children's Research Institute, Parkville, Melbourne, Australia; Department of Pediatrics, The University of Melbourne, Parkville, Melbourne, Australia; Royal Children's Hospital, Parkville, Melbourne, Australia
| | - Lisa Gold
- Deakin Health Economics, Deakin University, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Parkville, Melbourne, Australia
| | - Melissa Wake
- Murdoch Children's Research Institute, Parkville, Melbourne, Australia; Department of Pediatrics, The University of Melbourne, Parkville, Melbourne, Australia; Department of Paediatrics and the Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Sheena Reilly
- Murdoch Children's Research Institute, Parkville, Melbourne, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
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21
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Simpson A, Šarkic B, Enticott JC, Richardson Z, Buck K. Developmental vulnerability of Australian school-entry children with hearing loss. Aust J Prim Health 2020; 26:70-75. [PMID: 31954430 DOI: 10.1071/py18162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 09/23/2019] [Indexed: 11/23/2022]
Abstract
National data from the Australian Early Development Census (AEDC) was used to describe the sociodemographic and developmental characteristics of a cohort of Australian children entering their first year of primary school in 2012. Results, together with sociodemographic variables were reported for two groups: children with and without reported hearing loss. Data on 285232 children were analysed, with just over 1% of these children identified with hearing loss. Logistic regression analysis found that children with reported hearing loss had over double the odds than their hearing peers of being developmentally 'vulnerable' on one or more domains of the AEDC. Covariates of interest included Aboriginal and Torres Strait Islander heritage, as well as high rates of school absenteeism. Retrospective longitudinal research linking developmental outcomes with intervention efforts, such as newborn hearing screening, would be beneficial in future research.
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Affiliation(s)
- Andrea Simpson
- School of Allied Health, La Trobe University, Bundoora, Vic. 3086, Australia
| | - Bojana Šarkic
- School of Allied Health, La Trobe University, Bundoora, Vic. 3086, Australia
| | - Joanne C Enticott
- Southern Synergy, Department of Psychiatry, Monash University, 126-128 Cleeland Street, Dandenong, Vic. 3175, Australia; and Royal District Nursing Service (RDNS) Institute, 31 Alma Road, St Kilda, Vic. 3182, Australia
| | - Zoe Richardson
- School of Allied Health, La Trobe University, Bundoora, Vic. 3086, Australia
| | - Kimberly Buck
- School of Psychological Sciences, University of Melbourne, 14-20 Blackwood Street, North Melbourne, Vic. 3051, Australia; and Austin Health, Studley Road, Heidelberg, Vic. 3084, Australia; and Corresponding author
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Data Resource Profile: The Victorian Childhood Hearing Impairment Longitudinal Databank (VicCHILD). Int J Epidemiol 2019; 48:1409-1410h. [DOI: 10.1093/ije/dyz168] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2019] [Indexed: 01/26/2023] Open
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Sharma R, Gu Y, Ching TYC, Marnane V, Parkinson B. Economic Evaluations of Childhood Hearing Loss Screening Programmes: A Systematic Review and Critique. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2019; 17:331-357. [PMID: 30680698 PMCID: PMC7279710 DOI: 10.1007/s40258-018-00456-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Permanent childhood hearing loss is one of the most common birth conditions associated with speech and language delay. A hearing screening can result in early detection and intervention for hearing loss. OBJECTIVES To update and expand previous systematic reviews of economic evaluations of childhood hearing screening strategies, and explore the methodological differences. DATA SOURCES MEDLINE, Embase, the Cochrane database, National Health Services Economic Evaluation Database (NHS EED), the Health Technology Assessment (HTA) database, and Canadian Agency for Drugs and Technologies in Health's (CADTH) Grey matters. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS AND INTERVENTIONS Economic evaluations reporting costs and outcomes for both the intervention and comparator arms related to childhood hearing screening strategies. RESULTS Thirty evaluations (from 29 articles) were included for review. Several methodological issues were identified, including: few evaluations reported outcomes in terms of quality-adjusted life years (QALYs); none estimated utilities directly from surveying children; none included disutilities and costs associated with adverse events; few included costs and outcomes that differed by severity; few included long-term estimates; none considered acquired hearing loss; some did not present incremental results; and few conducted comprehensive univariate or probabilistic sensitivity analysis. Evaluations published post-2011 were more likely to report QALYs and disability-adjusted life years (DALYs) as outcome measures, include long-term treatment and productivity costs, and present incremental results. LIMITATIONS We were unable to access the economic models and, although we employed an extensive search strategy, potentially not all relevant economic evaluations were identified. CONCLUSIONS AND IMPLICATIONS Most economic evaluations concluded that childhood hearing screening is value for money. However, there were significant methodological limitations with the evaluations.
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Affiliation(s)
- Rajan Sharma
- Macquarie University Centre for the Health Economy, Sydney, NSW, Australia.
| | - Yuanyuan Gu
- Macquarie University Centre for the Health Economy, Sydney, NSW, Australia
- Department of Economics and Related Studies, University of York, York, UK
| | - Teresa Y C Ching
- National Acoustic Laboratories, Australian Hearing Hub, Sydney, NSW, Australia
| | - Vivienne Marnane
- National Acoustic Laboratories, Australian Hearing Hub, Sydney, NSW, Australia
| | - Bonny Parkinson
- Macquarie University Centre for the Health Economy, Sydney, NSW, Australia
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Bartlett AW, Hall BM, Palasanthiran P, McMullan B, Shand AW, Rawlinson WD. Recognition, treatment, and sequelae of congenital cytomegalovirus in Australia: An observational study. J Clin Virol 2018; 108:121-125. [PMID: 30300787 DOI: 10.1016/j.jcv.2018.09.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 09/18/2018] [Accepted: 09/25/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Australian national surveillance data was used to assess recognition, sequelae, and antiviral therapy for congenital cytomegalovirus (CMV) cases. STUDY DESIGN Data from congenital CMV cases reported through the Australian Paediatric Surveillance Unit born January 1999 to December 2016 were described and Chi-square tests used to characterise trends and associations in case reporting, maternal CMV serology testing, and antiviral therapy. Descriptive analyses for hearing loss and developmental delay were reported for cases born ≥2004, following introduction of universal neonatal hearing screening. RESULTS There were 302 congenital CMV cases (214 symptomatic, 88 asymptomatic). Congenital CMV was suspected in 70.6% by 30 days of age, with no differences across birth cohorts. Maternal CMV serology testing was associated with maternal illness during pregnancy but not birth cohort. There was increasing antiviral use for symptomatic cases, being used in 14% born 1999-2004, 19.6% born 2005-2010, and 44.4% born 2011-2016 (p < 0.001). For those born ≥2004, hearing loss was reported in 42.1% of symptomatic and 26.6% of asymptomatic cases; while developmental delay was reported in 16.9% of symptomatic and 1.3% of asymptomatic cases. CONCLUSION There appears to be under-reporting and under-recognition of congenital CMV despite increasing use of antiviral therapy. Universal newborn CMV screening should be considered to facilitate follow-up of affected children and targeted linkage into hearing and developmental services, and to provide population-level infant CMV epidemiology to support research and evaluation of antiviral and adjunctive therapies.
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Affiliation(s)
- Adam W Bartlett
- School of Women's and Children's Health, University of New South Wales, Sydney, Australia; Biostatistics and Databases Program, The Kirby Institute, University of New South Wales, Sydney, Australia; Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, Australia
| | - Beverley M Hall
- Serology & Virology Division, SEALS Microbiology, Prince of Wales Hospital, Sydney, Australia
| | - Pamela Palasanthiran
- School of Women's and Children's Health, University of New South Wales, Sydney, Australia; Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, Australia
| | - Brendan McMullan
- School of Women's and Children's Health, University of New South Wales, Sydney, Australia; Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, Australia
| | - Antonia W Shand
- Biostatistics and Databases Program, The Kirby Institute, University of New South Wales, Sydney, Australia; Menzies Centre for Health Policy, University of Sydney, Sydney, Australia; Department of Maternal Fetal Medicine, Royal Hospital for Women, Sydney, Australia
| | - William D Rawlinson
- School of Women's and Children's Health, University of New South Wales, Sydney, Australia; Serology & Virology Division, SEALS Microbiology, Prince of Wales Hospital, Sydney, Australia; School of Medical Sciences, University of New South Wales, Sydney, Australia; School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, Australia.
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25
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Thomson V, Yoshinaga-Itano C. The Role of Audiologists in Assuring Follow-Up to Outpatient Screening in Early Hearing Detection and Intervention Systems. Am J Audiol 2018; 27:283-293. [PMID: 30054620 DOI: 10.1044/2018_aja-17-0113] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 04/10/2018] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this study was to investigate the role of audiology involvement and other factors associated with failure to follow through from the initial hearing screening to the second outpatient screen. METHOD Linear regression, logistical regression, and descriptive analyses were used across demographic and hospital variables associated with infants who did not receive a follow-up outpatient screen. RESULTS The results included birthing hospital outpatient rescreen rates from January 1, 2005, through December 31, 2005. Variables were collected from the birth certificate and hospital surveys. Results showed higher loss to follow-up/documentation to outpatient screen for (a) infants born in hospitals with low rates for returning for follow-up, (b) infants born in hospitals that did not have an audiologist involved, (c) infants who were Hispanic, (d) infants who were born to mothers who were not married, (e) infants with mother's with < 12 years of education, and (f) infants with Apgar scores of 7 or below. CONCLUSIONS The findings were used to identify quality improvement strategies to decrease the loss to follow-up. Strategies included ensuring audiology support, providing information in the parent's native language, educating personnel in the newborn intensive care units, developing and disseminating information in Spanish in written form, and educating hospitals on the importance of scheduling the outpatient rescreening before hospital discharge.
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Affiliation(s)
- Vickie Thomson
- Department of Otolaryngology, University of Colorado Denver
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Language Outcomes in Deaf or Hard of Hearing Teenagers Who Are Spoken Language Users: Effects of Universal Newborn Hearing Screening and Early Confirmation. Ear Hear 2018; 38:598-610. [PMID: 28399063 PMCID: PMC5510717 DOI: 10.1097/aud.0000000000000434] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objectives: This study aimed to examine whether (a) exposure to universal newborn hearing screening (UNHS) and b) early confirmation of hearing loss were associated with benefits to expressive and receptive language outcomes in the teenage years for a cohort of spoken language users. It also aimed to determine whether either of these two variables was associated with benefits to relative language gain from middle childhood to adolescence within this cohort. Design: The participants were drawn from a prospective cohort study of a population sample of children with bilateral permanent childhood hearing loss, who varied in their exposure to UNHS and who had previously had their language skills assessed at 6–10 years. Sixty deaf or hard of hearing teenagers who were spoken language users and a comparison group of 38 teenagers with normal hearing completed standardized measures of their receptive and expressive language ability at 13–19 years. Results: Teenagers exposed to UNHS did not show significantly better expressive (adjusted mean difference, 0.40; 95% confidence interval [CI], −0.26 to 1.05; d = 0.32) or receptive (adjusted mean difference, 0.68; 95% CI, −0.56 to 1.93; d = 0.28) language skills than those who were not. Those who had their hearing loss confirmed by 9 months of age did not show significantly better expressive (adjusted mean difference, 0.43; 95% CI, −0.20 to 1.05; d = 0.35) or receptive (adjusted mean difference, 0.95; 95% CI, −0.22 to 2.11; d = 0.42) language skills than those who had it confirmed later. In all cases, effect sizes were of small size and in favor of those exposed to UNHS or confirmed by 9 months. Subgroup analysis indicated larger beneficial effects of early confirmation for those deaf or hard of hearing teenagers without cochlear implants (N = 48; 80% of the sample), and these benefits were significant in the case of receptive language outcomes (adjusted mean difference, 1.55; 95% CI, 0.38 to 2.71; d = 0.78). Exposure to UNHS did not account for significant unique variance in any of the three language scores at 13–19 years beyond that accounted for by existing language scores at 6–10 years. Early confirmation accounted for significant unique variance in the expressive language information score at 13–19 years after adjusting for the corresponding score at 6–10 years (R2 change = 0.08, p = 0.03). Conclusions: This study found that while adolescent language scores were higher for deaf or hard of hearing teenagers exposed to UNHS and those who had their hearing loss confirmed by 9 months, these group differences were not significant within the whole sample. There was some evidence of a beneficial effect of early confirmation of hearing loss on relative expressive language gain from childhood to adolescence. Further examination of the effect of these variables on adolescent language outcomes in other cohorts would be valuable.
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Martínez Rubioa A, Cortés Rico O, Pallás Alonso CR, Rando Diego Á, Sánchez Ruiz-Cabello FJ, Colomer Revuelta J, Esparza Olcina MJ, Gallego Iborra A, García Aguado J, Sánchez-Ventura JG, Merino Moína M, Mengual Gil JM. Resumen infancia y adolescencia. Actualización PAPPS 2018. Aten Primaria 2018; 50 Suppl 1:147-152. [PMID: 29866354 PMCID: PMC6836954 DOI: 10.1016/s0212-6567(18)30367-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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28
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Reilly S, Cini E, Gold L, Goldfeld S, Law J, Levickis P, Mensah F, Morgan A, Nicholson JM, Le HND, Pezic A, Tomblin B, Wake M, Wardrop L. Data resource profile: The Child LAnguage REpository (CLARE). Int J Epidemiol 2018; 47:688-688j. [DOI: 10.1093/ije/dyy034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/07/2018] [Accepted: 02/21/2018] [Indexed: 11/15/2022] Open
Affiliation(s)
- Sheena Reilly
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
- Murdoch Children’s Research Institute, The Royal Children's Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Eileen Cini
- Murdoch Children’s Research Institute, The Royal Children's Hospital, Parkville, VIC, Australia
| | - Lisa Gold
- School of Health and Social Development, Deakin University, Burwood, VIC, Australia
- Centre for Community Child Health, The Royal Children's Hospital, Parkville, VIC, Australia
| | - Sharon Goldfeld
- Murdoch Children’s Research Institute, The Royal Children's Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Centre for Community Child Health, The Royal Children's Hospital, Parkville, VIC, Australia
| | - James Law
- Murdoch Children’s Research Institute, The Royal Children's Hospital, Parkville, VIC, Australia
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Penny Levickis
- Murdoch Children’s Research Institute, The Royal Children's Hospital, Parkville, VIC, Australia
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Fiona Mensah
- Murdoch Children’s Research Institute, The Royal Children's Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Angela Morgan
- Murdoch Children’s Research Institute, The Royal Children's Hospital, Parkville, VIC, Australia
- Department of Audiology and Speech Pathology, The University of Melbourne, Parkville, VIC, Australia
| | - Jan M Nicholson
- Judith Lumley Centre, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, Australia
| | - Ha N D Le
- Centre for Community Child Health, The Royal Children's Hospital, Parkville, VIC, Australia
- Population Health Strategic Research Center, Deakin Health Economics, Deakin University, Geelong, VIC, Australia
| | - Angela Pezic
- Murdoch Children’s Research Institute, The Royal Children's Hospital, Parkville, VIC, Australia
| | - Bruce Tomblin
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA, USA
| | - Melissa Wake
- Murdoch Children’s Research Institute, The Royal Children's Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Department of Paediatrics and Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Louise Wardrop
- Murdoch Children’s Research Institute, The Royal Children's Hospital, Parkville, VIC, Australia
- Centre for Neuroscience of Speech, The University of Melbourne, Parkville, VIC, Australia
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Abstract
PURPOSE OF REVIEW The purpose of this review is to review the evaluation and management of children with syndromic hearing loss. Specific syndromes and the impact of those syndromes on managing hearing loss will be discussed. RECENT FINDINGS Improved molecular testing has increased the ability to identify syndromes-associated hearing loss. Accurate diagnosis of syndromic hearing loss can guide discussions regarding prognosis and appropriate management options for the hearing impairment. SUMMARY A significant portion of childhood hearing loss is associated with a syndrome. Depending on the syndrome, surgical intervention including a bone-anchored hearing aid or cochlear implant may be helpful. In the future, targeted gene therapies may become a viable option for treating syndromic hearing loss.
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Purcell PL, Sie KC, Edwards TC, Doyle DL, Neidt K. Identification of oral clefts as a risk factor for hearing loss during newborn hearing screening. JOURNAL OF EARLY HEARING DETECTION AND INTERVENTION 2018; 3:21-28. [PMID: 29911184 PMCID: PMC6002157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE This study assessed whether children with oral clefts are appropriately classified as at-risk for hearing loss at the time of newborn hearing screening and describes their screening and diagnostic results. DESIGN Birth certificates were used to identify children with cleft lip and palate or isolated cleft palate born in Washington State from 2008-2013. These were cross-referenced with the state's Early Hearing Detection, Diagnosis and Intervention (EHDDI) database. Multivariate logistic regression was used to examine associations. RESULTS Birth records identified 235 children with cleft lip and palate and 116 with isolated cleft palate. Six children were listed as having both diagnoses. Only 138 (39%) of these children were designated as having a craniofacial anomaly in the EHDDI database. Children who were misclassified were less likely to have referred on initial hearing screening, OR 0.3, 95% CI [0.2, 0.5]. Misclassification of risk factor status was also associated with delayed hearing screening past 30 days of age or unknown age at screening, OR 4.4, 95% CI [1.5, 13.3], p-value 0.008. Of 50 children with diagnostic results; 25 (50%) had hearing loss: 18 conductive, 2 mixed, and 5 unspecified. CONCLUSION A majority of children with oral clefts were misclassified regarding risk factor for hearing loss in the EHDDI database.
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Affiliation(s)
- Patricia L Purcell
- Department of Otolaryngology - Head & Neck Surgery, University of Washington, Seattle WA
| | - Kathleen Cy Sie
- Department of Otolaryngology - Head & Neck Surgery, University of Washington, Seattle WA
- Division of Pediatric Otolaryngology, Seattle Children's Hospital, Seattle, WA
| | - Todd C Edwards
- Department of Health Services, University of Washington, Seattle, WA
| | - Debra Lochner Doyle
- Screening and Genetics Unit, Washington State Department of Health, Shoreline, WA
| | - Karin Neidt
- Screening and Genetics Unit, Washington State Department of Health, Shoreline, WA
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Carew P, Mensah FK, Rance G, Flynn T, Poulakis Z, Wake M. Mild-moderate congenital hearing loss: secular trends in outcomes across four systems of detection. Child Care Health Dev 2018; 44:71-82. [PMID: 28612343 DOI: 10.1111/cch.12477] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 04/07/2017] [Accepted: 04/12/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND Universal newborn hearing screening (UNHS) targets moderate or greater hearing loss. However, UNHS also frequently detects children with mild loss that results in many receiving early treatment. The benefits of this approach are not yet established. We aimed to (i) compare language and psychosocial outcomes between four hearing loss detection systems for children aged 5-8 years with congenital mild-moderate hearing loss; (ii) determine whether age of detection predicts outcomes; and (iii) compare outcomes between children identified via well-established UNHS and the general population. METHODS Linear regression adjusted for potential confounding factors was used throughout. Via a quasi-experimental design, language and psychosocial outcomes were compared across four population-based Australian systems of hearing loss detection: opportunistic detection, born 1991-1993, n = 50; universal risk factor referral, born 2003-2005, n = 34; newly established UNHS, born 2003-2005, n = 41; and well-established UNHS, born 2007-2010, n = 21. In pooled analyses, we examined whether age of detection predicted outcomes. Outcomes were similarly compared between the current well-established UNHS system and typically developing children in the Early Language in Victoria Study, born 2003, n = 1217. RESULTS Age at diagnosis and hearing aid fitting fell steadily across the four systems. For moderate losses, mean expressive language (P for trend .05) and receptive vocabulary (P for trend .06) improved across the four systems, but benefit was not obvious for mild losses. In pooled analyses, diagnosis before age six months predicted better language outcomes for moderate losses. Children with mild-moderate losses exposed to well-established UNHS continue to experience expressive language scores well below children in the general population (adjusted mean difference -8.9 points, 95% CI -14.7 to -3.1). CONCLUSIONS Treatment arising from UNHS appears to be clearly benefitting children with moderate hearing losses. However, rigorous trials are needed to quantify benefits, versus costs and potential harms, of early aiding of children with mild losses.
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Affiliation(s)
- P Carew
- Murdoch Childrens Research Institute, Parkville, Australia
- The University of Melbourne, Parkville, Australia
| | - F K Mensah
- Murdoch Childrens Research Institute, Parkville, Australia
- The University of Melbourne, Parkville, Australia
- Royal Children's Hospital, Parkville, Australia
| | - G Rance
- The University of Melbourne, Parkville, Australia
| | - T Flynn
- Karolinska Institutet, Stockholm, Sweden
| | - Z Poulakis
- Murdoch Childrens Research Institute, Parkville, Australia
- The University of Melbourne, Parkville, Australia
- Royal Children's Hospital, Parkville, Australia
| | - M Wake
- Murdoch Childrens Research Institute, Parkville, Australia
- The University of Melbourne, Parkville, Australia
- Department of Paediatrics and the Liggins Institute, The University of Auckland, Auckland, New Zealand
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Grosse SD, Mason CA, Gaffney M, Thomson V, White KR. What Contribution Did Economic Evidence Make to the Adoption of Universal Newborn Hearing Screening Policies in the United States? Int J Neonatal Screen 2018; 4:25. [PMID: 30123850 PMCID: PMC6094389 DOI: 10.3390/ijns4030025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Universal newborn hearing screening (UNHS), when accompanied by timely access to intervention services, can improve language outcomes for children born deaf or hard of hearing (D/HH) and result in economic benefits to society. Early Hearing Detection and Intervention (EHDI) programs promote UNHS and using information systems support access to follow-up diagnostic and early intervention services so that infants can be screened no later than 1 month of age, with those who do not pass their screen receiving diagnostic evaluation no later than 3 months of age, and those with diagnosed hearing loss receiving intervention services no later than 6 months of age. In this paper, we first document the rapid roll-out of UNHS/EHDI policies and programs at the national and state/territorial levels in the United States between 1997 and 2005. We then review cost analyses and economic arguments that were made in advancing those policies in the United States. Finally, we examine evidence on language and educational outcomes that pertain to the economic benefits of UNHS/EHDI. In conclusion, although formal cost-effectiveness analyses do not appear to have played a decisive role, informal economic assessments of costs and benefits appear to have contributed to the adoption of UNHS policies in the United States.
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Affiliation(s)
- Scott D Grosse
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mail Stop E-87, Atlanta, GA 30341, USA;
| | - Craig A Mason
- College of Education and Human Development, University of Maine, Orono, ME 00469, USA;
| | - Marcus Gaffney
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mail Stop E-87, Atlanta, GA 30341, USA;
| | - Vickie Thomson
- Department of Otolaryngology, University of Colorado Denver, Denver, CO 80045, USA;
| | - Karl R White
- National Center for Hearing Assessment and Management (NCHAM), Utah State University, Logan, UT 84322, USA;
- Department of Psychology, Utah State University, Logan, UT 84322, USA
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Stevenson J, Pimperton H, Kreppner J, Worsfold S, Terlektsi E, Kennedy C. Emotional and behaviour difficulties in teenagers with permanent childhood hearing loss. Int J Pediatr Otorhinolaryngol 2017; 101:186-195. [PMID: 28964293 PMCID: PMC5636620 DOI: 10.1016/j.ijporl.2017.07.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 07/20/2017] [Accepted: 07/21/2017] [Indexed: 12/01/2022]
Abstract
OBJECTIVES It is known that during the middle childhood years those with permanent childhood hearing loss (PCHL) are at increased risk of showing emotional and behaviour difficulties (EBD). It has yet to be established whether this risk continues into the late teenage years. There is a paucity of longitudinal studies on the association between PCHL and EBD. METHODS The Strengths and Difficulties Questionnaire (SDQ) was used to measure EBD based on parent, teacher and self-ratings in 76 teenagers with PCHL and 38 in a hearing comparison group (HCG) from a population sample of children that was followed up from birth to adolescence. RESULTS On parent-rated SDQ, the PCHL group had significantly higher Total Difficulties score than the HCG (Standardised mean difference (SMD) = +0.39, 95%CI 0.00 to 0.79). Amongst the PCHL group the presence of disabilities other than hearing loss had a substantial impact on the level of parent-rated EBD (SMD = +1.68, 1.04 to 2.33). There was a relationship between receptive language ability and EBD in both the HCG (r = -0.33, 95%CI -0.59 to -0.01) and the PCHI group (r = -0.33, 95%CI -0.53 to -0.02). The effect of PCHL on EBD became non-significant when receptive language was included as a covariate (F = 0.12, df = 1,95, p = 0.729). Early confirmation of hearing loss (i.e. before 9 months of age) did not have a significant effect on EBD scores (SMD = +0.31, 95%CI -0.15 to 0.77). CONCLUSIONS PCHL continues to be associated with elevated EBD scores as measured by parent rated SDQ into the late teenage years but the degree of this elevation is less than in childhood and is not apparent on teacher or self-ratings. Poor receptive language ability appeared to account for these elevated EBD scores in the group with PCHL. Particular attention needs to be paid to the mental health of children and adolescents with PCHL that is accompanied by other disabilities and to those with poor receptive language ability. However, the majority of teenagers with PCHL do not show clinically significant elevated levels of EBD.
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Affiliation(s)
- Jim Stevenson
- Faculty of Social and Human Sciences, University of Southampton, Southampton, UK.
| | | | - Jana Kreppner
- Faculty of Social and Human Sciences, University of Southampton, Southampton, UK
| | - Sarah Worsfold
- Faculty of Medicine, University of Southampton, Southampton, UK
| | | | - Colin Kennedy
- Faculty of Medicine, University of Southampton, Southampton, UK
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35
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Ching TY, Dillon H, Button L, Seeto M, Van Buynder P, Marnane V, Cupples L, Leigh G. Age at Intervention for Permanent Hearing Loss and 5-Year Language Outcomes. Pediatrics 2017; 140:peds.2016-4274. [PMID: 28864712 PMCID: PMC5574730 DOI: 10.1542/peds.2016-4274] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/09/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Universal newborn hearing screening has been implemented to detect permanent childhood hearing loss (PCHL) early, with the ultimate goal of improving outcomes through early treatment. However, there is disagreement between studies on the size of this benefit and in some cases whether it is significantly different from 0. There have been no studies of sufficient size in which researchers have determined reliably whether the effect varies with degree of PCHL. We aimed to explore how intervention timing influences 5-year language in children with PCHL. METHODS Via a prospective study of 350 children, we used standard multiple regression analyses to investigate the effect of age at intervention or hearing screening on language outcomes after allowing for the effects of nonverbal IQ, degree of PCHL, sex, birth weight, maternal education, additional disabilities, and communication mode. RESULTS The benefit of early intervention for language development increased as hearing loss increased. Children whose amplification started at age 24 months had poorer language than those whose amplification started at 3 months. The difference was larger for 70-dB HL (-11.8 score points; 95% confidence interval [95% CI]: -18.7 to -4.8) than for 50-dB HL (-6.8; 95% CI: -10.8 to -2.8). Children who received cochlear implants at 24 months had poorer language than those implanted at 6 months (-21.4; 95% CI: -33.8 to -9.0). There was no significant effect of screening on outcomes. CONCLUSIONS Early intervention improves language outcomes, thereby lending support to streamlining clinical pathways to ensure early amplification and cochlear implantation after diagnosis.
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Affiliation(s)
- Teresa Y.C. Ching
- HEARing Cooperative Research Centre, Melbourne, Australia;,National Acoustic Laboratories, Sydney, Australia
| | - Harvey Dillon
- HEARing Cooperative Research Centre, Melbourne, Australia;,National Acoustic Laboratories, Sydney, Australia
| | - Laura Button
- HEARing Cooperative Research Centre, Melbourne, Australia;,National Acoustic Laboratories, Sydney, Australia
| | - Mark Seeto
- HEARing Cooperative Research Centre, Melbourne, Australia;,National Acoustic Laboratories, Sydney, Australia
| | - Patricia Van Buynder
- HEARing Cooperative Research Centre, Melbourne, Australia;,National Acoustic Laboratories, Sydney, Australia
| | - Vivienne Marnane
- HEARing Cooperative Research Centre, Melbourne, Australia;,National Acoustic Laboratories, Sydney, Australia
| | - Linda Cupples
- Department of Linguistics, Macquarie University, Sydney, Australia; and
| | - Greg Leigh
- HEARing Cooperative Research Centre, Melbourne, Australia;,Royal Institute for Deaf and Blind Children, Sydney, Australia
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Grosse SD, Riehle-Colarusso T, Gaffney M, Mason CA, Shapira SK, Sontag MK, Braun KVN, Iskander J. CDC Grand Rounds: Newborn Screening for Hearing Loss and Critical Congenital Heart Disease. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2017; 66:888-890. [PMID: 28837548 PMCID: PMC5687816 DOI: 10.15585/mmwr.mm6633a4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Newborn screening is a public health program that benefits 4 million U.S. infants every year by enabling early detection of serious conditions, thus affording the opportunity for timely intervention to optimize outcomes (1). States and other U.S. jurisdictions decide whether and how to regulate newborn screening practices. Most newborn screening is done through laboratory analyses of dried bloodspot specimens collected from newborns. Point-of-care newborn screening is typically performed before discharge from the birthing facility. The Recommended Uniform Screening Panel includes two point-of-care conditions for newborn screening: hearing loss and critical congenital heart disease (CCHD). The objectives of point-of-care screening for these two conditions are early identification and intervention to improve neurodevelopment, most notably language and related skills among infants with permanent hearing loss, and to prevent death or severe disability resulting from delayed diagnosis of CCHD. Universal screening for hearing loss using otoacoustic emissions or automated auditory brainstem response was endorsed by the Joint Committee on Infant Hearing in 2000 and 2007* and was incorporated in the first Recommended Uniform Screening Panel in 2005. Screening for CCHD using pulse oximetry was recommended by the Advisory Committee on Heritable Disorders in Newborns and Children in 2010 based on an evidence review† and was added to the Recommended Uniform Screening Panel in 2011.§.
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Yoshinaga-Itano C, Sedey AL, Wiggin M, Chung W. Early Hearing Detection and Vocabulary of Children With Hearing Loss. Pediatrics 2017; 140:e20162964. [PMID: 28689189 PMCID: PMC5595069 DOI: 10.1542/peds.2016-2964] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/02/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To date, no studies have examined vocabulary outcomes of children meeting all 3 components of the Early Hearing Detection and Intervention (EHDI) guidelines (hearing screening by 1 month, diagnosis of hearing loss by 3 months, and intervention by 6 months of age). The primary purpose of the current study was to examine the impact of the current EHDI 1-3-6 policy on vocabulary outcomes across a wide geographic area. A secondary goal was to confirm the impact of other demographic variables previously reported to be related to language outcomes. METHODS This was a cross-sectional study of 448 children with bilateral hearing loss between 8 and 39 months of age (mean = 25.3 months, SD = 7.5 months). The children lived in 12 different states and were participating in the National Early Childhood Assessment Project. RESULTS The combination of 6 factors in a regression analysis accounted for 41% of the variance in vocabulary outcomes. Vocabulary quotients were significantly higher for children who met the EHDI guidelines, were younger, had no additional disabilities, had mild to moderate hearing loss, had parents who were deaf or hard of hearing, and had mothers with higher levels of education. CONCLUSIONS Vocabulary learning may be enhanced with system improvements that increase the number of children meeting the current early identification and intervention guidelines. In addition, intervention efforts need to focus on preventing widening delays with chronological age, assisting mothers with lower levels of education, and incorporating adults who are deaf/hard-of-hearing in the intervention process.
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Affiliation(s)
| | - Allison L Sedey
- Institute of Cognitive Science, University of Colorado Boulder, Boulder, Colorado
- Colorado School for the Deaf and the Blind, Colorado Springs, Colorado; and
| | - Mallene Wiggin
- Institute of Cognitive Science, University of Colorado Boulder, Boulder, Colorado
| | - Winnie Chung
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
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Downie L, Halliday JL, Burt RA, Lunke S, Lynch E, Martyn M, Poulakis Z, Gaff C, Sung V, Wake M, Hunter M, Saunders K, Rose E, Rehm HL, Amor DJ. A protocol for whole-exome sequencing in newborns with congenital deafness: a prospective population-based cohort. BMJ Paediatr Open 2017; 1:e000119. [PMID: 29637142 PMCID: PMC5862171 DOI: 10.1136/bmjpo-2017-000119] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 07/31/2017] [Accepted: 08/02/2017] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The aetiology of congenital hearing loss is heterogeneous, and in many infants a genetic cause is suspected. Parents face a diagnostic odyssey when searching for a cause of their infant's hearing loss. Through the Melbourne Genomics Health Alliance, a prospective cohort of infants will be offered whole-exome sequencing (WES) with targeted analysis in conjunction with chromosome microarray to determine the genetic causes of congenital hearing loss. Parents will also be offered the opportunity to receive additional results from their infant's WES. METHODS Eligible infants will be identified through the Victorian Infant Hearing Screening Program and offered an appointment in a paediatrician-run clinic, a genetics assessment and enrolment in the Victorian Childhood Hearing Impairment Longitudinal Databank. If parents consent to WES, genes causing deafness will be analysed and they can choose to obtain additional findings. For the additional results component, a modified laboratory protocol has been designed for reporting of results in the absence of a relevant phenotype. Parents' experience of being offered WES will be evaluated using surveys. DISCUSSION This project will provide descriptive analysis of the genetic aetiology of congenital hearing loss in this cohort and may provide data on genotype-phenotype correlations. Additionally, choices regarding additional findings will be analysed. Participants will represent a diverse cross section of the population, increasing the ability to generalise results beyond the study group. Evaluation surveys will allow analysis of preferences around counselling, usefulness of a decision aid and adequacy of information provision.
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Affiliation(s)
- Lilian Downie
- Victorian Clinical Genetics Services, Victoria, Melbourne, Australia.,Murdoch Children's Research Institute, Victoria, Melbourne, Australia.,Royal Children's Hospital, Victoria, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Melbourne, Australia
| | - Jane L Halliday
- Murdoch Children's Research Institute, Victoria, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Melbourne, Australia
| | - Rachel A Burt
- Murdoch Children's Research Institute, Victoria, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Melbourne, Australia
| | - Sebastian Lunke
- Victorian Clinical Genetics Services, Victoria, Melbourne, Australia.,Murdoch Children's Research Institute, Victoria, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Melbourne, Australia
| | - Elly Lynch
- Melbourne Genomics Health Alliance, Victoria, Melbourne, Australia.,Austin Health, Victoria, Melbourne, Australia
| | - Melissa Martyn
- Murdoch Children's Research Institute, Victoria, Melbourne, Australia.,Melbourne Genomics Health Alliance, Victoria, Melbourne, Australia
| | - Zeffie Poulakis
- Murdoch Children's Research Institute, Victoria, Melbourne, Australia.,Royal Children's Hospital, Victoria, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Melbourne, Australia
| | - Clara Gaff
- Department of Paediatrics, University of Melbourne, Victoria, Melbourne, Australia.,Melbourne Genomics Health Alliance, Victoria, Melbourne, Australia
| | - Valerie Sung
- Murdoch Children's Research Institute, Victoria, Melbourne, Australia.,Royal Children's Hospital, Victoria, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Melbourne, Australia
| | - Melissa Wake
- Murdoch Children's Research Institute, Victoria, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Melbourne, Australia.,University of Auckland, Auckland, New Zealand
| | - Matthew Hunter
- Monash Health, Victoria, Melbourne, Australia.,Monash University, Victoria, Melbourne, Australia
| | - Kerryn Saunders
- Monash Health, Victoria, Melbourne, Australia.,Monash University, Victoria, Melbourne, Australia
| | - Elizabeth Rose
- Murdoch Children's Research Institute, Victoria, Melbourne, Australia.,Royal Children's Hospital, Victoria, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Melbourne, Australia
| | - Heidi L Rehm
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - David J Amor
- Victorian Clinical Genetics Services, Victoria, Melbourne, Australia.,Murdoch Children's Research Institute, Victoria, Melbourne, Australia.,Royal Children's Hospital, Victoria, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Melbourne, Australia
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Calcutt TL, Dornan D, Beswick R, Tudehope DI. Newborn hearing screening in Queensland 2009-2011: Comparison of hearing screening and diagnostic audiological assessment between term and preterm infants. J Paediatr Child Health 2016; 52:995-1003. [PMID: 27521761 DOI: 10.1111/jpc.13281] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 03/25/2016] [Accepted: 05/06/2016] [Indexed: 01/22/2023]
Abstract
AIM This study compares rates and timing of newborn hearing screening outcomes, audiological assessment and hearing loss diagnosis between infants of different gestational age groups. Early identification and management of sensorineural hearing loss (SNHL), ideally by 3-6 months of age, facilitates speech and language optimisation. Literature stratifying hearing screening and diagnostic audiology assessment by gestational age groups is lacking. METHODS Subjects were infants with recorded gestational ages receiving newborn hearing screening in Queensland between 2009 and 2011. Data were provided through the Queensland Healthy Hearing database. Infants were analysed in <34 weeks, 34-36+6 weeks, 37-38+6 weeks and ≥39 weeks gestational age groups. RESULTS Infants (175 911) were eligible for analysis, 7.9% being preterm. Per 1000 infants analysed, bilateral SNHL of >40 dB occurred in 2.4 for <34, 1.4 for 34-36+6 , 0.7 for 37-38+6 and 0.7 for ≥39 weeks gestation. Diagnoses attributable to newborn hearing screening direct referral were 93.1% for bilateral >40 dB SNHL and 88.2% for other hearing loss. Relative to term, preterm infants had a higher incidence of direct and targeted surveillance referrals, audiology assessment and hearing loss diagnosis. Preterm infants were screened later after birth. CONCLUSIONS Specific hearing screening and diagnosis characteristics differed between preterm infants <34 and 34-36+6 weeks gestation, and term infants. Consideration of unique gestational age strata characteristics supports care individualisation. Preterm infants represent a diagnostic challenge, with higher rates of bilateral >40 dB SNHL than term but correspondingly higher false positive results on screening, justifying vigilant monitoring. Focused research into specific risk factors in preterm infants is warranted.
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Affiliation(s)
- Trent L Calcutt
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Dimity Dornan
- Hear and Say, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia.,School of Health and Rehabilitation, University of Queensland, Brisbane, Queensland, Australia
| | - Rachael Beswick
- Healthy Hearing, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - David I Tudehope
- Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia.,Department of Paediatrics and Child Health, University of Queensland, Brisbane, Queensland, Australia
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Abstract
OBJECTIVE Identify variables associated with paediatric access to cochlear implants (CIs). DESIGN Part 1. Trends over time for age at CI surgery (N = 802) and age at hearing aid (HA) fitting (n = 487) were examined with regard to periods before, during, and after newborn hearing screening (NHS). Part 2. Demographic factors were explored for 417 children implanted under 3 years of age. Part 3. Pre-implant steps for the first 20 children to receive CIs under 12 months were examined. RESULTS Part 1. Age at HA fitting and CI surgery reduced over time, and were associated with NHS implementation. Part 2. For children implanted under 3 years, earlier age at HA fitting and higher family socio-economic status were associated with earlier CI. Progressive hearing loss was associated with later CIs. Children with a Connexin 26 diagnosis received CIs earlier than children with a premature / low birth weight history. Part 3. The longest pre-CI steps were Step 1: Birth to diagnosis/identification of hearing loss (mean 16.43 weeks), and Step 11: MRI scans to implant surgery (mean 15.05 weeks) for the first 20 infants with CIs under 12 months. CONCLUSION NHS implementation was associated with reductions in age at device intervention in this cohort.
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Affiliation(s)
- Shani Dettman
- a The University of Melbourne, Department of Audiology and Speech Pathology , Parkville, Victoria , Australia ;,b The Royal Victorian Eye and Ear Hospital , East Melbourne, Victoria , Australia ;,c The HEARing CRC , Carlton, Victoria , Australia
| | - Dawn Choo
- a The University of Melbourne, Department of Audiology and Speech Pathology , Parkville, Victoria , Australia ;,b The Royal Victorian Eye and Ear Hospital , East Melbourne, Victoria , Australia ;,c The HEARing CRC , Carlton, Victoria , Australia
| | - Richard Dowell
- a The University of Melbourne, Department of Audiology and Speech Pathology , Parkville, Victoria , Australia ;,b The Royal Victorian Eye and Ear Hospital , East Melbourne, Victoria , Australia ;,c The HEARing CRC , Carlton, Victoria , Australia
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Wake M, Carew P. Science, Not Philosophy, Will Help Deaf and Hard-of-Hearing Children Reach Their Potential. Pediatrics 2016; 137:peds.2015-3443. [PMID: 26684477 DOI: 10.1542/peds.2015-3443] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/07/2015] [Indexed: 11/24/2022] Open
Affiliation(s)
- Melissa Wake
- Departments of Paediatrics and Murdoch Childrens Research Institute, Melbourne, Australia; and Centre for Community Child Health, The Royal Children's Hospital, Melbourne, Australia
| | - Peter Carew
- Departments of Paediatrics and Murdoch Childrens Research Institute, Melbourne, Australia; and Audiology and Speech Pathology, The University of Melbourne, Melbourne, Australia
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