1
|
Ren AZ, Sung V. Factors that influence health service access in deaf and hard-of-hearing children: a narrative review. Int J Audiol 2024; 63:171-181. [PMID: 37335176 DOI: 10.1080/14992027.2023.2223357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 05/31/2023] [Accepted: 06/05/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVES Early diagnosis and intervention of deaf and hard-of-hearing (DHH) children leads to improved language and psychosocial outcomes. However, many child, parent and provider related factors can influence access to early intervention services, including hearing devices. This narrative review aims to explore factors that influence health service access in DHH children. DESIGN A systematic search was conducted to identify articles that explored factors that influenced health service access in DHH children in countries with Universal Newborn Hearing Screening, published between 2010 and 2022. STUDY SAMPLES Fifty-nine articles met the inclusion criteria for data extraction. This included 4 systematic reviews, 2 reviews, 39 quantitative and 5 mixed methods studies and 9 qualitative studies. RESULTS The identified factors were grouped into the following themes: (a) demographic factors, (b) family related factors, (c) child related factors, (d) factors specific to hearing devices, (e) service delivery, f) telehealth and (g) COVID-19. CONCLUSION This review provided a comprehensive summary of multiple factors that affect access to health services in DHH children. Psychosocial support, consistent clinical advice, allocation of resources to rural communities and use of telehealth are possible ways to address barriers and improve health service access.
Collapse
Affiliation(s)
- Angela Z Ren
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Valerie Sung
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Population Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Centre for Community Child Health, Royal Children's Hospital, Parkville, Victoria, Australia
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Gedik Soyuyuce O, Ayanoglu Aksoy E, Yapici Z. A case report of sudden-onset auditory neuropathy spectrum disorder associated with Brown-Vialetto-Van Laere syndrome (riboflavin transporter deficiency). Int J Audiol 2021; 61:258-264. [PMID: 33983862 DOI: 10.1080/14992027.2021.1921291] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The purpose of this paper is to describe a child with auditory neuropathy spectrum disorder (ANSD) associated with Brown-Vialetto-Van Laere (BVVL) syndrome, which is a rare, inherited, neurodegenerative disorder that is caused by defects in riboflavin transporter genes. DESIGN We report the audiological and clinical profile of a child who presented with a complaint of sudden loss of speech understanding associated with an atypical form of ANSD. He was later diagnosed with BVVL. STUDY SAMPLE An 11-year-old boy with ANSD associated with BVVL. RESULTS The patient's severe neurological symptoms improved within a year of supplementation with high doses of riboflavin. His fluctuating hearing loss and 0% WDS remained unchanged. The patient was able to use hearing aids without any discomfort after treatment initiation, but he stopped using them again due to a lack of benefit in speech understanding. Although cochlear implantation was recommended, the patient and his family decided not to consider it for another year since they still had hope for complete recovery. CONCLUSIONS Sudden-onset ANSD can be the earliest sign of undetected BVVL syndrome. Early detection of BVVL is crucial since all symptoms can be reversible with an early intervention of high doses of riboflavin supplementation.
Collapse
Affiliation(s)
| | | | - Zuhal Yapici
- Department of Neurology, Division of Child Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| |
Collapse
|
4
|
Porter A, Creed P, Hood M, Ching TYC. Parental Decision-Making and Deaf Children: A Systematic Literature Review. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2018; 23:295-306. [PMID: 29947773 PMCID: PMC6455895 DOI: 10.1093/deafed/eny019] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 05/23/2018] [Accepted: 05/27/2018] [Indexed: 06/08/2023]
Abstract
Parents or caregivers of children who are deaf or hard of hearing are required to make complex and rational decisions soon after the confirmation of hearing loss. Ways of facilitating decision-making have been a focus within the healthcare sector for two decades and shared decision-making is now widely viewed as the standard for good clinical care. A systematic literature review was undertaken to identify the extent to which the principles of shared decision-making and informed choice have been implemented for parents when they make decisions related to their children with permanent hearing loss. Five databases were searched for peer-reviewed papers describing the results of original research published from 2000 to 2017, yielding 37 relevant papers. Studies were reviewed using the three phases of decision-making-information exchange, deliberation, and implementation. Two decisions dominated these studies-implantable devices and communication modality. Most papers dealt with decision-making in the context of bilateral hearing loss, with only one study focusing on unilateral hearing loss. The review identified gaps where further research is needed to ensure the lessons learnt in the broader decision-making literature are implemented when parents make decisions regarding their child who is deaf or hard of hearing.
Collapse
Affiliation(s)
- Ann Porter
- School of Applied Psychology, Griffith University
| | - Peter Creed
- School of Applied Psychology, Griffith University
| | | | | |
Collapse
|
5
|
Turchetta R, Conti G, Marsella P, Orlando MP, Picciotti PM, Frezza S, Russo FY, Scorpecci A, Cammeresi MG, Giannantonio S, Greco A, Ralli M. Universal newborn hearing screening in the Lazio region, Italy. Ital J Pediatr 2018; 44:104. [PMID: 30143030 PMCID: PMC6108150 DOI: 10.1186/s13052-018-0534-5] [Citation(s) in RCA: 12] [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: 06/08/2018] [Accepted: 08/06/2018] [Indexed: 11/10/2022] Open
Abstract
Background The introduction of Universal Newborn Hearing Screening (UNHS) programs has drastically contributed to the early diagnosis of hearing loss in children, allowing prompt intervention with significant results on speech and language development in affected children. UNHS in the Lazio region has been initially deliberated in 2012; however, the program has been performed on a universal basis only from 2015. The aim of this retrospective study is to present and discuss the preliminary results of the UNHS program in the Lazio region for the year 2016, highlighting the strengths and weaknesses of the program. Methods Data from screening facilities in the Lazio region for year 2016 were retrospectively analyzed. Data for Level I centers were supplied by the Lazio regional offices; data for Level II and III centers were provided by units that participated to the study. Results During 2016, a total of 44,805 babies were born in the Lazio region. First stage screening was performed on 41,821 children in 37 different birth centers, with a coverage rate of 93.3%. Of these, 38.977 (93.2%) obtained a “pass” response; children with a “refer” result in at least one ear were 2844 (6.8%). Data from Level II facilities are incomplete due to missing reporting, one of the key issues in Lazio UNHS. Third stage evaluation was performed on 365 children in the three level III centers of the region, allowing identification of 70 children with unilateral (40%) or bilateral (60%) hearing loss, with a prevalence of 1.6/1000. Conclusions The analysis of 2016 UNHS in the Lazio region allowed identification of several strengths and weaknesses of the initial phase of the program. The strengths include a correct spread and monitoring of UNHS among Level I facilities, with an adequate coverage rate, and the proper execution of audiological monitoring and diagnosis among Level III facilities. Weakness, instead, mainly consisted in lack of an efficient and automated central process for collecting, monitoring and reporting of data and information.
Collapse
Affiliation(s)
- Rosaria Turchetta
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Guido Conti
- Department of Head and Neck Surgery, Institute of Otorhinolaryngology, Catholic University of Sacred Heart, Rome, Italy
| | - Pasquale Marsella
- Department of Surgery, Audiology and Otosurgery Unit, Bambino Gesù Pediatric Hospital, Rome, Italy
| | | | - Pasqualina Maria Picciotti
- Department of Head and Neck Surgery, Institute of Otorhinolaryngology, Catholic University of Sacred Heart, Rome, Italy
| | - Simonetta Frezza
- Department of Pediatrics, Division of Neonatology, Catholic University of Sacred Heart, Rome, Italy
| | | | - Alessandro Scorpecci
- Department of Surgery, Audiology and Otosurgery Unit, Bambino Gesù Pediatric Hospital, Rome, Italy
| | | | - Sara Giannantonio
- Department of Surgery, Audiology and Otosurgery Unit, Bambino Gesù Pediatric Hospital, Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy.
| |
Collapse
|
6
|
Ching TY, Scarinci N, Marnane V, Sjahalam-King J, Button L, Whitfield J. Factors influencing parents' decisions about communication choices during early education of their child with hearing loss: a qualitative study. DEAFNESS & EDUCATION INTERNATIONAL : THE JOURNAL OF THE BRITISH ASSOCIATION OF TEACHERS OF THE DEAF 2018; 20:154-181. [PMID: 30872975 PMCID: PMC6411083 DOI: 10.1080/14643154.2018.1512393] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To explore the factors influencing parents' choice of communication mode during early education of their child with hearing loss. DESIGN Qualitative descriptive analysis of semi-structured interviews of parents of children with hearing loss. STUDY SAMPLE Fourteen parents of children who participated in the Longitudinal Outcomes of Children with Hearing Impairment study. RESULTS Four themes emerged from thematic analysis of the interview data: (1) parents draw on a variety of experiences and information to make decisions; (2) parents' preferred outcomes for their children drive their choices; (3) child's preference and proficiency drive parental choice; and (4) parents' fears and worries influence decisions. Parents required unbiased, descriptive information as well as evaluative information from professionals, so that they could consider all options in making a decision that met their needs. They required continual support for implementation of their choices as they adjusted to their children's changing needs. CONCLUSIONS Decisions around communication mode are rarely made in isolation, but occur within a larger decision-making matrix that include device choices, early intervention agency choices and "future-proofing" the child's future communication options.
Collapse
Affiliation(s)
- Teresa Yc Ching
- HEARing Cooperative Research Centre
- National Acoustic Laboratories
| | | | - Vivienne Marnane
- HEARing Cooperative Research Centre
- National Acoustic Laboratories
| | | | - Laura Button
- HEARing Cooperative Research Centre
- National Acoustic Laboratories
| | | |
Collapse
|
7
|
The management of pediatric hearing loss caused by auditory neuropathy spectrum disorder. Curr Opin Otolaryngol Head Neck Surg 2018; 25:396-399. [PMID: 28708635 DOI: 10.1097/moo.0000000000000390] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Auditory neuropathy spectrum disorder (ANSD) is a condition in which auditory testing reveals normal otoacoustic emissions, but auditory brainstem testing is abnormal or absent and speech discrimination is poor. This constellation of findings ostensibly suggests that the cochlea is healthy and an abnormality of conduction or processing of sound occurs along the nerve fibers. As more is learned about this condition, it is becoming clear that ANSD describes heterogeneous, distinct clinical entities that must be taken into account when devising treatment modalities. RECENT FINDINGS Modern auditory testing, genetic testing, and neuroimaging can allow for an accurate understanding of the location of the lesion causing ANSD in the auditory pathway. Contributing causes can include genetic mutations, absent or deficient cochlear nerve, hypoxia and jaundice among others. Hearing aids can be successful in the management of ANSD. Several studies suggest that cochlear implantation can lead to successful hearing outcomes in a subset of this patient population. SUMMARY Auditory neuropathy spectrum disorder represents a relatively rare but important diagnosis for clinicians. Treatment for this condition includes hearing aids and FM systems in more mild cases, and cochlear implants in severe cases. Cochlear implantation for many patients can lead to a good hearing outcomes but the outcome can vary greatly depending on the underlying etiology of ANSD.
Collapse
|