1
|
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.
Collapse
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
| | | |
Collapse
|
2
|
Van den Borre E, Tufatulin G, Zupan L, Božanić Urbančič N, Lavie L, Holube I, Swarnalatha Nagaraj V, Gurses E, Denys S, van Wieringen A, Wouters J. A language-independent hearing screening self-test at school-entry. Sci Rep 2024; 14:2582. [PMID: 38297140 PMCID: PMC10831048 DOI: 10.1038/s41598-024-53026-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 01/26/2024] [Indexed: 02/02/2024] Open
Abstract
The usage of a tablet-based language-independent self-test involving the recognition of ecological sounds in background noise, the Sound Ear Check, was investigated. The results of 692 children, aged between 5 and 9 years and 4 months, recruited in seven different countries, were used to analyze the validity and the cultural independence of test. Three different test procedures, namely a monaural adaptive procedure, a procedure presenting the sounds dichotically in diotic noise, and a procedure presenting all the sounds with a fixed signal-to-noise ratio and a stopping rule were studied. Results showed high sensitivity and specificity of all three procedures to detect conductive, sensorineural and mixed hearing loss > 30 dB HL. Additionally, the data collected from different countries were consistent, and there were no clinically relevant differences observed between countries. Therefore, the Sound Ear Check can offer an international hearing screening test for young children at school entry, solving the current lack of hearing screening services on a global scale.
Collapse
Affiliation(s)
- Elien Van den Borre
- Department of Neurosciences, Research Group ExpORL, KU Leuven, Herestraat 49 Bus 721, 3000, Leuven, Belgium.
| | - Gaziz Tufatulin
- Center of Pediatric Audiology, St Petersburg, Russia
- North-Western State Medical University Named After I.I.Mechnikov, St Petersburg, Russia
- Scientific Research Institute of Ear, Nose, Throat and Speech, St Petersburg, Russia
| | - Lea Zupan
- Department of Ear, Nose, and Throat, General Hospital Celje, Celje, Slovenia
| | - Nina Božanić Urbančič
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, Department of Otorhinolaryngology, University of Ljubljana, Ljubljana, Slovenia
| | - Limor Lavie
- Department of Communication Sciences and Disorders, University of Haifa, Haifa, Israel
| | - Inga Holube
- Institute of Hearing Technology and Audiology, Jade University of Applied Sciences, Oldenburg, Germany
| | - Vinay Swarnalatha Nagaraj
- Audiology Group, Department of Neuromedicine and Movement Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Emre Gurses
- Department of Audiology, Faculty of Health Science, Hacettepe University, Ankara, Turkey
| | - Sam Denys
- Department of Neurosciences, Research Group ExpORL, KU Leuven, Herestraat 49 Bus 721, 3000, Leuven, Belgium
- Department of Otorhinolaryngology-Head and Neck Surgery, Multidisciplinary University Center for Speech-Language Pathology and Audiology, University Hospitals of Leuven, Leuven, Belgium
| | - Astrid van Wieringen
- Department of Neurosciences, Research Group ExpORL, KU Leuven, Herestraat 49 Bus 721, 3000, Leuven, Belgium
| | - Jan Wouters
- Department of Neurosciences, Research Group ExpORL, KU Leuven, Herestraat 49 Bus 721, 3000, Leuven, Belgium
| |
Collapse
|
3
|
Brockow I, Söhl K, Hanauer M, Heißenhuber A, Marzi C, Am Zehnhoff-Dinnesen A, Matulat P, Mansmann U, Nennstiel U. [Newborn hearing screening in Germany-results of the 2011/2012 and 2017/2018 evaluations]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023; 66:1259-1267. [PMID: 37843595 PMCID: PMC10622351 DOI: 10.1007/s00103-023-03779-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 09/18/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Newborn hearing screening (NHS) was introduced nationwide by the Federal Joint Committee (Gemeinsamer Bundesausschuss, G‑BA) in 2009. In this process, quality targets were also set in the pediatrics directive. In order to review the quality NHS in Germany, the G‑BA commissioned a consortium to conduct an initial evaluation for the years 2011 and 2012 and a follow-up evaluation for 2017 and 2018. METHODS The evaluations were based on NHS screening parameters (Sammelstatistiken) that must be documented by all obstetrics and neonatology departments as NHS providers and can also be compiled through cooperation with hearing screening centers (HSCs). Additional data were collected through questionnaires and interviews and routine data were used to evaluate the screening process. RESULTS In 13 federal states, a total of 15 HSCs are involved in the screening process. Across Germany, an NHS screening rate of 86.1% was documented in 2018 (82.4% in 2012), but this differed significantly between the federal states. The specified quality targets could not yet be implemented everywhere. For example, only less than half of the obstetric departments achieved the specified screening rate of over 95%. A comparison of data from the follow-up evaluation and the first evaluation showed that the structural quality of NHS had improved, while the process quality remained the same or had deteriorated. The refer rate (children who were discharged without passing the screening) increased from 5.3% to 6.0%. DISCUSSION To improve the quality of NHS, HSCs should be established nationwide and a second screening should be carried out more consistently before discharge in the case of a refer result in the initial screening.
Collapse
Affiliation(s)
- Inken Brockow
- GP1, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Veterinärstr. 2, 85764, München-Oberschleißheim, Deutschland.
| | - Kristina Söhl
- GP1, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Veterinärstr. 2, 85764, München-Oberschleißheim, Deutschland
| | - Marianne Hanauer
- GP1, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Veterinärstr. 2, 85764, München-Oberschleißheim, Deutschland
| | - Annette Heißenhuber
- GP1, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Veterinärstr. 2, 85764, München-Oberschleißheim, Deutschland
| | - Carola Marzi
- GP1, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Veterinärstr. 2, 85764, München-Oberschleißheim, Deutschland
| | | | - Peter Matulat
- Klinik für Phoniatrie und Pädaudiologie, Westfälische Wilhelms-Universität Münster (UKM), Münster, Deutschland
| | - Ulrich Mansmann
- Institut für Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität (LMU), München, Deutschland
| | - Uta Nennstiel
- GP1, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Veterinärstr. 2, 85764, München-Oberschleißheim, Deutschland
| |
Collapse
|
4
|
Tang JZT, Ng PG, Loo JHY. Do all infants with congenital hearing loss meet the 1-3-6 criteria? A study of a 10-year cohort from a universal newborn hearing screening programme in Singapore. Int J Audiol 2023; 62:795-804. [PMID: 35830492 DOI: 10.1080/14992027.2022.2095537] [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: 11/19/2021] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To evaluate 1) the outcomes of a local universal newborn hearing screening (UNHS) programme and its audiological follow-ups at 3- and 6-month points, 2) the education outcomes of children with congenital hearing loss (CHL). DESIGN Retrospective study that analysed data containing hearing screening, diagnosis, intervention and schooling information from electronic databases. STUDY SAMPLE Children aged 5 to 15 years old who were born between 2004-2014 and underwent UNHS in a local hospital. RESULTS Over a 10-year cohort, 99.4% of 29,972 newborns underwent UNHS; approximately 90% of them were screened by 1 month of age. However, only 10% of the cohort strictly fulfilled the 1-3-6 criteria recommended by the Joint Committee on Infant Hearing. Lost to follow-up (LTF) rate was highest at post-diagnosis (35%). 80% of infants who were intervened between 6 and 48 months of age went to mainstream schools. The remaining 20% had additional disabilities or family factors. CONCLUSIONS A high UNHS coverage rate may not translate to meeting the 1-3-6 criteria. Despite ease of access to our healthcare system, LTF at post-diagnosis remained high. In the absence of additional disabilities or family factors, infants intervened during the sensitive window could still potentially make it into mainstream schools.
Collapse
Affiliation(s)
- Joanna Z T Tang
- Department of Otolaryngology, Head and Neck Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Otolaryngology, Head and Neck Surgery, National University Hospital, Singapore, Singapore
| | - Pick Gate Ng
- Department of Neonatology, National University Hospital, Singapore, Singapore
| | - Jenny H Y Loo
- Department of Otolaryngology, Head and Neck Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Otolaryngology, Head and Neck Surgery, National University Hospital, Singapore, Singapore
| |
Collapse
|
5
|
Newborn Auditory Brainstem Responses in Children with Developmental Disabilities. J Autism Dev Disord 2023; 53:776-788. [PMID: 34181140 PMCID: PMC9549590 DOI: 10.1007/s10803-021-05126-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2021] [Indexed: 12/30/2022]
Abstract
We integrated data from a newborn hearing screening database and a preschool disability database to examine the relationship between newborn click evoked auditory brainstem responses (ABRs) and developmental disabilities. This sample included children with developmental delay (n = 2992), speech impairment (SI, n = 905), language impairment (n = 566), autism spectrum disorder (ASD, n = 370), and comparison children (n = 128,181). We compared the phase of the ABR waveform, a measure of sound processing latency, across groups. Children with SI and children with ASD had greater newborn ABR phase values than both the comparison group and the developmental delay group. Newborns later diagnosed with SI or ASD have slower neurological responses to auditory stimuli, suggesting sensory differences at birth.
Collapse
|
6
|
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).
Collapse
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
| | | | | |
Collapse
|
7
|
Meinzen-Derr J, Altaye M, Grove W, Folger AT, Wiley S. Association of Age of Enrollment in Early Intervention with Emergent Literacy in Children Who Are Deaf or Hard of Hearing. J Dev Behav Pediatr 2022; 43:104-110. [PMID: 34086635 PMCID: PMC8636537 DOI: 10.1097/dbp.0000000000000976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 04/01/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Literacy skill development in deaf or hard of hearing (DHH) children is essential for success in school and beyond. Our objective was to evaluate the association between age of early intervention (EI) enrollment for DHH children and emergent literacy in preschool. METHODS This was a population-based study that leveraged state public health and education data on all children identified with hearing loss. The sample included children born between 2008 and 2014 enrolled in EI for hearing loss who received preschool supports (years 2011-2014) through the Ohio Department of Education. The Get it! Got it! Go!, measuring emergent literacy domains of picture naming, rhyming, and alliteration, was administered during preschool in fall and spring. Exposure was enrollment into EI before age 6 months (early) versus at/after 6 months (later). Propensity score matching and mixed model analyses were used to examine associations between EI enrollment and outcomes over time. Model least square means with 95% confidence intervals (CIs) were reported. RESULTS One hundred two successful matches were made for 256 preschoolers. Children enrolled in EI early had significantly higher mean scores (mean [95% CI]) over time for emerging literacy domains of picture naming (2.42 [0.47-4.37]), rhyming (1.2 [0.35-2.06]), and alliteration (0.61 [0.15-1.07]) compared with later enrolled children. Children enrolled early had significantly higher emergent literacy scores at entry, although literacy development was similar between groups. CONCLUSION Children enrolled in EI before age 6 months had consistently higher scores in emergent literacy components over time compared with children enrolled at/after age 6 months.
Collapse
Affiliation(s)
- Jareen Meinzen-Derr
- Division of Biostatistics and Epidemiology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Mekibib Altaye
- Division of Biostatistics and Epidemiology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Wendy Grove
- Office of Early Learning and School Readiness, Ohio Department of Education, Columbus, Ohio
| | - Alonzo T. Folger
- Division of Biostatistics and Epidemiology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Susan Wiley
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| |
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
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.
Collapse
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;
| |
Collapse
|
10
|
van der Straaten TFK, Briaire JJ, Dirks E, Soede W, Rieffe C, Frijns JHM. The School Career of Children With Hearing Loss in Different Primary Educational Settings-A Large Longitudinal Nationwide Study. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2021; 26:405-416. [PMID: 33866374 PMCID: PMC8208104 DOI: 10.1093/deafed/enab008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 03/12/2021] [Accepted: 03/18/2021] [Indexed: 06/12/2023]
Abstract
Children with hearing loss (HL) are at risk for a lower educational achievement. This longitudinal study compared the school career of a nationwide Dutch cohort with and without HL based on descriptive data of the governmental authority Statistics Netherlands. From 2008 to 2018, 3,367,129 children, of whom 1,193 used cochlear implants (CIs) and 8,874 used hearing aids (HAs), were attending primary and/or secondary education. Sixty-one percent of children with HL attended mainstream and 31% special primary education. Compared to mainstreamed pupils without HL, mainstreamed pupils with HL achieved lower levels for language and mathematics in primary education but eventually attended comparable types of secondary education. Children with HL attending special primary education attained lower types of secondary education compared to mainstreamed peers with and without HL. These findings suggest that future educational (and as a result professional) attainment of a child with HL depends on the type of primary educational setting.
Collapse
Affiliation(s)
- Tirza F K van der Straaten
- Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, the Netherlands
| | - Jeroen J Briaire
- Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, the Netherlands
| | - Evelien Dirks
- Dutch Foundation for the Deaf and Hard of Hearing Child, Lutmastraat 167, 1073 GX, Amsterdam, the Netherlands
| | - Wim Soede
- Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, the Netherlands
| | - Carolien Rieffe
- Department of Developmental Psychology, Leiden University, P.O. Box 9555, 2300 RB, Leiden, the Netherlands
- Department of Psychology and Human Development, University College London, London WC1H 0AA, United Kingdom
| | - Johan H M Frijns
- Correspondence should be addressed to Johan H. M. Frijns, P.O. Box 9600, Leiden, the Netherlands. E-mail:
| |
Collapse
|
11
|
Petrou S, Khan K, Kennedy C. Bilateral Permanent Childhood Hearing Loss and Health-Related Quality of Life in Adolescence. CHILDREN (BASEL, SWITZERLAND) 2021; 8:484. [PMID: 34200452 PMCID: PMC8228680 DOI: 10.3390/children8060484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/01/2021] [Accepted: 06/03/2021] [Indexed: 11/16/2022]
Abstract
Little is known about the impact of bilateral permanent childhood hearing loss (PCHL) on health-related quality of life (HRQoL). The objective of this study was to describe preference-based and non-preference based HRQoL outcomes in adolescence, from both self and proxy perspectives, amongst participants of the Hearing Outcomes Project. The Health Utilities Index Marks II (HUI2) and III (HUI3) and the PedsQLTM Version 4.0 Generic Core Scales were used to measure HRQoL based on self and parent proxy reports in 114 adolescents aged 13-19 years, 76 with bilateral PCHL and 38 with normal hearing, recruited from a population sample that was followed up from birth to adolescence. Descriptive statistics and multivariable analyses were used to estimate the relationship between severity of PCHL and HRQoL outcomes. PCHL was associated with decrements in mean multi-attribute utility score that varied between 0.078 and 0.148 for the HUI2 (p = 0.001) and between 0.205 and 0.315 for the HUI3 (p < 0.001), dependent upon the national tariff set applied and respondent group. Multivariable analyses revealed that, after controlling for clinical and sociodemographic covariates, mean HUI3 multi-attribute utility scores were significantly lower in adolescents with moderately severe, severe and profound hearing loss than in adolescents with normal hearing. Significant differences in physical functioning, social functioning, psychosocial functioning and total PedsQLTM scores were only observed when assessments by parents were relied upon, but these dissipated in the multivariable analyses. Bilateral PCHL is associated with poorer HRQoL outcomes in adolescence. Further studies conducted are needed to understand the trajectory and underpinning mechanisms of HRQoL outcomes following PCHL.
Collapse
Affiliation(s)
- Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Kamran Khan
- Warwick Clinical Trials Unit, University of Warwick, Coventry CV4 7AL, UK;
| | - Colin Kennedy
- Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK;
- University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| |
Collapse
|
12
|
Söhl K, Brockow I, Matulat P, Am Zehnhoff-Dinnesen A, Mansmann U, Nennstiel U. [Evaluation of a Screening Program: Challenges of Data Collection Using the Example of the Newborn Hearing Screening]. DAS GESUNDHEITSWESEN 2021; 84:117-125. [PMID: 33951738 DOI: 10.1055/a-1306-0158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The aim of the newborn hearing screening (NHS) is to identify and treat children with bilateral hearing disorders early. The NHS is regulated in Germany by the Pediatric Directive, which recommends an evaluation after 5 years. This evaluation was performed for the first time nationwide for children born between 2011 and 2012 regarding structural, process and result quality. OBJECTIVES Challenges in the collection of appropriate data as basis for evaluation are described and possible improvements are suggested. METHODS All maternity and neonatology wards performing the NHS were identified and their documentations of the NHS analysed. In addition, all pediatric audiologists were identified to gather data on children with bilateral permanent congenital hearing disorder. RESULTS The identification of relevant maternity and neonatology wards was very burdensome. More than half of them were not aware that NHS had to be documented. There was no documentation on more than 15% of the children that were to be screened. Furthermore, data concerning bilateral congenital hearing disorders was only accessible for 60% of the expected number of affected children. CONCLUSIONS Data required for the evaluation of the NHS regarding structural, process and result quality were incomplete and missing. The database for evaluations should be defined precisely and structures needed to obtain meaningful results have to be established in advance. Nevertheless, the evaluation of the NHS provides meaningful results concerning the screening process in Germany.
Collapse
Affiliation(s)
- Kristina Söhl
- GE 4, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Oberschleißheim, Deutschland
| | - Inken Brockow
- GE 4, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Oberschleißheim, Deutschland
| | - Peter Matulat
- Klinik für Phoniatrie und Pädaudiologie, Universitätsklinikum Münster, Munster, Deutschland
| | | | - Ulrich Mansmann
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Luwig-Maximilians-Universität München (LMU), München, Deutschland
| | - Uta Nennstiel
- GE 4, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Oberschleißheim, Deutschland
| |
Collapse
|
13
|
Meinzen-Derr J, Sheldon R, Altaye M, Lane L, Mays L, Wiley S. A Technology-Assisted Language Intervention for Children Who Are Deaf or Hard of Hearing: A Randomized Clinical Trial. Pediatrics 2021; 147:peds.2020-025734. [PMID: 33452063 PMCID: PMC7891685 DOI: 10.1542/peds.2020-025734] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/12/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Children who are deaf or hard of hearing (DHH) often have persistent language delays despite early identification and interventions. The technology-assisted language intervention (TALI), which incorporates augmentative and alternative communication technology into a speech-language therapy model, was designed to support language learning. The study objective was to evaluate the impact of the TALI on spoken language outcomes in DHH children. METHODS Children aged 3 to 12 years with mild to profound bilateral hearing loss were enrolled in a single-site randomized controlled trial. Children were randomly assigned to receive the TALI or treatment as usual (TAU) (with no change in current care) and were followed for 24 weeks. Primary outcomes included spoken language measures elicited from language samples. Secondary outcomes included standardized assessments. Intention-to-treat analyses were used. RESULTS Analyses focused on 41 children randomly assigned to TALI (n = 21) or TAU (n = 20). Among all participants, mean age was 6.3 years (SD 2.5). Over 24 weeks, children in the TALI group, compared with those in the TAU group, had significantly greater increases in the length of phrases they used to express themselves (β = .91 vs .15, respectively; P< .0001). Similar findings were seen with conversational turn-taking and number of different words spoken. CONCLUSIONS Providing visual supports for language concepts that are typically challenging for DHH children to acquire allowed children to process and comprehend spoken language more fully. Such strategies can mitigate persistent language delays with the goal of improving lifelong outcomes and independence across settings.
Collapse
Affiliation(s)
| | - Rose Sheldon
- Developmental and Behavioral Pediatrics, Department of Pediatrics, College of Medicine, University of Cincinnati and Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | | | - Laura Lane
- Divisions of Biostatistics and Epidemiology and
| | - Lindsay Mays
- Developmental and Behavioral Pediatrics, Department of Pediatrics, College of Medicine, University of Cincinnati and Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Susan Wiley
- Developmental and Behavioral Pediatrics, Department of Pediatrics, College of Medicine, University of Cincinnati and Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| |
Collapse
|
14
|
Wong YA, Mazlan R, Abdul Wahab NA, Ja'afar R, Huda Bani N, Abdullah NA. Quality measures of a multicentre universal newborn hearing screening program in Malaysia. J Med Screen 2020; 28:238-243. [PMID: 33202173 DOI: 10.1177/0969141320973060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate and discuss the outcomes of the universal newborn hearing screening program conducted at four public hospitals in Malaysia. METHOD A retrospective analysis of the universal newborn hearing screening database from each hospital was performed. The database consisted of 28,432 and 30,340 screening results of babies born in 2015 and 2016, respectively. Quality indicators (coverage rate, referral rate, return for follow-up rate, and ages at screening and diagnosis) were calculated. RESULTS Overall coverage rate across the four hospitals was 75% in 2015 and 87.4% in 2016. Over the two years, the referral rates for the first screening ranged from 2.7% to 33.93% with only one hospital achieving the recommended benchmark of <4% in both years. The return for follow-up rates for each participating hospital was generally below the recommended benchmark of ≥95%. The mean age at screening was 3.9 ± 1.2 days and 3.3 ± 0.4 days, respectively. The mean age at diagnosis for 70 infants diagnosed with permanent hearing loss was 4.7 ± 0.7 months in 2015 and 3.6 ± 0.9 months in 2016. CONCLUSIONS Quality measures for the universal newborn hearing screening program in four public hospitals in Malaysia were lower than the required standards. Nevertheless, some quality indicators showed statistically significant improvements over the two years. Next steps involve identifying and implementing the best practice strategies to improve the outcome measures and thus the quality of the program.
Collapse
Affiliation(s)
- Yun Ai Wong
- Audiology Programme, Centre for Rehabilitation & Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Rafidah Mazlan
- Audiology Programme, Centre for Rehabilitation & Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.,Centre for Ear, Hearing and Speech, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Noor Alaudin Abdul Wahab
- Centre for Ear, Hearing and Speech, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Roslan Ja'afar
- Graduate School of Business, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Nurul Huda Bani
- Unit Audiologi, Hospital Rehabilitasi Cheras, Ministry of Health Malaysia, Jalan Ya'acob Latiff, Cheras, Malaysia
| | - Nurul Ain Abdullah
- Unit Audiologi, Hospital Sungai Buloh, Ministry of Health Malaysia, Jalan Hospital, Sungai Buloh, Malaysia
| |
Collapse
|
15
|
Al-Mulki K, Todd NW. Relation of public health staffing to follow-up after newborn hearing screening in three health districts in Georgia, 2009-2015. Int J Pediatr Otorhinolaryngol 2020; 129:109784. [PMID: 31760333 DOI: 10.1016/j.ijporl.2019.109784] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 11/14/2019] [Accepted: 11/14/2019] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To describe the association, or non-association, of public health district staffing (specifically, Early Hearing Detection and Intervention [EHDI] coordinator/navigator) and loss to follow-up in newborns who did not pass hearing screening in selected public health districts in Georgia, USA. METHODS By Freedom of Information request, data regarding newborn hearing screening and loss to follow-up for diagnostic testing and staffing were acquired for three districts in Georgia for six years. The districts were chosen because their coordinator/navigator positions were unfilled at times. RESULTS Lapses in staffing of the district EHDI coordinator/navigator position aligned temporally with decreased follow-up. Aggregate three district data showed that follow-up rates in quarter-years with a fulltime navigator were higher than quarter-years without a full-time navigator (p < .001). CONCLUSION Lapses in staffing dedicated to EHDI navigation-coordination correlated with poorer follow-up after not passing newborn hearing screening.
Collapse
Affiliation(s)
- Kareem Al-Mulki
- Department of Otolaryngology - Head and Neck Surgery, Emory University School of Medicine, 1365A Clifton Road NE, Atlanta, 30322, Georgia
| | - N Wendell Todd
- Department of Otolaryngology - Head and Neck Surgery, Emory University School of Medicine, 1365A Clifton Road NE, Atlanta, 30322, Georgia.
| |
Collapse
|
16
|
Brockow I, Söhl K, Nennstiel U. Newborn Hearing Screening in Bavaria-Is It Possible to Reach the Quality Parameters? Int J Neonatal Screen 2018; 4:26. [PMID: 33072947 PMCID: PMC7510247 DOI: 10.3390/ijns4030026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 07/24/2018] [Indexed: 11/27/2022] Open
Abstract
Since the 1 January, 2009, newborn hearing screening (NHS) has been obligatory for every child in Germany. NHS is part of the Pediatrics Directive of the Federal Joint Committee. In this directive, details of the procedures and screening quality to be achieved are given. We evaluate if these quality criteria were met in Bavaria in 2016. The NHS data of children born in 2016 in Bavaria were evaluated for quality criteria, such as screening coverage in screening facilities, screening methods, referral rate (rate of failed tests at discharge) and a child's age at the diagnosis of a hearing disorder. NHS was documented for 116,776 children born in Bavaria in 2016. In the first step, 78,904 newborns were screened with transient evoked otoacoustic emissions and 37,865 with automated auditory brainstem response. Of these, 9182 (7.8%) failed the first test in one or both ears. A second screening before discharge was performed on 53.3% of the newborns with a refer result in the first test, out of which 58.7% received a pass result. After the screening process, 4.6% of the newborns were discharged with a refer result. Only 18% of the first controls after discharge were performed by a pediatric audiologist. In 37.9% of the newborns, the screening center intervened to assure the control of any failed screening test. The median age of diagnosis for bilateral hearing loss was 5.3 months. In Bavaria, NHS was implemented successfully. A tracking system for all children who failed the hearing screening test is pivotal for early diagnosis and therapy of children with hearing deficiency.
Collapse
|
17
|
Worsfold S, Mahon M, Pimperton H, Stevenson J, Kennedy C. Predicting reading ability in teenagers who are deaf or hard of hearing: A longitudinal analysis of language and reading. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 77:49-59. [PMID: 29660589 PMCID: PMC5964066 DOI: 10.1016/j.ridd.2018.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 02/09/2018] [Accepted: 04/04/2018] [Indexed: 06/07/2023]
Abstract
BACKGROUND Deaf and hard of hearing (D/HH) children and young people are known to show group-level deficits in spoken language and reading abilities relative to their hearing peers. However, there is little evidence on the longitudinal predictive relationships between language and reading in this population. AIMS To determine the extent to which differences in spoken language ability in childhood predict reading ability in D/HH adolescents. METHODS and procedures: Participants were drawn from a population-based cohort study and comprised 53 D/HH teenagers, who used spoken language, and a comparison group of 38 normally hearing teenagers. All had completed standardised measures of spoken language (expression and comprehension) and reading (accuracy and comprehension) at 6-10 and 13-19 years of age. OUTCOMES and results: Forced entry stepwise regression showed that, after taking reading ability at age 8 years into account, language scores at age 8 years did not add significantly to the prediction of Reading Accuracy z-scores at age 17 years (change in R2 = 0.01, p = .459) but did make a significant contribution to the prediction of Reading Comprehension z-scores at age 17 years (change in R2 = 0.17, p < .001). CONCLUSIONS and implications: In D/HH individuals who are spoken language users, expressive and receptive language skills in middle childhood predict reading comprehension ability in adolescence. Continued intervention to support language development beyond primary school has the potential to benefit reading comprehension and hence educational access for D/HH adolescents.
Collapse
Affiliation(s)
- Sarah Worsfold
- Faculty of Medicine, University of Southampton, Southampton, SO16 6YD, UK.
| | - Merle Mahon
- Language and Cognition Research Department, UCL, London, WC1X 8EE, UK.
| | - Hannah Pimperton
- Faculty of Medicine, University of Southampton, Southampton, SO16 6YD, UK.
| | - Jim Stevenson
- Psychology, Faculty of Social and Human Sciences, University of Southampton, Southampton, SO17 1BJ, UK.
| | - Colin Kennedy
- Faculty of Medicine, University of Southampton, Southampton, SO16 6YD, UK; University Hospital Southampton NHS Foundation Trust, UK.
| |
Collapse
|
18
|
Cunningham M, Thomson V, McKiever E, Dickinson LM, Furniss A, Allison MA. Infant, Maternal, and Hospital Factors' Role in Loss to Follow-up After Failed Newborn Hearing Screening. Acad Pediatr 2018; 18:188-195. [PMID: 28549746 DOI: 10.1016/j.acap.2017.05.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 04/07/2017] [Accepted: 05/10/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Completion of newborn hearing screening (NBHS) is recommended by 1 month old. Delays and loss to follow-up and documentation (LTF/LTD) after failed NBHS are common. Committees of experts have established hospital guidelines to reduce LTF/LTD. We aimed to identify maternal and infant factors associated with LTF/LTD and determine if adherence to hospital guidelines is associated with timely completion of follow-up screening. METHODS We conducted a retrospective study of all infants born in Colorado hospitals who failed the newborn admission hearing screening from 2007 to 2012 and a cross-sectional survey of NBHS coordinators at Colorado birthing hospitals. Neonatal intensive care unit infants were excluded. Outcomes included documented completion of the follow-up NBHS and completion by 1 month. Data sources comprised the electronic birth record, infant hearing integrated data system, and NBHS coordinator survey. Data were analyzed by logistic regression. RESULTS A total of 13,904 newborns did not pass the newborn admission hearing screening from 2007 to 2012, and 11,422 (82%) had documentation of a completed follow-up screening. A total of 10,558 (76%) completed follow-up screening by 1 month. All 53 NBHS coordinators completed the survey. Maternal age, education, smoking, and birth country; and payer, race, birth order, and population density were associated with completion of follow-up hearing screening. Maternal education, payer, population density, birth weight, and cleft lip were associated with completion by 1 month of age. Only birth in a facility that charges a rescreening fee was associated with completion of follow-up screening. CONCLUSIONS Low-income, rural, and minority infants are at risk for LTF. Further studies are needed to determine if adherence to guidelines can overcome barriers to follow-up.
Collapse
Affiliation(s)
- Maureen Cunningham
- Department of Pediatrics, University of Colorado Denver, Aurora, Colo; Children's Hospital Colorado, Aurora, Colo.
| | - Vickie Thomson
- Department of Otolaryngology, University of Colorado Denver, Aurora, Colo
| | - Erica McKiever
- Colorado Department of Public Health and Environment, Denver, Colo
| | - L Miriam Dickinson
- Department of Family Medicine, University of Colorado Denver, Aurora, Colo; Adult and Child Consortium for Outcomes Research and Delivery Science, Aurora, Colo
| | - Anna Furniss
- Adult and Child Consortium for Outcomes Research and Delivery Science, Aurora, Colo
| | - Mandy A Allison
- Department of Pediatrics, University of Colorado Denver, Aurora, Colo; Children's Hospital Colorado, Aurora, Colo; Adult and Child Consortium for Outcomes Research and Delivery Science, Aurora, Colo
| |
Collapse
|
19
|
Stevenson J, Pimperton H, Kreppner J, Worsfold S, Terlektsi E, Mahon M, Kennedy C. Language and reading comprehension in middle childhood predicts emotional and behaviour difficulties in adolescence for those with permanent childhood hearing loss. J Child Psychol Psychiatry 2018; 59:180-190. [PMID: 28872675 PMCID: PMC5811921 DOI: 10.1111/jcpp.12803] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Permanent childhood hearing loss (PCHL) is associated with an elevated level of emotional and behaviour difficulties (EBD). In children and adolescents with PCHL, EBD has been found to be linked to language ability in children with PCHL. The present study was designed to test whether childhood language and/or reading comprehension abilities of children with PCHL predict subsequent EBD in adolescence. METHODS Language comprehension (LC) and reading comprehension (RC) were measured at ages 6-10 years (Time 1) and 13-20 years (Time 2) in participants with PCHL who preferred to communicate using spoken language (n = 57) and a hearing comparison group (n = 38). EBD was measured at both time points by parent and by teacher ratings on the Strengths and Difficulties Questionnaire. RESULTS Within the PCHL group there were negative correlations between EBD scores and concurrent LC and RC scores at Time 1 and at Time 2. Cross-lagged latent variable models fitted to the longitudinal data indicated that the associations between LC, RC and teacher-rated EBD were more likely to arise from the impact of LC and RC on behaviour rather than the other way around. CONCLUSIONS In those with PCHL, poor language and reading comprehension in middle childhood increased the risk of emotional and behaviour difficulties at school in the teenage years. The results suggest that effective language and literacy interventions for children with hearing loss may also bring benefits to their mental health.
Collapse
Affiliation(s)
- Jim Stevenson
- Faculty of Social and Human SciencesUniversity of SouthamptonSouthamptonUK
| | | | - Jana Kreppner
- Faculty of Social and Human SciencesUniversity of SouthamptonSouthamptonUK
| | - Sarah Worsfold
- Faculty of MedicineUniversity of SouthamptonSouthamptonUK
| | | | - Merle Mahon
- Language and Cognition Research DepartmentUniversity College LondonLondonUK
| | - Colin Kennedy
- Faculty of MedicineUniversity of SouthamptonSouthamptonUK
| |
Collapse
|
20
|
Blythe HI, Dickins JH, Kennedy CR, Liversedge SP. Phonological processing during silent reading in teenagers who are deaf/hard of hearing: an eye movement investigation. Dev Sci 2018; 21:e12643. [PMID: 29356239 DOI: 10.1111/desc.12643] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 10/19/2017] [Indexed: 11/30/2022]
Abstract
There has been considerable variability within the literature concerning the extent to which deaf/hard of hearing individuals are able to process phonological codes during reading. Two experiments are reported in which participants' eye movements were recorded as they read sentences containing correctly spelled words (e.g., church), pseudohomophones (e.g., cherch), and spelling controls (e.g., charch). We examined both foveal processing and parafoveal pre-processing of phonology for three participant groups-teenagers with permanent childhood hearing loss (PCHL), chronological age-matched controls, and reading age-matched controls. The teenagers with PCHL showed a pseudohomophone advantage from both directly fixated words and parafoveal preview, similar to their hearing peers. These data provide strong evidence for phonological recoding during silent reading in teenagers with PCHL.
Collapse
Affiliation(s)
- Hazel I Blythe
- Department of Psychology, University of Southampton, Southampton, UK
| | | | - Colin R Kennedy
- Department of Medicine, University of Southampton, Southampton, UK
| | | |
Collapse
|
21
|
Chorozoglou M, Mahon M, Pimperton H, Worsfold S, Kennedy CR. Societal costs of permanent childhood hearing loss at teen age: a cross-sectional cohort follow-up study of universal newborn hearing screening. BMJ Paediatr Open 2018; 2:e000228. [PMID: 29637192 PMCID: PMC5887866 DOI: 10.1136/bmjpo-2017-000228] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 01/10/2018] [Accepted: 01/14/2018] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To investigate the effects in adolescence of bilateral permanent childhood hearing loss (PCHL) > 40 dB and of exposure to universal newborn hearing screening (UNHS) on societal costs accrued over the preceding 12 months. DESIGN SETTING PARTICIPANTS An observational cohort study of a sample of 110 adolescents aged 13-20 years, 73 with PCHL and 37 in a normally hearing comparison group (HCG) closely similar in respect of place and date of birth to those with PCHL, drawn from a 1992-1997 cohort of 157 000 births in Southern England, half of whom had been exposed to a UNHS programme. INTERVENTION Birth in periods with and without UNHS. OUTCOME MEASURES Resource use and costs in the preceding 12-month period, estimated from interview at a mean age of 16.9 years and review of medical records. Effects on costs were examined in regression models. RESULTS Mean total costs for participants with PCHL and the HCG were £15 914 and £5883, respectively (difference £10 031, 95% CI £6460 to £13 603), primarily driven by a difference in educational costs. Compared with the HCG, additional mean costs associated with PCHL of moderate, severe and profound severity were £5916, £6605 and £18 437, respectively. The presence of PCHL and an additional medical condition (AMC) increased costs by £15 385 (95% CI £8532 to £22 238). An increase of one unit in receptive language z-score was associated with £1616 (95% CI £842 to £2389) lower costs. Birth during periods of UNHS was not associated with significantly lower overall costs (difference £3594, 95% CI -£2918 to £10 106). CONCLUSIONS The societal cost of PCHL was greater with more severe losses and in the presence of AMC and was lower in children with superior language scores. There was no statistically significant reduction in costs associated with birth in periods with UNHS. TRIAL REGISTRATION NUMBER ISRCTN03307358, pre-results.
Collapse
Affiliation(s)
| | - Merle Mahon
- Language and Cognition Research Department, University College London, London, UK
| | | | - Sarah Worsfold
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Colin R Kennedy
- Faculty of Medicine, University of Southampton, Southampton, UK.,University Child Health, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| |
Collapse
|
22
|
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.
Collapse
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
| |
Collapse
|
23
|
Hawley KA, Goldberg DM, Anne S. Utility of a multidisciplinary approach to pediatric hearing loss. Am J Otolaryngol 2017; 38:547-550. [PMID: 28535875 DOI: 10.1016/j.amjoto.2017.05.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 05/08/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Because management of hearing loss (HL) often requires multiple specialists, a multidisciplinary clinic, Pediatric Hearing Management Clinic, (PHMC) was established to coordinate care for children with newly diagnosed HL. METHODS Retrospective review of patients seen in PHMC from February 2009 to April 2010. RESULTS Clinic information was available for 40/41 of the patients and was included in the study. 37/41 had confirmed HL. HL was categorized into bilateral/symmetric [15], bilateral/asymmetric [12] and unilateral [10]. Sixteen patients subsequently received hearing amplification after PHMC visit. Follow up was successfully established with otolaryngology in 23/32 (72%) patients, audiology in 29/40 (73%) patients, speech pathology in 11/12 (92%) patients, and ophthalmology in 15/30 (50%) patients. Twenty-nine patients completed evaluations of PHMC. The mean score in six total categories was 3.8/4.0 (4.0 as the highest satisfaction). CONCLUSION A multidisciplinary clinic approach provides a convenient and effective way to coordinate care for children with HL.
Collapse
|
24
|
Merugumala SV, Pothula V, Cooper M. Barriers to timely diagnosis and treatment for children with hearing impairment in a southern Indian city: a qualitative study of parents and clinic staff. Int J Audiol 2017; 56:733-739. [DOI: 10.1080/14992027.2017.1340678] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sri Vamshi Merugumala
- Brighton & Sussex Medical School, Brighton, UK,
- Barts and The London NHS Trust, London, UK, and
| | - Vijay Pothula
- Department of Otolaryngology, Wigan and Leigh NHS Foundation Trust, Wrightington, UK
| | - Max Cooper
- Brighton & Sussex Medical School, Brighton, UK,
| |
Collapse
|
25
|
Meinzen-Derr J, Wiley S, McAuley R, Smith L, Grether S. Technology-assisted language intervention for children who are deaf or hard-of-hearing; a pilot study of augmentative and alternative communication for enhancing language development. Disabil Rehabil Assist Technol 2016; 12:808-815. [PMID: 27982714 DOI: 10.1080/17483107.2016.1269210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Pilot study to assess the effect of augmentative and alternative communication technology to enhance language development in children who are deaf or hard-of-hearing. MATERIALS AND METHODS Five children ages 5-10 years with permanent bilateral hearing loss who were identified with language underperformance participated in an individualized 24-week structured program using the application TouchChat WordPower on iPads®. Language samples were analyzed for changes in mean length of utterance, vocabulary words and mean turn length. Repeated measures models assessed change over time. RESULTS The baseline median mean length of utterance was 2.41 (range 1.09-6.63; mean 2.88) and significantly increased over time (p = 0.002) to a median of 3.68 at final visit (range 1.97-6.81; mean 3.62). At baseline, the median total number of words spoken per language sample was 251 (range 101-458), with 100 (range 36-100) different words spoken. Total words and different words significantly increased over time (β = 26.8 (7.1), p = 0.001 for total words; β = 8.0 (2.7), p = 0.008 for different words). Mean turn length values also slightly increased over time. CONCLUSIONS Using augmentative and alternative communication technology on iPads® shows promise in supporting rapid language growth among elementary school-age children who are deaf or hard-of-hearing with language underperformance.
Collapse
Affiliation(s)
- Jareen Meinzen-Derr
- a Division of Biostatistics and Epidemiology , Cincinnati Children's Hospital Medical Center , Cincinnati , OH , United States
| | - Susan Wiley
- b Division of Developmental and Behavioral Pediatrics , Cincinnati Children's Hospital Medical Center , Cincinnati , OH , United States
| | - Rose McAuley
- b Division of Developmental and Behavioral Pediatrics , Cincinnati Children's Hospital Medical Center , Cincinnati , OH , United States
| | - Laura Smith
- a Division of Biostatistics and Epidemiology , Cincinnati Children's Hospital Medical Center , Cincinnati , OH , United States
| | - Sandra Grether
- b Division of Developmental and Behavioral Pediatrics , Cincinnati Children's Hospital Medical Center , Cincinnati , OH , United States
| |
Collapse
|
26
|
Tan J, Dowell R, Vogel A. Mandarin Lexical Tone Acquisition in Cochlear Implant Users With Prelingual Deafness: A Review. Am J Audiol 2016; 25:246-56. [PMID: 27387047 DOI: 10.1044/2016_aja-15-0069] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 02/20/2016] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this review article is to synthesize evidence from the fields of developmental linguistics and cochlear implant technology relevant to the production and perception of Mandarin lexical tone in cochlear implant users with prelingual deafness. The aim of this review was to identify potential factors that determine outcomes for tonal-language speaking cochlear implant users and possible directions for further research. METHOD A computerized database search of MEDLINE, CINAHL, Academic Search Premier, Web of Science, and Google Scholar was undertaken in June and July 2014. Search terms used were lexical tone AND tonal language, speech development AND/OR speech production AND/OR speech perception AND cochlear implants, and pitch perception AND cochlear implants, anywhere in the title or abstract. CONCLUSION Despite the demonstrated limitations of pitch perception in cochlear implant users, there is some evidence that typical production and perception of lexical tone is possible by cochlear implant users with prelingual deafness. Further studies are required to determine the factors that contribute to better outcomes to inform rehabilitation processes for cochlear implant users in tonal-language environments.
Collapse
Affiliation(s)
- Johanna Tan
- The University of Melbourne, Victoria, Australia
| | | | - Adam Vogel
- Center for Neuroscience of Speech, The University of Melbourne, Victoria, Australia
- Hertie Institute for Clinical Brain Research, Eberhard Karls Universität Tübingen, Germany
- Murdoch Childrens Research Institute, The Bruce Lefroy Centre for Genetic Health Research, Melbourne, Victoria, Australia
| |
Collapse
|
27
|
Pimperton H, Blythe H, Kreppner J, Mahon M, Peacock JL, Stevenson J, Terlektsi E, Worsfold S, Yuen HM, Kennedy CR. The impact of universal newborn hearing screening on long-term literacy outcomes: a prospective cohort study. Arch Dis Child 2016; 101:9-15. [PMID: 25425604 PMCID: PMC4717422 DOI: 10.1136/archdischild-2014-307516] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 11/09/2014] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To determine whether the benefits of universal newborn hearing screening (UNHS) seen at age 8 years persist through the second decade. DESIGN Prospective cohort study of a population sample of children with permanent childhood hearing impairment (PCHI) followed up for 17 years since birth in periods with (or without) UNHS. SETTING Birth cohort of 100 000 in southern England. PARTICIPANTS 114 teenagers aged 13-19 years, 76 with PCHI and 38 with normal hearing. All had previously their reading assessed aged 6-10 years. INTERVENTIONS Birth in periods with and without UNHS; confirmation of PCHI before and after age 9 months. MAIN OUTCOME MEASURE Reading comprehension ability. Regression modelling took account of severity of hearing loss, non-verbal ability, maternal education and main language. RESULTS Confirmation of PCHI by age 9 months was associated with significantly higher mean z-scores for reading comprehension (adjusted mean difference 1.17, 95% CI 0.36 to 1.97) although birth during periods with UNHS was not (adjusted mean difference 0.15, 95% CI -0.75 to 1.06). The gap between the reading comprehension z-scores of teenagers with early compared with late confirmed PCHI had widened at an adjusted mean rate of 0.06 per year (95% CI -0.02 to 0.13) during the 9.2-year mean interval since the previous assessment. CONCLUSIONS The benefit to reading comprehension of confirmation of PCHI by age 9 months increases during the teenage years. This strengthens the case for UNHS programmes that lead to early confirmation of permanent hearing loss. TRIAL REGISTRATION NUMBER ISRCTN03307358.
Collapse
Affiliation(s)
| | - Hazel Blythe
- Faculty of Social and Human Sciences, University of Southampton, Southampton, UK
| | - Jana Kreppner
- Faculty of Social and Human Sciences, University of Southampton, Southampton, UK
| | - Merle Mahon
- Developmental Science Research Department, UCL, London, UK
| | - Janet L Peacock
- Division of Health and Social Care Research, King's College London, NIHR Biomedical Research Centre at Guy's and St Thomas’ NHS Foundation Trust and King's College London, London, UK
| | - Jim Stevenson
- Faculty of Social and Human Sciences, University of Southampton, Southampton, UK
| | | | - Sarah Worsfold
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Ho Ming Yuen
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Colin R Kennedy
- Faculty of Medicine, University of Southampton, Southampton, UK,University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| |
Collapse
|
28
|
Mincarone P, Leo CG, Sabina S, Costantini D, Cozzolino F, Wong JB, Latini G. Evaluating reporting and process quality of publications on UNHS: a systematic review of programmes. BMC Pediatr 2015. [PMID: 26198353 PMCID: PMC4511235 DOI: 10.1186/s12887-015-0404-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Congenital hearing loss is one of the most frequent birth defects, and Early Detection and Intervention has been found to improve language outcomes. The American Academy of Pediatrics (AAP) and the Joint Committee on Infant Hearing (JCIH) established quality of care process indicators and benchmarks for Universal Newborn Hearing Screening (UNHS). We have aggregated some of these indicators/benchmarks according to the three pillars of universality, timely detection and overreferral. When dealing with inter-comparison, relying on complete and standardised literature data becomes crucial. The purpose of this paper is to verify whether literature data on UNHS programmes have included sufficient information to allow inter-programme comparisons according to the indicators considered. Methods We performed a systematic search identifying UNHS studies and assessing the quality of programmes. Results The identified 12 studies demonstrated heterogeneity in criteria for referring to further examinations during the screening phase and in identifying high-risk neonates, protocols, tests, staff, and testing environments. Our systematic review also highlighted substantial variability in reported performance data. In order to optimise the reporting of screening protocols and process performance, we propose a checklist. Another result is the difficulty in guaranteeing full respect for the criteria of universality, timely detection and overreferral. Conclusions Standardisation in reporting UNHS experiences may also have a positive impact on inter-program comparisons, hence favouring the emergence of recognised best practices. Electronic supplementary material The online version of this article (doi:10.1186/s12887-015-0404-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Pierpaolo Mincarone
- Institute for Research on Population and Social Policies, National Research Council, Rome, 00185, Italy.
| | - Carlo Giacomo Leo
- Institute of Clinical Physiology, National Research Council, Lecce, 73100, Italy. .,Division of Clinical Decision Making, Department of Medicine, Tufts Medical Center, Boston, MA, 02111, USA.
| | - Saverio Sabina
- Institute of Clinical Physiology, National Research Council, Lecce, 73100, Italy.
| | - Daniele Costantini
- Newborn Hearing Screening Service, Azienda USL7 Siena, Siena, 53100, Italy.
| | | | - John B Wong
- Division of Clinical Decision Making, Department of Medicine, Tufts Medical Center, Boston, MA, 02111, USA. .,School of Medicine, Tufts University, Boston, MA, 02111, USA.
| | - Giuseppe Latini
- Institute of Clinical Physiology, National Research Council, Lecce, 73100, Italy. .,Division of Neonatology, "Perrino" Hospital, ASL Brindisi, Brindisi, 72100, Italy.
| |
Collapse
|
29
|
Abstract
OBJECTIVE The primary aim of this study was to investigate the relationship between language levels and communication and social function skills in young children who are deaf/hard-of-hearing. METHOD A cross-sectional design was used with participants sampled predominately from a single clinic setting. Children between 3 and 6 years of age with permanent bilateral hearing loss were enrolled in the study. All children received the Preschool Language Scales-Fifth Edition language assessment and a neurocognitive assessment using the Leiter International Performance Scale-Revised at the study visit. Communication and social function skills were measured using the Vineland Adaptive Behavior Scales-Second Edition (VABS-II; mean 100 ± 15) and the Pediatric Evaluation of Disability Inventory (PEDI; mean 50 ± 10). RESULTS Analysis included 65 children with mild to profound bilateral hearing loss (mean age 56.8 months, SD ± 14.1); 52% had hearing loss in the mild to moderate range. The mean nonverbal intelligence quotient (IQ) was 95.7 (±18.8), the mean receptive language standard score was 83.7 (±18.6), and mean expressive language standard score was 83.0 (±18.5). The mean VABS-II communication standard score was 89.1 (±17.5), and the mean PEDI social function score was 39.6 (±15.3). Both nonverbal IQ and receptive language relative to nonverbal IQ (the ratio of language to IQ) were significantly associated with communication and social functioning, explaining more than 50% of the variance in communication function scores. Children with language commensurate with their IQ had significantly higher communication and social function scores than children with language significantly lower than IQ. This finding was consistent across different levels of IQ and independent of degree of hearing loss. CONCLUSION Even with early identification and intervention, hearing loss continues to have a life-long impact on functioning. It is important to identify when language levels are not meeting a child's capabilities in order to intervene most effectively.
Collapse
|
30
|
Uhler K, Thomson V, Cyr N, Gabbard SA, Yoshinaga-Itano C. State and Territory EHDI Databases: What We Do and Don't Know About the Hearing or Audiological Data From Identified Children. Am J Audiol 2014; 23:34-43. [DOI: 10.1044/1059-0889(2013/13-0015)] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose
The purpose of this study was to define the information currently collected by state and territory Early Hearing Detection and Intervention (EHDI) coordinators and to determine whether best practice guidelines are used.
Method
A multiple-choice electronic survey querying areas of diagnostic assessment, amplification, early intervention (EI) and medical information regarding hearing loss was sent to all state and territory EHDI coordinators.
Results
Seventy percent of surveys were completed. Diagnostic, amplification, and Part C services were tracked by the majority of respondents. Additionally, medical prenatal and postnatal risks were collected.
Conclusion
Data collected on audiologic screening and diagnostic evaluations has increased. On the basis of these results, it is difficult to discern whether best practices are being used for each child. A delay in reporting a confirmed hearing loss was observed. Amplification results suggest that systems are not in place to ensure consistency and accountability for fitting amplification in infants. The results of this survey identified audiologic and EI information tracked by states to help provide a framework to monitor quality care in the future.
Collapse
Affiliation(s)
- Kristin Uhler
- Marion Downs Hearing Center at the University of Colorado Hospital, University of Colorado at Boulder
| | - Vickie Thomson
- Marion Downs Hearing Center at the University of Colorado Hospital, University of Colorado at Boulder
| | - Nicole Cyr
- Marion Downs Hearing Center at the University of Colorado Hospital, University of Colorado at Boulder
| | - Sandra Abbott Gabbard
- Marion Downs Hearing Center at the University of Colorado Hospital, University of Colorado at Boulder
| | - Christine Yoshinaga-Itano
- Marion Downs Hearing Center at the University of Colorado Hospital, University of Colorado at Boulder
| |
Collapse
|
31
|
Lü J, Huang Z, Ma Y, Li Y, Mei L, Yao G, Wang Y, Shen X, Wu H. Comparison between hearing screening-detected cases and sporadic cases of delayed-onset hearing loss in preschool-age children. Int J Audiol 2014; 53:229-34. [DOI: 10.3109/14992027.2013.858278] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
32
|
Blaiser KM, Behl D, Callow-Heusser C, White KR. Measuring Costs and Outcomes of Tele-Intervention When Serving Families of Children who are Deaf/Hard-of-Hearing. Int J Telerehabil 2013; 5:3-10. [PMID: 25945213 PMCID: PMC4352990 DOI: 10.5195/ijt.2013.6129] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Optimal outcomes for children who are deaf/hard-of-hearing (DHH) depend on access to high quality, specialized early intervention services. Tele-intervention (TI), the delivery of early intervention services via telehealth technology, has the potential to meet this need in a cost-effective manner. METHOD Twenty-seven families of infants and toddlers with varying degrees of hearing loss participated in a randomized study, receiving their services primarily through TI or via traditional in-person home visits. Pre- and post-test measures of child outcomes, family and provider satisfaction, and costs were collected. RESULTS The TI group scored statistically significantly higher on the expressive language measure than the in-person group (p =.03). A measure of home visit quality revealed that the TI group scored statistically significantly better on the Parent Engagement subscale of the Home Visit Rating Scales-Adapted & Extended (HOVRS-A+; Roggman et al., 2012). Cost savings associated with providing services via TI increased as the intensity of service delivery increased. Although most providers and families were positive about TI, there was great variability in their perceptions. CONCLUSIONS Tele-intervention is a promising cost-effective method for delivering high quality early intervention services to families of children who are DHH.
Collapse
Affiliation(s)
- Kristina M Blaiser
- Department of Communicative Disorders and Deaf Education, College of Education and Human Services, Utah State University, Logan, UT
| | - Diane Behl
- National Center for Hearing Assessment and Management, Utah State University, Logan, UT
| | | | - Karl R White
- National Center for Hearing Assessment and Management, Utah State University, Logan, UT
| |
Collapse
|
33
|
Lieu JEC, Ratnaraj F, Ead B. Evaluating a prediction model for infant hearing loss. Laryngoscope 2013; 123:2873-9. [PMID: 23564305 DOI: 10.1002/lary.24033] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 12/13/2012] [Accepted: 01/14/2013] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS The objective of this study was to determine whether a prognostic model using risk factors for hearing loss could predict the chance that infants who failed a newborn hearing screen would subsequently be found to have hearing loss diagnosed by auditory brainstem response testing. STUDY DESIGN Individual retrospective case-control study. METHODS We studied 229 infants with hearing loss compared with 458 infants with normal hearing. All infants had undergone natural sleep or sedated auditory brainstem response, predominantly for not passing a newborn hearing screen. Risk factors, birth history, and other information were extracted via medical record review. Multiple logistic regression analyses identified independent predictors of hearing loss. RESULTS Four risk factors were independently predictive of hearing loss diagnosed by sleep or sedated auditory brainstem response: prematurity, 5-minute APGAR score ≤ 6, intracranial complication, and craniofacial abnormality. A prognostic model developed from these risk factors was associated with a 15% rate of hearing loss in stage I, 52% rate of hearing loss in stage II, and 96% rate of hearing loss in stage III. CONCLUSIONS The presence of any one of four independently predictive risk factors in infants who did not pass newborn hearing screen was associated with a 50% rate of hearing loss; having three or more was associated with a 90% rate of hearing loss. Knowing that an infant is at high risk of hearing loss can motivate parents to follow up with diagnostic auditory brainstem response testing so that early identification can lead to early intervention.
Collapse
Affiliation(s)
- Judith E C Lieu
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, U.S.A
| | | | | |
Collapse
|
34
|
Al-Rowaily MA, AlFayez AI, AlJomiey MS, AlBadr AM, Abolfotouh MA. Hearing impairments among Saudi preschool children. Int J Pediatr Otorhinolaryngol 2012; 76:1674-7. [PMID: 22921777 DOI: 10.1016/j.ijporl.2012.08.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Revised: 07/29/2012] [Accepted: 08/02/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Hearing loss among school-entrant children in the developing world has been widely reported as a significant health problem. Failure to detect hearing loss, either congenital or acquired, in children may result in lifelong deficits in speech and language acquisition. The aims of this study were: (1) to estimate the prevalence of hearing loss and (2) to identify its different types. METHODS This is a cross-sectional study that included all children (n=2574) aged 4-8 years who attended the obligatory health examination for kindergarten (=370) and primary school (n=2204) entry at the school health center of King Abdulaziz Medical City, Riyadh, Saudi Arabia, from March 2009 to December 2010. Pure-tone air conduction audiometry was conducted for each child in a sound-treated room followed by a diagnostic test. Tympanometry was performed as a complement to the overall objectives of a hearing screening program. RESULTS A total of 45 children were diagnosed with hearing impairment (84.4% conductive and 15.6% sensori-neural), with an overall prevalence of 1.75% (95% C.I.: 1.25, 2.25). The majority of cases were females (71.1%), of school age (80.0%), with conductive deafness (84.4%). More than one-half of cases had bilateral deafness (55.6%) of mild degree (57.8%). As for conductive deafness, otitis media with effusion ranked first as a cause of deafness (34.9%), followed by wax and chronic otitis media (23.3% each), while traumatic perforated drum came last (2.3%). Sensorineural deafness constituted 16.2% of all cases. CONCLUSION Conductive hearing loss is the primary type of hearing loss among children and is easy to correct. The urgent development of audiological services in other school health centers in the country, particularly those with good referral systems to Ministry of Health hospitals, is needed. Evidence-based guidelines to identify, monitor, and manage otitis media with effusion (OME) in children in the primary healthcare setting and a strategy to prevent hearing loss are recommended.
Collapse
Affiliation(s)
- Mohammed A Al-Rowaily
- Family and Community Medicine Department, King Saud bin Abdul-Aziz University for Health Sciences, Riyadh NGHA, Saudi Arabia.
| | | | | | | | | |
Collapse
|
35
|
Abstract
The present statement reviews the evidence for universal newborn hearing screening (UNHS). A systematic review of the literature was conducted using Medline and using search dates from 1996 to the third week of August 2009. The following search terms were used: neonatal screening AND hearing loss AND hearing disorders. The key phrase "universal newborn hearing screening" was also searched. The Cochrane Central Register of Controlled Trials and systematic reviews was searched. Three systematic reviews, one controlled non-randomized trial and multiple cohort studies were found. It was determined that there was satisfactory evidence to support UNHS. The results of the available literature are consistent and indicate clear evidence that without UNHS, delayed diagnosis leads to significant harm for children and their families; with UNHS, diagnosis and intervention occur earlier; earlier intervention translates to improved language outcomes; and in well-run programs, there is negligible harm from screening.
Collapse
|
36
|
Pimperton H, Kennedy CR. The impact of early identification of permanent childhood hearing impairment on speech and language outcomes. Arch Dis Child 2012; 97:648-53. [PMID: 22550319 DOI: 10.1136/archdischild-2011-301501] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
It is well established that permanent childhood hearing impairment (PCHI) has a detrimental impact on speech and language development. The past two decades have seen the gradual introduction of universal newborn hearing screening (UNHS) programmes coupled with early intervention programmes. We review studies that have capitalised on the advent of newborn hearing screening to assess the impact of early identification of PCHI on language outcomes in deaf children. The research supports the conclusion that, in children with PCHI, newborn hearing screening and early identification lead to beneficial effects on language development, with the most consistent evidence provided for links between early identification of PCHI and positive language outcomes. Future research needs to encompass a wider range of outcomes and to assess the impact of UNHS in adolescents and young adults.
Collapse
Affiliation(s)
- Hannah Pimperton
- Clinical Neurosciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | | |
Collapse
|
37
|
Ross DS, Visser SN. Pediatric primary care physicians' practices regarding newborn hearing screening. J Prim Care Community Health 2012; 3:256-63. [PMID: 23804171 DOI: 10.1177/2150131912440283] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Approximately 2 to 3 out of 1000 infants are born with hearing loss in the United States each year. Pediatric primary care physicians (PCPs) can play an important role in ensuring that infants with hearing loss are identified early and provided appropriate services. In this study, pediatric PCPs were surveyed about their practices regarding early hearing detection and intervention. METHODS Responses from the 2008 DocStyles survey were used to examine patient, physician, and practice variables associated with actions consistent with the 2007 Joint Committee on Infant Hearing position statement, which includes follow-up protocols for medical home providers. RESULTS Pediatricians working in a group setting were more likely to receive hearing screening results than were those in individual practices or hospitals and clinics. Family/general physicians with heavier caseloads were more likely to receive hearing screening results for their pediatric patients than were those with lighter caseloads. Few pediatric PCPs reported contacting their state's early hearing detection and intervention program if they knew that an infant failed the newborn hearing screening. Although high proportions of pediatric PCPs reported referring an infant with hearing loss to an otolaryngologist, only about half reported referring a child with risk factors for hearing loss for audiological and speech-language assessment, even if the parents expressed concern or if the results of a developmental screening indicated a possible delay. Few respondents reported referring an infant with hearing loss under their care to an ophthalmologist. CONCLUSIONS This study highlights the need to improve infrastructure for pediatric PCPs to receive and request infant hearing screening results to facilitate reporting and coordinate follow-up services for infants identified with hearing loss.
Collapse
Affiliation(s)
- Danielle S Ross
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | |
Collapse
|
38
|
Lü J, Huang Z, Yang T, Li Y, Mei L, Xiang M, Chai Y, Li X, Li L, Yao G, Wang Y, Shen X, Wu H. Screening for delayed-onset hearing loss in preschool children who previously passed the newborn hearing screening. Int J Pediatr Otorhinolaryngol 2011; 75:1045-9. [PMID: 21705096 DOI: 10.1016/j.ijporl.2011.05.022] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Revised: 05/24/2011] [Accepted: 05/30/2011] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The goal of this study was to investigate the prevalence of delayed-onset hearing loss in preschool children who previously passed newborn hearing screening in Shanghai, China. METHODS Between October 2009 and September 2010, 21,427 preschool children were enrolled from five areas of Shanghai, who had passed newborn hearing screening. Children were screened for delayed-onset hearing loss with pediatric audiometers. Children with positive results in initial and re-screening tests were assessed audiologically and for risk indicators according to the Year 2007 Statement of the American Joint Committee on Infant Hearing (JCIH). RESULTS During the study period, 445 children (2.08%) were referred for audiologic assessment; 16 (0.75/1000, 95% CI 0.38-1.12) had permanent delayed-onset hearing loss. Of these, five (0.23/1000) had bilateral moderate hearing loss; seven (0.33/1000) had mild bilateral hearing loss; and four (0.19/1000) had unilateral moderate or mild hearing loss. JCIH risk indicators were established for six children (6/16, 37.5%), including parental concern regarding speech and language developmental delay, neonatal intensive care unit with assisted ventilation or hyperbilirubinemia, recurrent otitis media with effusion, craniofacial malformation, and family history (n=1 for each). The remaining ten (62.5%) had no related risk factors. CONCLUSIONS A significant proportion of preschool children have undiagnosed delayed-onset hearing loss. Hearing screening in preschool is recommended for an early detection.
Collapse
Affiliation(s)
- Jingrong Lü
- Department of Otolaryngology-Head & Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
van Dommelen P, van Straaten HLM, Verkerk PH. Ten-year quality assurance of the nationwide hearing screening programme in Dutch neonatal intensive care units. Acta Paediatr 2011; 100:1097-103. [PMID: 21342253 DOI: 10.1111/j.1651-2227.2011.02230.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To evaluate 10-year quality assurance of newborn hearing screening (NHS) in Dutch neonatal intensive care units (NICU). METHODS Results of the two-stage automated auditory brainstem response (AABR) screening and diagnostic examination in NICU graduates were centrally registered between October 1998 and December 2008. This registration facilitates screening, tracking and follow-up after abnormal screening results. Outcome measures are referral rates, prevalence rate of hearing loss and (trends of) coverage rates and timeliness of follow-up. RESULTS Thirty-two thousand one hundred and two infants have been screened. Referral rates were 9.2% at the first and 26.3% at the second stage. Hearing loss was diagnosed in 728 infants (2.2%). Coverage rates were 98.7% at the first, 92.1% at the second stage, 92.3% for the diagnostic examination and 97.9% for the complete programme. After correction for gestational age, 95.8% of the infants had their first AABR<1 month, 81.8% of the referred infants had their second AABR<6 weeks and 67.1% were diagnosed<3 months. There was a positive trend in referred infants that had their second AABR<6 weeks (p=0.004) as well as in infants diagnosed<3 months (p<0.001). CONCLUSION The NHS in Dutch NICUs is effective. Timely identification of hearing loss is improving over time.
Collapse
Affiliation(s)
- P van Dommelen
- Department of Statistics, TNO Quality of Life, Leiden, The Netherlands.
| | | | | |
Collapse
|
40
|
Affiliation(s)
- Andrej Kral
- Institute of Audioneurotechnology and the Department of Experimental Otology, Ear, Nose, and Throat Clinics, Medical University Hannover, Hannover, Germany.
| | | |
Collapse
|
41
|
Worsfold S, Mahon M, Yuen HM, Kennedy C. Narrative skills following early confirmation of permanent childhood hearing impairment. Dev Med Child Neurol 2010; 52:922-8. [PMID: 20187874 DOI: 10.1111/j.1469-8749.2010.03641.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
AIM the aim of this study was to compare spoken language production in children with permanent childhood hearing impairment (PCHI) whose PCHI was confirmed either early or late. METHOD audio-taped spoken narrative was assessed for syntax, phonology, morphology, and narrative in transcripts from a population-based sample of 89 children (49 males, 40 females; age mean age 7y 7mo, SD1y 1mo, range 6y 6mo-10y 9mo) with bilateral PCHI (≥ 40dB hearing loss) and a comparison group of 63 children (37 males, 26 females; mean age 8y 1mo; SD 1y) with normal hearing. Of the 89 children with PCHI, 41 (21 males, 20 females) had their hearing impairment confirmed by the age of 9 months. All children with PCHI were tested with hearing aids in place, including 16 with cochlear implants. The group of children whose PCHI had been confirmed by age 9 months was compared with the group with later confirmation of PCHI using regression models on the outcome measures. RESULTS compared with those with late-confirmed PCHI, children with early-confirmed PCHI used significantly more sentences (mean difference 2.7; 95% confidence interval [CI] 0.49-5.24; p=0.019) and categories of high-pitched morphological markers (mean difference 6.64; 95% CI 1.96-11.31; p=0.006). The number of categories of low-pitched morphological markers, phonological simplifications, and sentences with multiple clauses did not differ between groups. The odds ratios (95% CI) of superior narrative structure and narrative content in children whose PCHI was confirmed early were 3.03 (1.09-8.46; p=0.034) and 4.43 (1.52-12.89; p=0.006) respectively. INTERPRETATION early confirmation compared with late confirmation of PCHI was associated with benefit to narrative skills and to certain expressive aspects of syntax and morphology, but not expressive phonology.
Collapse
Affiliation(s)
- Sarah Worsfold
- Clinical Neurosciences, School of Medicine, University of Southampton, Southampton, UK.
| | | | | | | |
Collapse
|
42
|
Limb SJ, McManus MA, Fox HB, White KR, Forsman I. Ensuring financial access to hearing AIDS for infants and young children. Pediatrics 2010; 126 Suppl 1:S43-51. [PMID: 20679323 DOI: 10.1542/peds.2010-0354i] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Many young children with permanent hearing loss do not receive hearing aids and related professional services, in part because of public and private financing limitations. In 2006 the Children's Audiology Financing Workgroup was convened by the National Center for Hearing Assessment and Management to evaluate and make recommendations about public and private financing of hearing aids and related professional services for 0- to 3-year-old children. The workgroup recommended 4 possible strategies for ensuring that all infants and young children with hearing loss have access to appropriate hearing aids and professional services: (1) clarify that the definition of assistive technology, which is a required service under Part C of the Individuals With Disabilities Education Act (IDEA), includes not only analog hearing aids but also digital hearing aids with appropriate features as needed by young children with hearing loss; (2) clarify for both state Medicaid and Children's Health Insurance Programs that digital hearing aids are almost always the medically necessary type of hearing aid required for infants and young children and should be covered under the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program; (3) encourage the passage of private health insurance legislative mandates to require coverage of appropriate digital hearing aids and related professional services for infants and young children; and (4) establish hearing-aid loaner programs in every state. The costs of providing hearing aids to all 0- to 3-year old children in the United States are estimated here.
Collapse
Affiliation(s)
- Stephanie J Limb
- Maternal and Child Health Policy Research Center, Washington, DC 20006, USA
| | | | | | | | | |
Collapse
|
43
|
White KR, Forsman I, Eichwald J, Munoz K. The evolution of early hearing detection and intervention programs in the United States. Semin Perinatol 2010; 34:170-9. [PMID: 20207267 DOI: 10.1053/j.semperi.2009.12.009] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Identifying and treating children with congenital hearing loss during the first few months of life is a relatively new concept. To assist states in the development of statewide Early Hearing Detection and Intervention programs, the federal government provides grants and/or cooperative agreements to almost all states and has established "National Goals, Program Objectives and Performance Measures" to guide the development and implementation of those systems. This article reviews the history of newborn hearing screening programs in the United States, summarizes the content of legislation and regulations passed by states related to universal newborn hearing screening, and describes how well each National Goal has been addressed. Although substantial progress has been made in the percentage of infants screened for hearing loss before hospital discharge, significant improvement is needed with respect to the availability of pediatric audiologists, implementation of effective tracking and data management systems, program evaluation and quality assurance, availability of appropriate early intervention programs, and linkages with medical home providers.
Collapse
Affiliation(s)
- Karl R White
- National Center for Hearing Assessment and Management (NCHAM), Utah State University, Logan, UT 84322-2880, USA.
| | | | | | | |
Collapse
|
44
|
Stevenson J, McCann D, Watkin P, Worsfold S, Kennedy C. The relationship between language development and behaviour problems in children with hearing loss. J Child Psychol Psychiatry 2010; 51:77-83. [PMID: 19686333 DOI: 10.1111/j.1469-7610.2009.02124.x] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND There are well-replicated findings that link poor development on a range of communication skills with increased behavioural problems. This paper examines this relationship in children with hearing loss. METHOD One hundred and twenty children with hearing loss (67 boys, 53 girls) and 63 hearing children (37 boys, 26 girls) with a mean age of 8 years from eight districts in Southern England were assessed for receptive and expressive language skills. The relationships between these measures and an aggregate of parent- and teacher-reported behaviour problems in the children were investigated. RESULTS Children with hearing loss had higher levels of behaviour problems compared to hearing children. Once the language abilities of children with hearing loss are taken into account, the negative effects of hearing loss on behaviour disappear. CONCLUSIONS Behaviour problems are found more commonly in children with hearing loss and the level of behaviour problems is highest amongst those children with hearing loss with the least developed language capabilities.
Collapse
|
45
|
Grosse SD, Dollard S, Ross DS, Cannon M. Newborn screening for congenital cytomegalovirus: Options for hospital-based and public health programs. J Clin Virol 2009; 46 Suppl 4:S32-6. [PMID: 19783205 DOI: 10.1016/j.jcv.2009.08.019] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2009] [Revised: 07/18/2009] [Accepted: 08/22/2009] [Indexed: 12/30/2022]
Abstract
BACKGROUND Congenital cytomegalovirus (CMV) infection is a leading cause of sensorineural hearing loss (SNHL) and developmental disability in children. Early identification of infected children through screening could allow for early intervention and improvement in functional outcomes among the subset who develop sequelae. OBJECTIVES To outline potential options and strategies for screening newborns for congenital CMV infection and to discuss barriers to screening and data needs to inform future policy decisions. STUDY DESIGN Commentary based on the literature and expert opinion on newborn dried blood spot screening, newborn hearing screening/Early Hearing Detection and Intervention (EHDI) programs, and congenital CMV. RESULTS Although no population-based screening for congenital CMV is underway, pilot newborn screening studies using a variety of assays with urine or dried blood spot specimens are underway. Challenges to screening are both practical-uncertain sensitivity of blood spot assays suitable for large-scale screening and lack of infrastructure for collection of urine specimens; and evidentiary-the need to demonstrate improved outcomes and value of screening to offset the expense and potential adverse psychosocial consequences for children and families whose children require periodic monitoring but never develop sequelae. CONCLUSIONS Screening for congenital CMV infection is a potentially important intervention that merits additional research, including the logistical feasibility of different screening options and psychosocial consequences for families.
Collapse
Affiliation(s)
- Scott D Grosse
- National Center on Birth Defects and Developmental Disabilities, USA.
| | | | | | | |
Collapse
|