Archives of Disease in Childhood · 2005 · 161 citations · 20 references
Health ProfessionsAudiologyPediatricsHearing AidsHearing AssessmentPediatric AudiologyAudiologic EvaluationHearing ImpairmentHearing LossLanguage ImpairmentPediatric Diagnostic AudiologyPediatric Hearing AssessmentDiagnostic Audiology In ChildrenLanguage Development After Hearing InterventionLong-term Disability BenefitsOutcome MeasuresPediatric Audiologic AssessmentPediatric Audiometric AssessmentPediatric Hearing AidsSelf-fitting Hearing Aids
Early diagnosis of hearing impairment in preschool children is associated with better language outcomes regardless of severity. The study aims to evaluate how age at diagnosis and severity of hearing impairment affect language outcomes in 7‑8‑year‑old children, and to identify factors influencing good or poor outcomes. Language performance was assessed using CELF and PPVT, with predictors of pure‑tone average and age at diagnosis modeled via general linear models. Among 89 children, mean age at diagnosis was 21.6 months; severity of hearing impairment, but not age at diagnosis, was associated with lower CELF and PPVT scores, indicating that more severe HI predicts poorer language outcomes at 7‑8 years.
Better language outcomes are reported for preschool children with hearing impairment (HI) diagnosed very early, irrespective of severity. However, population studies of older children are required to substantiate longer term benefits of early detection.To study impact of age of diagnosis and severity of HI in a population cohort of 7-8 year old children.Eighty eight 7-8 year old children born in Victoria, who were (a) fitted with hearing aids for congenital HI by 4.5 years and (b) did not have intellectual or major physical disability were studied. Main outcome measures were Clinical Evaluation of Language Fundamentals (CELF) and Peabody Picture Vocabulary Test (PPVT). Predictors were pure tone average (0.5, 1, 2 kHz) in better ear at diagnosis and age at diagnosis. Marginal (adjusted) means were estimated with general linear models.Response rate was 67% (n = 89; 53 boys). Mean age at diagnosis was 21.6 months (SD 14.4); 21% had mild, 34% moderate, 21% severe, and 24% profound HI; mean non-verbal IQ was 104.6 (SD 16.7). Mean total CELF score was 76.7 (SD 21.4) and mean PPVT score 78.1 (SD 18.1). Age of diagnosis, adjusted for severity and IQ, did not contribute to language scores. In contrast, adjusted mean CELF and PPVT language scores fell sequentially with increasing severity of HI.More severe HI, but not later diagnosis, was strongly related to poorer language outcomes at 7-8 years. Further systematic study is needed to understand why children with hearing impairment have good or poor outcomes.
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Language of Early- and Later-identified Children With Hearing Loss
Christine Yoshinaga‐Itano, Allison L. Sedey, Diane K. Coulter et al. · PEDIATRICS · 1998 · 2.1K citations