Outcomes for Children With HL: Effects of Age of ID, Sign Support, and Auditory Prosthesis

2008 ◽  
Vol 18 (2) ◽  
pp. 74-82 ◽  
Author(s):  
Susan Nittrouer

Abstract The purpose of the project reported here was to examine the effects of three independent variables on developmental outcomes for children with hearing loss (HL): age of identification of hearing loss, whether or not spoken language input was supported with signs and whether children used hearing aids (HAs) or cochlear implants (CI). Children with and without hearing loss were tested multiple times between 12 and 48 months of age, at their 6-month birthdays. Dependent variables were selected to examine all aspects of child development: receptive and expressive language, psychosocial components of personality, deleterious behaviors, adaptive behaviors, parental language style, and levels of parenting stress. Results support several main findings: None of the independent variables had any significant effect on any dependent variable unrelated to language. Mean levels of all language skills were delayed for all groups of children with HL, even those children identified at birth with only moderate losses that could be appropriately aided with HAs. For children with losses identified at birth, the use or nonuse of signs to support spoken language input did not affect language outcomes in the long run. Within the restricted range examined here, age of identification did not affect language outcomes, if children were not getting sign support; children with late-identified hearing loss receiving sign support were more delayed on all language measures than other children with HL. Regarding prosthesis, some experience using HAs was associated with better outcomes, even if children eventually received CIs. A parental language style that involved being very verbally responsive to the child's communicative attempts was strongly associated with positive language outcomes.

2021 ◽  
pp. 105381512110252
Author(s):  
Brittany Grey ◽  
Elizabeth K. Deutchki ◽  
Emily A. Lund ◽  
Krystal L. Werfel

This study compared preschool spoken language outcomes for children with hearing loss who met the Early Hearing Detection and Intervention (EHDI) guidelines to those who did not, as well as compared outcomes for those who met the current EHDI guidelines to those who met the earlier benchmarks. Finally, the predictive role of meeting each component of the guidelines was evaluated relative to language outcomes. Children who met the EHDI guidelines had higher language scores than those who did not; however, there was no difference between children who met the current guidelines and those who met the earlier benchmarks. Entering early intervention by 6 months of age was the only unique predictor of spoken language outcomes. The findings suggest that EHDI programs should target increasing the number of children with hearing loss who meet the current 1-3-6 benchmarks with a particular focus on enrollment in early intervention by 6 months.


2020 ◽  
Vol 63 (1) ◽  
pp. 234-258 ◽  
Author(s):  
Susan Nittrouer ◽  
Joanna H. Lowenstein ◽  
Joseph Antonelli

Purpose Parental language input (PLI) has reliably been found to influence child language development for children at risk of language delay, but previous work has generally restricted observations to the preschool years. The current study examined whether PLI during the early years explains variability in the spoken language abilities of children with hearing loss at those young ages, as well as later in childhood. Participants One hundred children participated: 34 with normal hearing, 24 with moderate losses who used hearing aids (HAs), and 42 with severe-to-profound losses who used cochlear implants (CIs). Mean socioeconomic status was middle class for all groups. Children with CIs generally received them early. Method Samples of parent–child interactions were analyzed to characterize PLI during the preschool years. Child language abilities (CLAs) were assessed at 48 months and 10 years of age. Results No differences were observed across groups in how parents interacted with their children. Nonetheless, strong differences across groups were observed in the effects of PLI on CLAs at 48 months of age: Children with normal hearing were largely resilient to their parents' language styles. Children with HAs were most influenced by the amount of PLI. Children with CIs were most influenced by PLI that evoked child language and modeled more complex versions. When potential influences of preschool PLI on CLAs at 10 years of age were examined, those effects at preschool were replicated. When mediation analyses were performed, however, it was found that the influences of preschool PLI on CLAs at 10 years of age were partially mediated by CLAs at preschool. Conclusion PLI is critical to the long-term spoken language abilities of children with hearing loss, but the style of input that is most effective varies depending on the severity of risk for delay.


2010 ◽  
Vol 20 (1) ◽  
pp. 3-11 ◽  
Author(s):  
Christine Yoshinaga-Itano

Abstract It is possible for children who are deaf or hard of hearing to attain language development comparable to their hearing peers, but these outcomes are not guaranteed. The population of children with hearing loss is a diverse population and although the variable of the age of identification is less variable, there are numerous variables that could potentially and have historically impacted language outcomes of children who are deaf or hard of hearing. Variables such as hearing loss, maternal level of education, and maternal bonding can overcome the benefits of earlier identification and intervention.


2010 ◽  
Vol 20 (1) ◽  
pp. 27-31
Author(s):  
Lyn Robertson

Abstract Learning to listen and speak are well-established preludes for reading, writing, and succeeding in mainstream educational settings. Intangibles beyond the ubiquitous test scores that typically serve as markers for progress in children with hearing loss are embedded in descriptions of the educational and social development of four young women. All were diagnosed with severe-to-profound or profound hearing loss as toddlers, and all were fitted with hearing aids and given listening and spoken language therapy. Compiling stories across the life span provides insights into what we can be doing in the lives of young children with hearing loss.


2019 ◽  
Vol 9 (2) ◽  
pp. 153 ◽  
Author(s):  
Frush Holt

Radical advancements in hearing technology in the last 30 years have offered some deaf and hard-of-hearing (DHH) children the adequate auditory access necessary to acquire spoken language with high-quality early intervention. However, meaningful achievement gaps in reading and spoken language persist despite the engineering marvel of modern hearing aids and cochlear implants. Moreover, there is enormous unexplained variability in spoken language and literacy outcomes. Aspects of signal processing in both hearing aids and cochlear implants are discussed as they relate to spoken language outcomes in preschool and school-age children. In suggesting areas for future research, a case is made for not only expanding the search for mechanisms of influence on outcomes outside of traditional device- and child-related factors, but also for framing the search within Biopsychosocial systems theories. This theoretical approach incorporates systems of risk factors across many levels, as well as the bidirectional and complex ways in which factors influence each other. The combination of sophisticated hearing technology and a fuller understanding of the complex environmental and biological factors that shape development will help maximize spoken language outcomes in DHH children and contribute to laying the groundwork for successful literacy and academic development.


2017 ◽  
Vol 2 (9) ◽  
pp. 10-24 ◽  
Author(s):  
Jena McDaniel ◽  
Stephen Camarata

Purpose We review the evidence for attenuating visual input during intervention to enhance auditory development and ultimately improve spoken language outcomes in children with cochlear implants. Background Isolating the auditory sense is a long-standing tradition in many approaches for teaching children with hearing loss. However, the evidence base for this practice is surprisingly limited and not straightforward. We review four bodies of evidence that inform whether or not visual input inhibits auditory development in children with cochlear implants: (a) audiovisual benefits for speech perception and understanding for individuals with typical hearing, (b) audiovisual integration development in children with typical hearing, (c) sensory deprivation and neural plasticity, and (d) audiovisual processing in individuals with hearing loss. Conclusions Although there is a compelling theoretical rationale for reducing visual input to enhance auditory development, there is also a strong theoretical argument supporting simultaneous multisensory auditory and visual input to potentially enhance outcomes in children with hearing loss. Despite widespread and long-standing practice recommendations to limit visual input, there is a paucity of evidence supporting this recommendation and no evidence that simultaneous multisensory input is deleterious to children with cochlear implants. These findings have important implications for optimizing spoken language outcomes in children with cochlear implants.


Author(s):  
Kristin Uhler ◽  
Shannon M. Burns ◽  
Molly Dalpes ◽  
Christine Yoshinaga-Itano

A sample of children from Spanish-speaking homes who are hard-of-hearing demonstrated less than optimal outcomes following cochlear implantation. The authors developed a unique diagnostic protocol to identify potential causes. Inclusion criteria included hearing loss identified by 3 months of age, amplification, a Spanish-speaking home, and enrollment in the statewide early intervention system by 6-months of age. The authors collected extensive demographic data from participants, and the participants completed the same language assessments in 6-month time intervals, examining receptive and expressive language as well as parent-child interaction. Additional assessments included cortical auditory-evoked potentials (i.e., P1), infant speech perception, auditory skill questionnaires, and audio recordings taken over a 12–16 hour period in the child's natural language environment. This auditory spoken language matrix allowed identification of good auditory performers who performed poorly on expressive language measures and poor auditory performers with poor expressive and receptive language outcomes. The comprehensive nature of the assessment allowed examination of spoken language input and helped determine if poor language outcomes were associated with a lack of spoken language input (Hart & Risely, 1995). This matrix allowed the authors to rule out audibility, discrimination, auditory development, and quality of exposure to auditory spoken language as causes of delayed development. The article discusses additional benefits of using this protocol.


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