Objective To determine whether audiologic characteristics of unilateral hearing loss in children were associated with language, cognitive or achievement scores. Study design Case-control study Setting Pediatric otolaryngology ambulatory practice Patients Cases (n=109) were children aged 6–12 years with permanent unilateral hearing loss; controls (n=95) were siblings with normal bilateral hearing. Interventions Audiologic characteristics measured included side and severity of hearing loss, and word recognition scores in quiet and in noise. Main outcome measures Cognitive abilities were measured using the Wechsler Abbreviated Scale of Intelligence; reading, math and writing achievement was measured with the Wechsler Individual Achievement Test-Second Edition-Abbreviated; and oral language skills were measured with the Oral Written and Language Scales. Results Children with unilateral hearing loss had worse verbal cognitive and oral language scores than children with normal hearing, but no differences in achievement scores. Children with profound unilateral hearing loss tended to have worse cognitive scores and had significantly lower oral language scores. Higher word recognition scores in quiet of the normal hearing ear were associated with higher cognitive, oral language, and reading achievement scores. Higher word recognition scores in noise were slightly correlated with higher oral language scores. Conclusions As expected, children with unilateral hearing loss had worse language scores than their siblings with normal hearing with trends toward worse cognitive scores. Children with profound unilateral hearing loss tended to have worse outcomes than children with normal hearing or less severe unilateral loss. However, there were no differences in outcomes between children with right or left unilateral hearing loss.

Objective To determine whether patterns of functional connectivity of cortical regions responsible for auditory processing and executive functions differ in children with unilateral hearing loss (UHL) versus their normal hearing (NH) siblings. Study Design Prospective observational study Setting Academic medical center Subjects and Methods Children with severe-to-profound UHL (9 right UHL, 7 left UHL) and 10 NH sibling controls were imaged using resting state functional connectivity MRI (rs-fcMRI). All MRI images were transformed to a single common atlas; regions of interest (ROI) were chosen based on previous literature and unpublished results. Mean region-wise correlations and conjunction analyses were performed across 34 seed ROIs to identify temporally synchronized, low-frequency spontaneous fluctuations in the resting state blood oxygenation level-dependent (BOLD) signal that reveal functionally related regions. Results Mean region-wise T-tests found a left posterior opercular region with more correlated resting state activity with the inferior parietal lobule seed in the children with both left and right UHL than NH. In conjunction analysis, 4 regions showed different resting-state functional interactions between the NH and both UHL groups. These differences were in left medial globus pallidus, left middle temporal gyrus, right parahippocampal gyrus, and in mid-cingulate cortex. These regions include areas associated with auditory processing, executive function and memory formation. Conclusions Resting state fcMRI identified differences in brain network interconnections between children with UHL and NH and may inform further investigation into the educational and behavioral difficulties experienced by children with UHL.

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Objective The impact of hearing loss (HL) on quality of life (QOL) in young children has not been examined systematically. The objective of this study was to examine patient, parent, and professional perspectives on experiences and situations that affect the QOL in young children with HL and to identify themes that emerged from coded data to develop a parent-proxy QOL measure for young children with HL. Study Design Qualitative study with 6 focus groups followed by semistructured interviews with other parents and professionals as stakeholder checks. Setting Academic medical center and local schools for the deaf. Methods Audiology department clinic lists were used to identify eligible participants, who included 5- to 7-year-old children with permanent HL and parents of 2- to 7-year-old children with permanent HL. A sample of 6 children and 12 parents participated in focus groups. An audiology department and multiple schools for the deaf in the area were contacted to recruit for professional participants, resulting in a sample of 10 professionals who participated in focus groups. Focus groups and interviews were audiotaped and transcribed verbatim. Inductive thematic analysis of focus group transcripts identified key concepts and emerging themes of how HL affects young children. Results Six themes emerged from the data: behavior, feelings, environments, social/activities, family, and hearing equipment. Child, parent, and professional focus group themes overlapped well, and data saturation was reached. Conclusion These qualitative data provided insight into HL-related issues affecting young children’s QOL and were used to create items for a new parent-proxy QOL questionnaire.

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.