Purpose: This study examined the effects of consistent hearing aid (HA) use on outcomes in children with mild hearing loss (HL). Method: Five-or 7-year-old children with mild HL were separated into 3 groups on the basis of patterns of daily HA use. Using analyses of variance, we compared outcomes between groups on speech and language tests and a speech perception in noise task. Regression models were used to investigate the influence of cumulative auditory experience (audibility, early intervention, HA use) on outcomes. Results: Full-time HA users demonstrated significantly higher scores on vocabulary and grammar measures compared with nonusers. There were no significant differences between the 3 groups on articulation or speech perception measures. After controlling for the variance in age at confirmation of HL, level of audibility, and enrollment in early intervention, only amount of daily HA use was a significant predictor of grammar and vocabulary. Conclusions: The current results provide evidence that children's language development benefits from consistent HA use. Nonusers are at risk in areas such as vocabulary and grammar compared with other children with mild HL who wear HAs regularly. Service providers should work collaboratively to encourage consistent HA use.
Purpose: To describe factors affecting early intervention (EI) for children who are hard of hearing, we analyzed (a) service setting(s) and the relationship of setting to families' frequency of participation, and (b) provider preparation, caseload composition, and experience in relation to comfort with skills that support spoken language for children who are deaf and hard of hearing (CDHH). Method: Participants included 122 EI professionals who completed an online questionnaire annually and 131 parents who participated in annual telephone interviews. Results: Most families received EI in the home. Family participation in this setting was significantly higher than in services provided elsewhere. EI professionals were primarily teachers of CDHH or speech-language pathologists. Caseload composition was correlated moderately to strongly with most provider comfort levels. Level of preparation to support spoken language weakly to moderately correlated with provider comfort with 18 specific skills. Conclusions: Results suggest family involvement is highest when EI is home-based, which supports the need for EI in the home whenever possible. Access to hands-on experience with this population, reflected in a high percentage of CDHH on providers' current caseloads, contributed to professional comfort. Specialized preparation made a modest contribution to comfort level.
Objectives: 1) Identify the etiologies and risk factors of the patient cohort and determine the degree to which they reflected the incidence for children with hearing loss and 2) quantify practice management patterns in three catchment areas of the United States with available centers of excellence in pediatric hearing loss Design: Medical information for 307 children with bilateral, mild to severe hearing loss was examined retrospectively. Children were participants in the Outcomes of Children with Hearing Loss (OCHL) study, a five-year longitudinal study that recruited subjects at three different sites. Children aged 6 months to 7 years at time of OCHL enrollment were participants in this study. Children with cochlear implants, children with severe or profound hearing loss, and children with significant cognitive or motor delays were excluded from the OCHL study and, by extension, from this analysis. Medical information was gathered using medical records and participant intake forms, the latter reflecting a caregiver's report. A comparison group included 134 children with normal hearing. A chi-square test on two-way tables was used to assess for differences in referral patterns by site for the children who are hard of hearing (CHH). Linear regression was performed on gestational age and birth weight as continuous variables. Risk factors were assessed using ttests. The alpha value was set at p < 0.05.Results: Neonatal intensive care unit stay, mechanical ventilation, oxygen requirement, aminoglycoside exposure, and family history were correlated with hearing loss. For this study cohort, congenital cytomegalovirus (CMV), strep positivity, bacterial meningitis, extracorporeal
Purpose To characterize preschool and school services for children who are hard of hearing (CHH), we described service setting, amount, and configuration and analyzed the relationship between service receipt and student hearing levels and language scores. Characteristics of professionals providing services were described and then used to predict level of comfort with skills supporting listening and spoken language. The amount of provider communication with children's audiologists was also investigated. Method Participants included parents of CHH (preschool n = 174; school n = 155) and professionals (preschool n = 133; school n = 104) who completed interviews and questionnaires as part of a longitudinal study. Children's hearing, speech, and language data were collected from annual testing and analyzed in relation to service data. Results A majority (81%) of preschool-age CHH received services. Children were more likely to be in a preschool for children who are deaf or hard of hearing (CDHH) or exceptional children than a general education preschool. By elementary school, 70% received services, nearly all in general education settings. Sessions averaged twice a week for a total of approximately 90 min. Children who no longer received services performed significantly better on speech/language measures than those who received services, regardless of service setting. Professionals were primarily speech-language pathologists (SLPs) and teachers of CDHH. SLPs reported significantly less comfort with skills involving auditory development and hearing technologies and less frequent communication with the child's audiologists than teachers of CDHH. Overall communication with audiologists was more frequent in the preschool years. Conclusions As preschool-age CHH transition into school, the majority continue to qualify for services. Congruent with national trends, school-age CHH in the Outcomes of Children with Hearing Loss study were most often in general education settings. Without specialized preprofessional or postgraduate training, SLPs and teachers of CDHH did not report comfort with all the skills critical to developing listening and spoken language. This finding supports the need for increased implementation of interprofessional practice among SLPs and teachers of CDHH, as well as audiologists, to best meet the needs unique to this population.
Purpose The purpose of this study was to examine confidence levels and identify predictors of increased confidence of school-based speech-language pathologists (SLPs) relative to different aspects of the augmentative and alternative communication (AAC) assessment process. Method Surveys were completed by 272 school-based SLPs. Questions were designed to capture demographic information and confidence in areas of assessment such as student capabilities, participation, and feature matching. Results There were variable levels of confidence across aspects of assessment. Respondents were less confident in tasks related to assessing students with severe physical impairments and incorporating aspects related to cultural and linguistic diversity in their assessment. SLPs were more confident assessing student participation and unaided communication. Additionally, respondents had less confidence in matching the features of high-tech speech-generating devices to their students. Self-identification as an AAC specialist, years of experience, percentage of caseload of students with complex communication needs, and length of longest continuing education experiences all contributed to predicting confidence in most areas of assessment. However, years of experience did not contribute to predicting confidence in feature matching. Conclusions Results from this study acknowledge that SLPs are likely to have varied degrees of confidence in aspects of assessment related to preparation, clinical experience, and self-identification of specialty. Findings from this study support increasing training opportunities in AAC assessment. As specialization was the strongest predictor of confidence, further research should investigate the characteristics and preparation of self-identified AAC specialists. This is an important first step in pinpointing ways to increase confidence in school-based SLPs.
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