Objectives To assess the prevalence, characteristics, and risk of sensorineural hearing loss (SNHL) through 18 years of age in children with congenital CMV infection identified through hospital-based newborn screening who were asymptomatic at birth compared to uninfected children. Methods We included 92 case-patients and 51 controls assessed using auditory brainstem response and behavioral audiometry. We used Kaplan-Meier survival analysis to estimate prevalence of SNHL, defined as ≥25 dB hearing level (HL) at any frequency, and Cox proportional hazards regression analyses to compare SNHL risk between groups. Results At the end of follow-up, SNHL prevalence was 25% (95% CI: 17–36%) among case-patients and 8% (95% CI: 3–22%) in controls (hazard ratio (HR): 4.0; 95% CI: 1.2–14.5; p-value=0.02). Among children without SNHL by age 5 years, the risk of delayed-onset SNHL was not significantly greater for case-patients than for controls (HR: 1.6; 95% CI: 0.4–6.1; P=0.5). Among case-patients, the risk of delayed-onset SNHL was significantly greater among those with unilateral congenital/early-onset loss than those without (hazard ratio: 6.9; 95% CI: 2.5–19.1; P<0.01). At the end of follow-up, the prevalence of severe to profound bilateral SNHL among case-patients was 2% (95% CI: 1–9%). Conclusions Delayed-onset and progression of SNHL among children with asymptomatic congenital CMV infection continued to occur throughout adolescence. However, the risk of developing SNHL after age 5 years among case-patients was not different than in uninfected children. An estimated 2% of case-patients developed SNHL severe enough to be candidates for cochlear implantation.

BACKGROUND AND OBJECTIVES To date, no studies have examined vocabulary outcomes of children meeting all 3 components of the Early Hearing Detection and Intervention (EHDI) guidelines (hearing screening by 1 month, diagnosis of hearing loss by 3 months, and intervention by 6 months of age). The primary purpose of the current study was to examine the impact of the current EHDI 1-3-6 policy on vocabulary outcomes across a wide geographic area. A secondary goal was to confirm the impact of other demographic variables previously reported to be related to language outcomes. METHODS This was a cross-sectional study of 448 children with bilateral hearing loss between 8 and 39 months of age (mean = 25.3 months, SD = 7.5 months). The children lived in 12 different states and were participating in the National Early Childhood Assessment Project. RESULTS The combination of 6 factors in a regression analysis accounted for 41% of the variance in vocabulary outcomes. Vocabulary quotients were significantly higher for children who met the EHDI guidelines, were younger, had no additional disabilities, had mild to moderate hearing loss, had parents who were deaf or hard of hearing, and had mothers with higher levels of education. CONCLUSIONS Vocabulary learning may be enhanced with system improvements that increase the number of children meeting the current early identification and intervention guidelines. In addition, intervention efforts need to focus on preventing widening delays with chronological age, assisting mothers with lower levels of education, and incorporating adults who are deaf/hard-of-hearing in the intervention process.

Background Over 12,000 children are diagnosed with cancer every year in the United States. In addition to symptoms associated with their disease, children undergoing chemotherapy frequently experience significant pain, which is unfortunately often undertreated. The field of m-Health offers an innovative avenue for pain assessment and intervention in the home setting. The current study describes the development and initial evaluation of a tablet-based program, Pain Buddy, aimed to enhance pain management and foster improved quality of life in children ages 8–18 years undergoing cancer treatment. Methods An animated avatar-based tablet application was developed using state-of-the-art software. Key aspects of Pain Buddy include daily pain and symptom diaries completed by children, remote monitoring of symptoms by uploading patient’s data through internet to a cloud server, cognitive and behavioral skills training, interactive three-dimensional avatars that guide children through the program, and an incentive system to motivate engagement. Twelve children between the ages of 8 and 18 participated in a pilot study of Pain Buddy. Results Children were highly satisfied with the program. Pain and appetite disturbances were most frequently endorsed. Symptom trigger alerts to outside providers were largely related to clinically significant pain. Children infrequently used analgesics, and reported using some non-pharmacological pain management strategies. Conclusion Pain Buddy appears to be a promising tool to improve pain and symptom management in children undergoing cancer treatment. Results from the current study will inform future improvements to Pain Buddy, in preparation for a randomized controlled trial to assess the efficacy of this innovative treatment.