Cross-sectional epidemiology of hearing loss in Australian children aged 11–12 years old and 25-year secular trends

Wang, Jing; Clercq, Carlijn M. P. le; Sung, Valerie; Carew, Peter; Liu, Richard S; Mensah, Fiona; Burt, Rachel; Gold, Lisa; Wake, Melissa

doi:10.1136/archdischild-2017-313505

Cited by 17 publications

(21 citation statements)

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“…Inclusion of more disadvantaged families might have reduced mean language scores somewhat, although applying study weights should have partly mitigated this; it is difficult to predict what effect this might have on concordance values. Some participants were tested before we acquired soundproof booths, which could have yielded slightly higher (worse) hearing thresholds, although we saw no evidence of this 41. Time constraints required omitting the intra-octave 3 and 6 kHz (whose thresholds are typically intermediate to those of the two bounding octave frequencies42) and 0.5 kHz (both the least relevant to spoken speech and the most affected by residual background noise) frequencies.…”

Section: Discussionmentioning

confidence: 92%

Hearing, speech reception, vocabulary and language: population epidemiology and concordance in Australian children aged 11 to 12 years and their parents

et al. 2019

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ObjectivesTo describe the epidemiology and parent-child concordance of hearing, speech reception, vocabulary and language in Australian parent-child dyads at child age 11 to 12 years.DesignPopulation-based cross-sectional study (Child Health CheckPoint) nested within the Longitudinal Study of Australian Children.SettingAssessment centres in seven Australian cities and eight regional towns or home visits around Australia, February 2015 to March 2016.ParticipantsOf all participating CheckPoint families (n=1874), 1516 children (50% female) and 1520 parents (87% mothers, mean age 43.8 years) undertook at least one of four measurements of hearing and language.Outcome measuresHearing threshold (better ear mean of 1, 2 and 4 kHz) from pure-tone audiometry, speech reception threshold, receptive vocabulary, expressive and receptive languages using a sentence repetition task. Parent-child concordance was examined using Pearson’s correlation coefficients and adjusted linear regression models. Survey weights and methods accounted for Longitudinal Study of Australian Children’s complex sampling and stratification.ResultsChildren had a similar speech reception threshold to parents (children mean −14.3, SD 2.4; parents −14.9, SD 3.2 dB) but better hearing acuity (children 8.3, SD 6.3; parents 13.4, SD 7.0 decibels hearing level). Standardised sentence repetition scores were similar (children 9.8, SD 2.9; parents 9.1, SD 3.3) but, as expected, parents had superior receptive vocabularies. Parent-child correlations were higher for the cognitively-based language measures (vocabulary 0.31, 95% CI 0.26 to 0.36; sentence repetition 0.29, 95% CI 0.24 to 0.34) than the auditory measures (hearing 0.18, 95% CI 0.13 to 0.23; speech reception threshold 0.18, 95% CI 0.13 to 0.22). Mother-child and father-child concordances were similar for all measures.ConclusionsWe provide population reference values for multiple measures spanning auditory and verbal communication systems in children and mid-life adults. Concordance values aligned with previous twin studies and offspring studies in adults, in keeping with polygenic heritability that is modest for audition but around 60% for language by late childhood.

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Section: Discussionmentioning

confidence: 92%

Hearing, speech reception, vocabulary and language: population epidemiology and concordance in Australian children aged 11 to 12 years and their parents

et al. 2019

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“…H earing loss among children is prevalent, with recent population-based studies reporting increased puretone hearing thresholds among 15.2% to 22.6% of school-aged children. [1][2][3] These figures comprise mainly slight hearing loss at the 16-dB to 25-dB hearing level (HL), which often is not acknowledged as clinically relevant. In practice, relevant hearing loss is usually defined as hearing loss of mild or worse degree, starting from a hearing threshold of 26-dB to 40-dB HL.…”

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Association of Slight to Mild Hearing Loss With Behavioral Problems and School Performance in Children

Clercq

Labuschagne

Franken

et al. 2020

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Children with severe hearing loss are known to have more behavioral problems and may perform worse at school than children without. Few large-scale studies of slight to mild hearing loss are available.OBJECTIVE To examine the relevance of slight to mild hearing loss by studying its association with behavioral problems and school performance. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study was performed within an ongoing prospective birth cohort study in Rotterdam, the Netherlands. Participants were part of a population-based sample of children. Between ages 9 and 11 years, 5355 children underwent audiometric and behavioral evaluations. Children were excluded if they had missing data for either audiometry or both outcomes. Data were collected from April 2012 through October 2015. Data were analyzed from March to June 2018. EXPOSURES Audiometric evaluation included pure-tone audiometry tests and speech-in-noise testing.MAIN OUTCOMES AND MEASURES Child behavior was rated by the primary caregiver using the Child Behavior Checklist at ages 9 to 11 years (n = 4471). School performance was measured with a standardized test at age 12 years (n = 2399). RESULTSThe final sample included 4779 participants who were a mean (SD) age of 9.8 (0.3) years. The sample had nearly equal distribution between boys (n = 2200; 49.2%) and girls (n = 2271; 50.8%). Associations of hearing thresholds with behavioral problems differed between boys and girls. Among boys, higher pure-tone hearing thresholds at low frequencies were associated with higher total problem, social problem, and attention problem scores (total problems for the better-hearing ear: β = 0.01; 95% CI, 0-0.02). Higher speech reception thresholds were associated with higher attention problem scores among girls (β = 0.04; 95% CI, 0-0.08). Higher speech reception thresholds were associated with poorer school performance scores for both boys and girls (β = −0.06; 95% CI, −0.10 to −0.02). CONCLUSIONS AND RELEVANCEHigher hearing thresholds during pure-tone audiometric and speech-in-noise testing were associated with higher behavioral problem scores and poorer school performance. This supports the relevance of slight to mild hearing loss with these outcomes in school-aged children.

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“…Understanding the population-level impact of slight/mild hearing loss in children is important. One major reason is that hearing loss of slight/mild degree (16–40 decibels hearing loss (dB HL)) is very common, with 9.3% and 13.3% of children aged 11–12 years having bilateral and unilateral speech frequency slight/mild losses, respectively 1. Moreover, the prevalence seems to be increasing over time 1 2.…”

Section: Introductionmentioning

confidence: 99%

“…One major reason is that hearing loss of slight/mild degree (16–40 decibels hearing loss (dB HL)) is very common, with 9.3% and 13.3% of children aged 11–12 years having bilateral and unilateral speech frequency slight/mild losses, respectively 1. Moreover, the prevalence seems to be increasing over time 1 2. Universal newborn hearing screening programmes are now widely implemented with the goal of early treatment of moderate to profound hearing loss (>40 dB HL), a level of hearing loss that has major negative impacts on child outcomes (eg, speech and language, academic performance, social interaction and isolation, behaviour and health-related quality of life (HRQL)) 3–5.…”

Section: Introductionmentioning

confidence: 99%

Academic, behavioural and quality of life outcomes of slight to mild hearing loss in late childhood: a population-based study

et al. 2019

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ObjectiveTo investigate the associations of hearing thresholds and slight to mild hearing loss with academic, behavioural and quality of life outcomes in children at a population level.MethodsDesign and participants:children aged 11–12 years in the population-based cross-sectional Child Health CheckPoint study within the Longitudinal Study of Australian Children. Audiometry:mean hearing threshold across 1, 2 and 4 kHz (better and worse ear); slight/mild hearing loss (threshold of 16–40 decibels hearing loss (dB HL)). Outcomes: National Assessment Program – Literacy and Numeracy, language, teacher-reported learning, parent and teacher reported behaviour and self-reported quality of life. Analysis:linear regression quantified associations of hearing threshold/loss with outcomes.ResultsOf 1483 children (mean age 11.5 years), 9.2% and 13.1% had slight/mild bilateral and unilateral hearing loss, respectively. Per SD increment in better ear threshold (5.7 dB HL), scores were worse on several academic outcomes (eg, reading 0.11 SD, 95% CI 0.05 to 0.16), parent-reported behaviour (0.06 SD, 95% CI 0.01 to 0.11) and physical (0.09 SD, 95% CI 0.04 to 0.14) and psychosocial (0.06 SD, 95% CI 0.01 to 0.11) Pediatric Quality of Life Inventory (PedsQL). Compared with normally hearing children, children with bilateral slight/mild losses scored 0.2–0.3 SDs lower in sentence repetition, teacher-reported learning and physical PedsQL but not other outcomes. Similar but attenuated patterns were seen in unilateral slight/mild losses.ConclusionsHearing thresholds and slight/mild hearing loss showed small but important associations with some child outcomes at 11–12 years. Justifying hearing screening or intervention at this age would require better understanding of its longitudinal and indirect effects, alongside effective management and appropriate early identification programmes.

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Cross-sectional epidemiology of hearing loss in Australian children aged 11–12 years old and 25-year secular trends

Abstract: Childhood hearing loss is prevalent and has risen since 1990. Future research should investigate the causes, course and impact of these changes.

Cited by 17 publications

References 34 publications

Hearing, speech reception, vocabulary and language: population epidemiology and concordance in Australian children aged 11 to 12 years and their parents

Hearing, speech reception, vocabulary and language: population epidemiology and concordance in Australian children aged 11 to 12 years and their parents

Association of Slight to Mild Hearing Loss With Behavioral Problems and School Performance in Children

Academic, behavioural and quality of life outcomes of slight to mild hearing loss in late childhood: a population-based study

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