Do Audiologic Characteristics Predict Outcomes in Children With Unilateral Hearing Loss?

Abstract

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.

Perda auditiva unilateral em crianças: avaliação fonológica e do vocabulário

“…Some studies (27,28) have suggested that children with UHL in the right ear present more difficulty of speech and learning than the ones with hearing loss in the left ear. Other studies (29,30) did not find significant differences between these groups. In the present study, this trend was not observed, since the results that were not according to the standard parameters of the ABFW test were noticed both in subjects with hearing loss in the right (2) and the left ear (2).…”

Spatial Release From Masking in Children: Effects of Simulated Unilateral Hearing Loss

“…Children with permanent UHL often experience developmental difficulties, even in cases of mild UHL. This could be due, in part to reduced access to binaural cues, which are important for speech perception in complex listening environments (Quigley & Thomure 1969; Bess et al 1986; Brookhouser et al 1991; Lieu et al 2010, 2012, 2013). Specifically, binaural cues facilitate spatial release from masking (SRM) when a target talker (e.g., the teacher) is spatially separated from background talkers (e.g., classmates).…”

“…Adults with permanent or simulated UHL achieve significantly less SRM than their counterparts with normal bilateral hearing, and this deficit is exacerbated in the presence of relatively complex maskers (e.g., two-talker speech; Marrone et al 2008; Rothpletz et al 2012). While previous studies demonstrate that children with permanent UHL experience degraded speech understanding in relatively steady maskers (e.g., Bess et al 1986; Ruscetta et al 2005; Lieu et al 2013), their ability to achieve SRM in the presence of complex maskers has not been systematically investigated. This is a critical gap in the literature considering recent evidence that the real-world performance of children with permanent bilateral hearing loss is better predicted by speech recognition in a two-talker than a steady noise masker (Hillock-Dunn et al 2015).…”

“…There are relatively few data pertinent to SRM in school-age children with permanent sensorineural UHL, but available data indicate reduced benefit of target/masker spatial separation and poorer speech recognition overall for children with UHL (e.g., Bess et al 1986; Bovo et al 1988; Hartvig et al 1989; Kenworthy et al 1990; Updike 1994; Lieu et al 2010; Noh & Park 2012; Lieu et al 2013; Reeder et al 2015). For example, Reeder et al (2015) reported that 7- to 16-year-olds with moderately-severe to profound sensorineural UHL performed worse than age-matched peers with normal hearing on a range of tasks.…”

Potential benefits from cochlear implantation of children with unilateral hearing loss

“…Contributing factors were shown to include not only specific listening difficulties such as hearing in noise, but also secondary problems such as low selfesteem and increased fatigue. While the overall picture now appears relatively clear, there is still limited evidence differentiating the impact of UHL in children with different types and severity of hearing loss, though Lieu et al (2013) provide evidence of poorer cognitive and oral language performance in children with profound UHL than in those with milder losses. An example of a study with a homogeneous group was by Kesser et al (2013), which reported on responses from a postal survey of 40 elementary school children with unilateral atresia, of which 65% required some additional resource, including individual education plans (47.5%) and speech therapy (45%).…”