Language Ability after Early Detection of Permanent Childhood Hearing Impairment

Kennedy, Colin; McCann, Donna C.; Campbell, Mike; Law, Catherine; Mullee, Mark; Petrou, Stavros; Watkin, Peter; Worsfold, Sarah; Yuen, Ho Ming; Stevenson, Jim

doi:10.1056/nejmoa054915

Cited by 424 publications

(368 citation statements)

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“…[14][15][16] For example, in a mixed group of 7-to 9-year-old children with moderate to profound PCHI, we reported significantly higher receptive and expressive language scores in children whose PCHI was confirmed by 9 months compared with those with later-confirmed hearing loss. 17 Others have reported that children with PCHI aged under 6 years increased their narrative abilities over time after cochlear implantation. 18 In this report, we present a detailed analysis of our audiotaped expressive language data from a population of children with PCHI, half of whom had been exposed to UNHS.…”

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confidence: 99%

“…Participants were similar to non-participants with respect to age, sex, and severity of hearing loss. 17 Twenty-three of these 120 were either non-verbal or used British Sign Language as their first language (Table II). Audio recordings of the completed Bus Story assessment were available in 89 of the 97 participants with PCHI whose first preference was to use oral language, with or without sign language, and in all 63 children in the comparison group with normal hearing.…”

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Narrative skills following early confirmation of permanent childhood hearing impairment

Worsfold

Mahon

Yuen

et al. 2010

Develop Med Child Neuro

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PCHI Permanent childhood hearing impairment UNHS Universal newborn hearing screening AIM The aim of this study was to compare spoken language production in children with permanent childhood hearing impairment (PCHI) whose PCHI was confirmed either early or late.METHOD Audio-taped spoken narrative was assessed for syntax, phonology, morphology, and narrative in transcripts from a population-based sample of 89 children (49 males, 40 females; age mean age 7y 7mo, SD1y 1mo, range 6y 6mo-10y 9mo) with bilateral PCHI ( ‡40dB hearing loss) and a comparison group of 63 children (37 males, 26 females; mean age 8y 1mo; SD 1y) with normal hearing. Of the 89 children with PCHI, 41 (21 males, 20 females) had their hearing impairment confirmed by the age of 9 months. All children with PCHI were tested with hearing aids in place, including 16 with cochlear implants. The group of children whose PCHI had been confirmed by age 9 months was compared with the group with later confirmation of PCHI using regression models on the outcome measures.RESULTS Compared with those with late-confirmed PCHI, children with early-confirmed PCHI used significantly more sentences (mean difference 2.7; 95% confidence interval [CI] 0.49-5.24; p=0.019) and categories of high-pitched morphological markers (mean difference 6.64; 95% CI 1. 96-11.31; p=0.006). The number of categories of low-pitched morphological markers, phonological simplifications, and sentences with multiple clauses did not differ between groups. The odds ratios (95% CI) of superior narrative structure and narrative content in children whose PCHI was confirmed early were 3.03 (1.09-8.46; p=0.034) and 4.43 (1.52-12.89; p=0.006) respectively.INTERPRETATION Early confirmation compared with late confirmation of PCHI was associated with benefit to narrative skills and to certain expressive aspects of syntax and morphology, but not expressive phonology.Spoken language is a socially agreed code of auditory symbols that is governed by various systems of rules. Simply put, these systems are the phonological system, which describes the rules governing speech sounds (phonemes); the morphological system, in which the combination of meaningful speech sounds (morphemes) into words is described; and the syntactic system, which describes rules for combining words into sentences. As children acquire language, their skill in using these systems develops and becomes more complex. For example, in the expanding syntactic system, single words are used first, and are then combined into clauses and sentences, which can then later be linked to form narratives. 1 Typically developing children acquire these language skills progressively during the preschool period, and by the age of 5 years are using many adult-like forms. More sophisticated constructions, such as use of complex sentences and connectors (e.g. 'however', 'actually'), continue to develop during childhood. 2 Typically developing children acquire language within a social context through exposure to spoken language. 3 To begin this process, they mu...

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Narrative skills following early confirmation of permanent childhood hearing impairment

Worsfold

Mahon

Yuen

et al. 2010

Develop Med Child Neuro

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“…For comparisons within the group of teenagers with PCHL, we used norms obtained from the HCG (Kennedy et al., 2006). The group mean score and standard deviation scores for the HCG on each measure were used to derive age‐adjusted z scores for the teenagers with PCHL on that measure.…”

Section: Methodsmentioning

confidence: 99%

“…We have previously shown in this sample that those with PCHL had mean reading levels significantly below those of the hearing comparison group (HCG) at both age groups 6–10 years (McCann et al., 2009) and 13–20 years (Pimperton et al., 2016). Similar findings have also been reported for language comprehension scores (Kennedy et al., 2006; Pimperton et al., 2017). Reading deficits for teenagers with PCHL were most severe in the domain of comprehension (Pimperton et al., 2016).…”

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Language and reading comprehension in middle childhood predicts emotional and behaviour difficulties in adolescence for those with permanent childhood hearing loss

Stevenson

Pimperton

Kreppner

et al. 2017

Child Psychology Psychiatry

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BackgroundPermanent childhood hearing loss (PCHL) is associated with an elevated level of emotional and behaviour difficulties (EBD). In children and adolescents with PCHL, EBD has been found to be linked to language ability in children with PCHL. The present study was designed to test whether childhood language and/or reading comprehension abilities of children with PCHL predict subsequent EBD in adolescence.MethodsLanguage comprehension (LC) and reading comprehension (RC) were measured at ages 6–10 years (Time 1) and 13–20 years (Time 2) in participants with PCHL who preferred to communicate using spoken language (n = 57) and a hearing comparison group (n = 38). EBD was measured at both time points by parent and by teacher ratings on the Strengths and Difficulties Questionnaire.ResultsWithin the PCHL group there were negative correlations between EBD scores and concurrent LC and RC scores at Time 1 and at Time 2. Cross‐lagged latent variable models fitted to the longitudinal data indicated that the associations between LC, RC and teacher‐rated EBD were more likely to arise from the impact of LC and RC on behaviour rather than the other way around.ConclusionsIn those with PCHL, poor language and reading comprehension in middle childhood increased the risk of emotional and behaviour difficulties at school in the teenage years. The results suggest that effective language and literacy interventions for children with hearing loss may also bring benefits to their mental health.

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“…While the impact of undernutrition on cognitive and psychosocial development as well as educational attainment is well documented (6,7) , limited evidence still exists on the relationship between undernutrition and communication disorders in young infants, in sharp contrast with other sensory disabilities such as visual impairment which has been extensively linked with vitamin A deficiency (1) . Yet, such evidence is crucial for achieving optimal developmental outcomes in infants with CESHL, as effective intervention may be limited to the first year of life (8,9) . For instance, in line with the resolution of the World Health Assembly urging for early hearing detection programmes for infants (10) , the Joint Committee on Infant Hearing recommends that CESHL be detected by the age of 3 months to facilitate enrolment in appropriate family-oriented intervention ideally by the age of 6 months (4) .…”

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Is undernutrition a risk factor for sensorineural hearing loss in early infancy?

Olusanya

2009

Br J Nutr

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The present cross-sectional study set out to determine the nutritional status of infants aged 0 -3 months with the WHO Multicentre Growth Reference (WHO-MGR) and examine the relationship between undernutrition and congenital or early-onset sensorineural hearing loss (CESHL) rarely reported for developing countries. The nutritional status of all infants attending community-based clinics for routine Bacille de Calmette-Guérin (BCG) immunisation from July 2005 to December 2006 was determined by weight-for-age, weight-for-length and BMI-for-age based on the WHO-MGR. Hearing loss status was determined by tympanometry, auditory brainstem response (ABR) and visual response audiometry after a two-stage screening with transient evoked otoacoustic emissions and automated ABR. The relationship between nutritional status and CESHL were explored after adjusting for potentially confounding maternal and infant characteristics using multivariable logistic regression analyses. Of the 3386 infants who completed the hearing evaluation protocol, seventy-one were confirmed with hearing loss (.30 dB hearing level). More than one-third (37·9 %) of all infants and over half (54·9 %) of those with CESHL were undernourished by at least one measure of growth. Stunting (35·3 %) was the most prevalent nutritional deficit in infants with CESHL. In the final logistic model, infants with any undernourished physical state were significantly likely to have CESHL (OR 1·67; 95 % CI 1·03, 2·77) and of a severe-to-profound degree (OR 3·92; 95 % CI 1·38, 11·17) compared with infants without any undernourishment. Prospective studies to establish the full spectrum of the relationship between undernutrition and CESHL, particularly in resource-poor countries, are therefore warranted.

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Language Ability after Early Detection of Permanent Childhood Hearing Impairment

Abstract: Early detection of childhood hearing impairment was associated with higher scores for language but not for speech in midchildhood.

Cited by 424 publications

References 19 publications

Narrative skills following early confirmation of permanent childhood hearing impairment

Narrative skills following early confirmation of permanent childhood hearing impairment

Language and reading comprehension in middle childhood predicts emotional and behaviour difficulties in adolescence for those with permanent childhood hearing loss

Is undernutrition a risk factor for sensorineural hearing loss in early infancy?

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