Parent Report of Amplification Use in Children with Mild Bilateral or Unilateral Hearing Loss

Abstract

Amplification is considered to be one of the most important interventions for children with hearing loss. However, achieving consistent use of hearing technology in young children is an important problem, particularly when hearing loss is of mild degree. Little information is available about amplification use specifically for children with mild bilateral or unilateral hearing loss when such losses are targeted and identified early because of the availability of newborn hearing screening.We examined amplification use in a contemporary cohort of early-identified children with mild bilateral and unilateral hearing loss.As part of the Mild and Unilateral Hearing Loss in Children Study, we collected parent reports on their child’s use of amplification during the preschool years.A total of 69 children (38 unilateral and 31 bilateral mild) enrolled in the study from 2010 to 2015. Children entered the study at various ages between 12 and 36 mo of age and were followed up to age 48 mo. The median age of the children at enrollment was 16.5 mo (interquartile range [IQR] = 9.5, 26.8). Hearing loss was confirmed in these children at a median age of 3.6 mo (IQR = 2.4, 5.7).Baseline characteristics related to the child and family were collected through an intake form at study enrollment. Data on amplification fitting and use were collected via parent questionnaires at each assessment interval. Information from parent questionnaires was summarized descriptively and amplification use was grouped into categories. Through logistic regression, we examined the relationship between amplification use and laterality of hearing loss, sex, and maternal education.Amplification was recommended for 59 (85.5%) children at a median age of 6.5 mo (IQR = 3.6, 21.2) and children were fitted at a median age of 10.9 mo (IQR = 6.0, 22.1). Based on parent report, hearing aid use was consistent for 39 (66.1%) of 59 children who had amplification recommended. Parent questionnaires showed very little change in use for most of the children over the study period. More children with bilateral hearing loss used their amplification consistently than those with unilateral hearing loss. After adjusting for maternal education and sex of the child, the odds for consistent use in children with mild bilateral loss was almost seven times higher (odds ratio = 6.75; 95% confidence interval = 1.84, 24.8) than for those with unilateral loss.Although 85.5% of children with mild bilateral or unilateral hearing loss received amplification recommendations, only two-thirds achieved consistent use by age 3–4 yr based on parent report. Children with mild bilateral loss were more likely to use amplification during the preschool years than those with unilateral loss.

Newborn Hearing Screening and Intervention in Children with Unilateral Hearing Impairment: Clinical Practices in Three Nordic Countries

“…Our results also revealed variations in screening and diagnostics regarding access to early intervention and the types of interventions that were provided. The heterogeneity of services is not surprising, given the limited evidence base available, and similar results have been reported by others [ 27 , 49 , 50 ]. Even if heterogeneity in early intervention can be expected because each child and family has different needs, the variation between hospitals suggests that families receive quite a different type of intervention depending on where they live.…”

“…In the United States, eligibility criteria for early intervention differ between states, resulting in the inclusion of children with UHI in some states only [ 49 ]. Amplification is often recommended late [ 27 ], and professionals may vary in whether they recommend amplification at all, especially in mild UHI cases [ 50 ]. Moreover, parents may be reluctant to amplification or early intervention, as the benefit might not be as evident for children with UHI compared to more profound degrees of bilateral HI [ 51 , 52 ].…”

“…Amplification is often recommended late [ 27 ], and professionals may vary in whether they recommend amplification at all, especially in mild UHI cases [ 50 ]. Moreover, parents may be reluctant to amplification or early intervention, as the benefit might not be as evident for children with UHI compared to more profound degrees of bilateral HI [ 51 , 52 ]. Overall, the risk of unequal access to hearing healthcare is evident, and some children might not receive the appropriate support.…”

Performance of Children With Hearing Loss on an Audiovisual Version of a Nonword Repetition Task

“…the CMBHL. Once fit with amplification, CUHL have also been shown to be less consistent users of amplification, at least during the preschool years, compared to children with bilateral hearing loss (Fitzpatrick et al, 2019(Fitzpatrick et al, , 2018. In addition to differences in auditory access and perception, some CUHL may have subtle deficits in the skills that support NWR.…”

Service Preferences of Parents of Children With Mild Bilateral or Unilateral Hearing Loss: A Conjoint Analysis Study

“…There is heightened interest in the service needs of children with mild bilateral and unilateral hearing loss (McKay et al 2008;Tharpe 2008;Fitzpatrick et al 2016;Porter et al 2016). The interest stems from several realities: (1) The prevalence of young children first presenting with mild bilateral or unilateral hearing loss is higher than was previously known before the implementation of widespread universal newborn hearing screening (UNHS). These children accounted for more than 40% of those identified with permanent hearing loss in one population-based study (Fitzpatrick et al 2014); (2) children with these hearing profiles can be identified at substantially younger ages in the context of newborn screening (Fitzpatrick et al 2014(Fitzpatrick et al , 2017aGhogomu et al 2014) even when not specifically targeted as part of the disorder (Wood et al 2015); (3) the longer term impact of early identified mild bilateral or unilateral loss remains relatively unknown.…”