Service Delivery to Children With Mild Hearing Loss: Current Practice Patterns and Parent Perceptions

Walker, Elizabeth; Spratford, Meredith; Ambrose, Sophie E.; Holte, Lenore; Oleson, Jacob

doi:10.1044/2016_aja-16-0063

Cited by 26 publications

(22 citation statements)

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“…This is in line with international studies e.g. Australian Hearing [7] and with the findings of Walker et al [45] in the US. Whatever the reasons for the late fitting in mild HL (etiological, medical, social, or organisational), there is today ample evidence for the risk of language learning difficulties and academic shortcomings in mild HL [6,18,22].…”

Section: Discussionsupporting

confidence: 93%

Best ear hearing level, time factors and language outcome in Swedish children with mild and moderate hearing loss with hearing aids

Sahlén

Ibertsson

Asker-Árnason

et al. 2021

Logopedics Phoniatrics Vocology

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Aim: The risk for language disorder is high in children with all levels of hearing loss (HL). Early identification and intervention should be as important for children with mild HL as for those with more severe HL. Despite new-born hearing screening, a recent survey of speech language therapist services in southern Sweden indicates that children with mild and moderate HL are severely neglected when it comes to language assessment and language intervention. In this study we explore associations between Best Ear Hearing Level (BEHL), time factors and language skills in Swedish children with HL with hearing aids (HA). Method: Participants were 19 children with mild HL (BEHL 23-39) and 22 children with moderate HL (BEHL 40-70) aged 5-15 years. Information on age at diagnosis and at HA fitting were collected. The children performed a nonword repetition and a sentence comprehension task. Results: The time elapsed between diagnosis and fitting with HA was longer for the children with mild HL.Participants with mild HL received their HA significantly later than children with moderate HL. No association between BEHL and the two language measures was found, and language skills were not better in children with mild than moderate HL. 17% of participants performed below cut-off for language disorder on both language measures. Conclusion: Given the risk for long-term academic and social consequences of even mild HL delayed HA intervention for children with HLleads to serious concerns by families, clinicians, and pedagogues.

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Section: Discussionsupporting

confidence: 93%

Best ear hearing level, time factors and language outcome in Swedish children with mild and moderate hearing loss with hearing aids

Sahlén

Ibertsson

Asker-Árnason

et al. 2021

Logopedics Phoniatrics Vocology

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“…A broad definition of mild hearing loss was used in the current study (Walker, Spratford, Ambrose, Holte, & Oleson, 2017). CMBHL qualified if they (a) had a fourfrequency (0.5, 1, 2, and 4 kHz) better-ear PTA greater than 20 dB HL and ≤ 45 dB HL with no more than one threshold from 0.25 to 4 kHz greater than 50 dB HL in the better hearing ear or (b) had a high-frequency hearing loss with one or more thresholds greater than 25 dB HL at or above Note.…”

Section: Hearingmentioning

confidence: 99%

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

Al-Salim

Moeller

McGregor

2020

LSHSS

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Purpose The aims of this study were to (a) determine if a high-quality adaptation of an audiovisual nonword repetition task can be completed by children with wide-ranging hearing abilities and to (b) examine whether performance on that task is sensitive to child demographics, hearing status, language, working memory, and executive function abilities. Method An audiovisual version of a nonword repetition task was adapted and administered to 100 school-aged children grouped by hearing status: 35 with normal hearing, 22 with mild bilateral hearing loss, 17 with unilateral hearing loss, and 26 cochlear implant users. Participants also completed measures of vocabulary, working memory, and executive function. A generalized linear mixed-effects model was used to analyze performance on the nonword repetition task. Results All children were able to complete the nonword repetition task. Children with unilateral hearing loss and children with cochlear implants repeated nonwords with less accuracy than normal-hearing peers. After adjusting for the influence of vocabulary and working memory, main effects were found for syllable length and hearing status, but no interaction effect was observed. Conclusions The audiovisual nonword repetition task captured individual differences in the performance of children with wide-ranging hearing abilities. The task could act as a useful tool to aid in identifying children with unilateral or mild bilateral hearing loss who have language impairments beyond those imposed by the hearing loss.

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“…Another factor noted to be related to delays in the EHDI process was presence of a mild hearing loss. Walker et al (2017) found that children with mild hearing loss were fitted with hearing aids at significantly greater ages than those with more significant degrees of hearing loss. A similar trend was found in this project.…”

Section: Barriers To Meeting 1-3-6mentioning

confidence: 99%

“…Provider-related barriers include limited access to audiologists with pediatric experience, appointment wait times, and delay in diagnosis of hearing loss due to multiple rescreenings and diagnostic tests (Holte et al, 2012;MacNeil, Liu, Stone, & Farrell, 2007;Munoz, Blaiser, & Barwick, 2013). Patientrelated barriers include patient comorbidities, unilateral or mild hearing loss, general health/neonatal intensive care unit (NICU) stay, and presence of otitis media (Coplan, 1987;Dalzell et al, 2000;Harrison & Roush, 1996;Holte et al, 2012;Moeller, Eiten, White, & Shisler, 2006;Walker, Spratford, Ambrose, Holte, & Oleson, 2017). Family-related barriers include family understanding of the importance of follow-up, subjective observation of the child's response to sounds, acceptance of hearing loss, work schedules, and socioeconomic status (Folsom et al, 2000;Holte et al, 2012;MacNeil et al, 2007;Munoz et al, 2013).…”

Section: Challenges To Meeting the Jcih Guidelinesmentioning

confidence: 99%

“…Furthermore, mean age at hearing aid fitting was 5.88 months (SD = 1.11 months) for babies with middle ear pathology, compared to 4.39 months (SD = 1.82 months) for babies without middle ear pathology. We also examined if mild hearing loss versus greater degrees of hearing loss was related to age at hearing aid fitting based on previous findings that infants with mild hearing losses are fitted later than those with greater degrees of hearing loss (Dalzell et al, 2000;Walker et al, 2017). A significant inverse relationship was observed (r = −.469, p < .05).…”

Section: Are We Meeting the 1-3-6 Guidance?mentioning

confidence: 99%

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Meeting the Joint Committee on Infant Hearing Standards in a Large Metropolitan Children's Hospital: Barriers and Next Steps

2019

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Purpose The aim of this study was to determine how a large metropolitan children's hospital's practices align with the Joint Committee on Infant Hearing (JCIH) 1-3-6 guidelines (diagnose hearing loss by 3 months of age, fitted with hearing aids within 1 month of diagnosis, and enroll in early intervention by 6 months of age) and examine variables that have impacted meeting these guidelines. This hospital is not a birthing hospital. Therefore, the first recommendation (hearing screen by 1 month of age) was not evaluated. Method One hundred forty-one auditory evoked potential evaluations for infants under the age of 6 months were reviewed for this study. Data were only gathered for infants identified with a bilateral hearing loss ( n = 34). The following was recorded: degree of hearing loss, number of diagnostic sessions over time, the percentage of infants who transitioned to hearing aid fittings, and the age at which JCIH benchmarks were accomplished. Results Sixty-two percent of infants were diagnosed with hearing loss by 3 months of age, 48% of infants were fitted with hearing aids by 4 months of age, and the average age of infants enrolled in early intervention was 4.58 months. Seventy percent of infants were fitted within 1 month of the diagnosis of hearing loss. The identified variables that led to the hearing aids being fitted greater than 1 month after the diagnosis are as follows: cancellations/missed appointments, middle ear involvement, and mild hearing loss. Conclusions Results of this internal audit revealed opportunities for growth in better meeting and exceeding JCIH recommendations of diagnosis by 3 months of age and hearing aid fitting within 1 month of diagnosis. Adjustments in the scheduling process and appointment options have been implemented in response to these results. Additional examination of why these recommendations are not being met and what can be done to achieve them is needed.

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Service Delivery to Children With Mild Hearing Loss: Current Practice Patterns and Parent Perceptions

Cited by 26 publications

References 50 publications

Best ear hearing level, time factors and language outcome in Swedish children with mild and moderate hearing loss with hearing aids

Best ear hearing level, time factors and language outcome in Swedish children with mild and moderate hearing loss with hearing aids

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

Meeting the Joint Committee on Infant Hearing Standards in a Large Metropolitan Children's Hospital: Barriers and Next Steps

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