Timeliness of Service Delivery for Children With Later-Identified Mild-to-Severe Hearing Loss

Abstract

Purpose This study examined diagnostic and intervention services for children identified with hearing loss (HL) after the newborn period. Method We compared ages at service delivery and length of delays between service delivery steps for 57 later-identified children with HL and 193 children who referred for assessment from the newborn hearing screen (NHS). For only later-identified children, regression models were used to investigate relationships among predictor variables and dependent variables related to service delivery. Results Children who referred from the NHS received follow-up services at younger ages than later-identified children. Later-identified children had significantly longer delays between entry into early intervention to HL confirmation, compared to children who referred from the NHS. For later-identified children, degree of HL predicted ages at follow-up clinical services. Children with more severe HL received services at younger ages compared to children with milder HL. Gender predicted the length of the delay between confirmation to entry into early intervention, with females demonstrating shorter delays. Conclusions The current results lend support to the need for ongoing hearing monitoring programs after the neonatal period, particularly when children enter early intervention programs because of language/developmental delays.

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

“…For those children who had permanent HL when they started early intervention, it is likely that the intervention would have been more effective if the HL had been addressed. These results parallel the findings in Walker et al (2014) and again highlight the fact that hearing screenings are not a required component of Part C/birth-to-3 services in the federal Individuals with Disabilities Education Act. JCIH (2007) recommends that medical care providers refer patients for audiological testing in any cases of children who display speech and language delays regardless of whether they passed the NHS.…”

“…This result leads us to believe that all families of children with mild HLregardless of socioeconomic status-may be at risk for delays in service delivery. It is unclear what other factors are contributing to timing of service delivery for children with mild HL, although the parent-reported reasons for delays between service delivery milestones for NHS-and later-identified groups of children with mild HL were similar to those reported from the larger OCHL cohorts in Holte et al (2012) and Walker et al (2014).…”

“…When considering maternal education, degree of HL, gender, and test site for children in the OCHL study identified at NHS, maternal education level was the only variable that predicted unique variance in age at first diagnostic evaluation, confirmation of HL, and HA fitting in children with congenital mild-to-severe HL (Holte et al, 2012). For later-identified children with mild-to-severe HL in the OCHL study , Walker et al (2014) found that degree of HL in the better ear predicted age at service delivery (first evaluation, confirmation, HA fitting). In another study, Fitzpatrick et al (2014) also found that BEPTA influenced HA receipt for children with mild HL who were earlier and later identified.…”

“…Although little is known about timing of service delivery specifically for contemporary children with mild HL, the OCHL team recently published two studies examining timing of service delivery for children with mild-to-severe HL who referred on the NHS (NHS group; Holte et al, 2012) and children with mild-to-severe HL who either passed the screen or were not screened (later-identified group; Walker et al, 2014). The purpose of these studies was to determine when EHDI follow-up steps were occurring for the respective groups and identify factors that predicted delays in these follow-up steps.…”

The Influence of Hearing Aid Use on Outcomes of Children With Mild Hearing Loss

“…Thus, as a whole, children with mild HL who were identified by the NHS were receiving follow-up services in as timely a fashion as children with more severe HL. On the other hand, Walker et al (2014) showed that children with mild HL who passed the NHS and were later-identified were at risk for delays in service delivery. The current study seeks to provide more information about service provision in a group of children with mild HL.…”