Trends and Predictors of Longitudinal Hearing Aid Use for Children Who Are Hard of Hearing

Objectives This study examined the language outcomes of children with mild to severe hearing loss during the preschool years. The longitudinal design was leveraged to test whether language growth trajectories were associated with degree of hearing loss and whether aided hearing influenced language growth in a systematic manner. The study also explored the influence of the timing of hearing aid fitting and extent of use on children’s language growth. Finally, the study tested the hypothesis that morphosyntax may be at particular risk due to the demands it places on the processing of fine details in the linguistic input. Design The full cohort of children in this study was comprised of 290 children were hard of 34 hearing (CHH) and 112 children with normal hearing (CNH) who participated in the Outcomes 35 of Children with Hearing Loss (OCHL) study between the ages of 2 and 6 years. CHH had a mean better ear pure tone average of 47.66 dB HL (SD = 13.35). All children received a comprehensive battery of language measures at annual intervals, including standardized tests, parent report measures, and spontaneous and elicited language samples. Principal components analysis supported the use of a single composite language score for each of the age levels (2, 3, 4, 5, 6 years). Measures of unaided (better ear pure tone average, Speech Intelligibility Index) and aided (residualized Speech Intelligibility Index) hearing were collected, along with parent report measures of daily hearing aid use time. Mixed modeling procedures were applied to examine the rate of change (227 CHH; 94 CNH) in language ability over time in relation to 1) degree of hearing loss, 2) aided hearing, 3) age of hearing aid fit and duration of use, and 4) daily hearing aid use. Principal components analysis was also employed to examine factor loadings from spontaneous language samples and to test their correspondence with standardized measures. Multiple regression analysis was used to test for differential effects of hearing loss on morphosyntax and lexical development. Results Children with mild to severe hearing loss, on average, showed depressed language levels compared to peers with normal hearing who were matched on age and socioeconomic status. The degree to which CHH fell behind increased with greater severity of hearing loss. The amount of improved audibility with hearing aids was associated with differential rates of language growth; better audibility was associated with faster rates of language growth in the preschool years. Children fit early with hearing aids had better early language achievement than children fit later. However, children who were fit after 18 months of age improved in their language abilities as a function of the amount of hearing aid use. These results suggest that the language learning system remains open to experience provided by improved access to linguistic experience. Performance in the domain of morphosyntax was found to be more delayed in CHH than their semantic abilities. Conclusion The data obtained in thi...

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“…Data concerning daily HA use were obtained via a parent questionnaire (see Walker et al this issue, pp. XXX and Walker et al 2013).…”

Section: Methodsmentioning

confidence: 99%

Language Outcomes in Young Children with Mild to Severe Hearing Loss

et al. 2015

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“…XXXX), consistently-worn amplification (Tomblin et al, this volume, pp. XXXX; Walker et al, this volume, pp. XXXX), and provision of high quality language exposure in the home (Ambrose et al, this volume, pp.…”

Section: Introductionmentioning

confidence: 99%

Epilogue

2015

Ear &Amp; Hearing

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The primary purpose of the epilogue article is to synthesize the key findings from the Outcomes of Children with Hearing Loss (OCHL) study by presenting a set of ten major conclusions. The conclusion statements provide a concise summary of the main results related to children’s auditory and language outcomes and factors identified as moderators of these outcomes. The second section of this article summarizes the primary clinical implications that follow from the OCHL study in relation to three questions: 1) Can we afford to be complacent about the current outcomes of children who are hard of hearing? 2) What malleable factors can be addressed to promote success through implementation of best practices? and 3) What non-malleable factors are consequential and what are their implications for practice? We end with some future research directions for the OCHL project.

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“…Recent studies show that hearing aid (HA) use is highly variable in infants and toddlers (Marnane & Ching 2015; Muñoz et al, 2014, 2015; Walker et al 2015). For example, it has been shown that children between 6 months and 2 years of age use their HAs for an average of 4.36 hours per day; whereas, pre-school children between the ages of 2 and 4 years wear their hearing aids on average 7.5 hours per day (Walker et al 2015). While there is no comparison regarding wear time in the literature between children younger than 3 years who use HAs and children who wear CIs, recent unpublished data on CI use in young children also show variable use (Tournis, Reference Note 1).…”

Section: Discussionmentioning

confidence: 99%

The Effect of Hearing Loss on Novel Word Learning in Infant- and Adult-Directed Speech

2017

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Objectives Relatively little is known about how young children with hearing impairment (HI) learn novel words in infant- and adult- directed speech. Infant-directed speech (IDS) supports word learning in typically developing infants relative to adult-directed speech (ADS). This study examined how children with normal hearing (NH) and children with HI learn novel words in IDS and ADS. It was predicted that IDS would support novel word learning in both groups of children. In addition, children with HI were expected to be less proficient word learners as compared to their NH peers. Design A looking-while-listening paradigm was used to measure novel word learning in 16 children with sensorineural HI (age range 23.2–42.1 months) who wore either bilateral hearing aids (n = 10) or bilateral cochlear implants (n = 6) and 16 children with NH (age range 23.1–42.1 months) who were matched for gender, chronological age, and maternal education level. Two measures of word learning were assessed (accuracy and reaction time). Each child participated in two experiments approximately one week apart, one in IDS and one in ADS. Results Both groups successfully learned the novel words in both speech type conditions, as evidenced by children looking at the correct picture significantly above chance. As a group, children with NH outperformed children with HI in the novel word learning task, however there were no significant differences between performance on IDS vs ADS. More fine-grained time course analyses revealed that children with HI, and particularly children who use hearing aids, had more difficulty learning novel words in ADS, compared to children with NH. Conclusions The pattern of results observed in the children with HI suggests that they may need extended support from clinicians and caregivers, through the use of IDS, during novel word learning. Future research should continue to focus on understanding the factors (e.g., device type and use, age of intervention, audibility, acoustic characteristics of input, etc.) that may influence word learning in children with HI in both IDS and ADS.

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Trends and Predictors of Longitudinal Hearing Aid Use for Children Who Are Hard of Hearing

Cited by 87 publications

References 35 publications

Language Outcomes in Young Children with Mild to Severe Hearing Loss

Language Outcomes in Young Children with Mild to Severe Hearing Loss

Epilogue

The Effect of Hearing Loss on Novel Word Learning in Infant- and Adult-Directed Speech

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