Early intervention following early detection is key to better language outcomes: update on the LOCHI study (Outcomes Symposium Paper 1)

Dr Teresa YC Ching1,2, the LOCHI team1,2

National Acoustic Laboratories, Macquarie University, Australia, 2HEARing CRC, Australia

We propose a series of 4 papers to feature in a Symposium on Improving outcomes for children through early detection and intervention. All papers draw on data from the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study to shed light on children’s abilities and parents’ perspectives.

Universal newborn hearing screening has led to detection of hearing loss soon after birth, but there has been insufficient evidence on its efficacy for improving outcomes of children with permanent childhood hearing loss. The extent to which variability in speech and language outcomes may be related to screening status, age at intervention, and other demographic variables has been examined in a population-based study that investigated factors influencing Longitudinal Outcomes of Children with Hearing Impairment (the LOCHI study)

Methods. Participants were 339 children using hearing aids (HAs) or cochlear implants (CI) who are enrolled in the LOCHI study. At 5 years of age, speech pathologists completed direct assessments of language (Pre-school Language Scale v.4), receptive vocabulary (Peabody Picture Vocabulary Test) and speech production (Diagnostic Evaluation of Articulation and Phonology) of the children. Information about demographic and audiological characteristics was collected. Multiple regression analyses were conducted to examine the influence of child- and family-related factors on speech and language abilities.

Results. Regression models accounted for 45% to 70% of variance in scores across different language and speech assessments. For both children with HAs and children with CIs, earlier device fitting and higher nonverbal ability were associated with better outcomes. Severity of hearing loss and maternal education also influenced outcomes of children with HAs. For children with CIs, the presence of additional disabilities was associated with poorer outcomes on all measures.

Conclusions. The findings provide strong evidence for the benefits of early HA fitting and early cochlear implantation for improving children’s language outcomes.


Dr Ching is head of Rehabilitation Procedures research at the National Acoustic Laboratories, Australia. Her current research focuses on investigating efficacy of early intervention for populations of children with bilateral hearing loss or unilateral hearing loss, identifying factors affecting outcomes, evaluation of sound detection and discrimination in infants with hearing loss or auditory neuropathy spectrum disorder, and prescription of hearing aids and electric-acoustic stimulation (bimodal fitting) for children and adults. Teresa has published more than 120 peer-reviewed manuscripts. She is regularly invited to deliver key note presentations at international conferences. She serves on the editorial boards of four international journals.