Expressive language in a population cohort of two-year-old children with hearing loss

Ms Michelle Xu Lin1, Dr Valerie Sung1,2, Ms Libby Smith2, Ms Emma Creelman1, Dr Peter Carew1,2

 1The University Of Melbourne, Carlton, Australia,

2Murdoch Children’s Research Institute, Royal Children’s Hospital Melbourne, Australia


Purpose of presentation: Present results from a Universal Newborn Hearing Screening (UNHS)-based population-level study of expressive language skills in two-year-old children with any degree of hearing loss from Victoria, Australia.

Nature and scope of topic: A cross-sectional study of 137 two-year-olds (mean=25.6 months, SD=3 months) with bilateral and unilateral hearing loss. Participants were identified through the Victorian Infant Hearing Screening Program (VIHSP) and enrolled in the Victorian Childhood Hearing Impairment Longitudinal Databank (VicCHILD). Expressive language skills were assessed using a standardized parent-report checklist, the Sure Start Language Measure (SSLM).

This study aimed to report early expressive language skills as predicted by hearing loss severity and type, age of early intervention commencement and non-English speaking background.

Issue or problem under consideration: Congenital hearing loss can negatively impact language outcomes. To date, no published population-based studies have considered early expressive language in children with hearing loss, both unilateral and bilateral, identified solely under a UNHS system. Language evaluation during the critical language development period may clinically inform early intervention efficacy and flag need for additional supports.

Outcome or conclusion reached: Children with unilateral hearing loss as a whole demonstrated better early expressive language than those with bilateral losses. Fewer than half of the children with moderate-severe bilateral hearing loss achieved SSLM scores within the average range for normally hearing children. All children with mild unilateral hearing loss achieved age appropriate SSLM scores, however nearly a quarter with moderate-severe unilateral hearing loss attained scores more than 1 standard deviation below the standardized mean. Thus, even at the early age of two years, some children with moderate-severe unilateral hearing loss already demonstrate expressive language skills below expectations for their normally hearing peers. Further research is needed to monitor language outcome trajectories and establish if additional intervention is required to prevent lengthening of language delays.


Peter is an audiologist and Lecturer in the Department of Audiology and Speech Pathology at The University of Melbourne. He has a special interest in the diagnosis and management of children born with milder degrees of hearing loss. His research focuses on exploring the population-level outcomes of these children. Peter works collaboratively with researchers around Australia and internationally, with the goal of positively influencing the whole-of-life outcomes for impacted individuals and their families.