Dr Peter Carew1,2, Dr Daisy Shepherd1,2, Libby Smith2, Tegan Howell2, Michelle Lin2, Prof Edith Bavin2,3, Prof Sheena Reilly1,2,4, Prof Melissa Wake1,2,5, A/Prof Valerie Sung1,2,6
1The University Of Melbourne , Parkville, Australia, 2Murdoch Children’s Research Institute, Parkville, Australia, 3La Trobe University, , Australia, 4Menzies Health Institute, Griffith University, , Australia, 5Liggins Institute, University of Auckland, , New Zealand, 6Royal Children’s Hospital, Parkville, Australia
Despite routine early detection of congenital hearing loss effectively reducing the median age of hearing loss detection, language outcomes for affected children remain poorer than normative expectations and population means. Understanding modifiable factors that may improve language outcomes, over and above well-established early detection systems, may help reduce the inequities in language outcomes between children with and without hearing loss.
Within a community-based sample of over 300 2-year-old children born with unilateral and bilateral hearing loss, we used causal modelling to examine the impact of hearing loss on caregiver-reported expressive vocabulary outcomes. We compared these children’s outcomes to children without hearing loss from the same community. We also investigated the impact of intervention-related factors (amplification device use, age at first amplification, age at first enrolment with early intervention services) on expressive vocabulary outcomes.
Two-year-old children with, versus without, hearing loss had poorer expressive vocabulary scores, with mean scores for bilateral loss 0.5 (mild) to 0.9 (profound) standard deviations lower, and for unilateral loss marginally (0.1 to 0.3 standard deviations) lower. Early intervention and amplification by 3 months, rather than by 6 months or older, predicted higher expressive vocabulary scores in children with hearing loss. Among those with hearing loss, 40%, 21% and 39% used their devices ‘always’, ‘sometimes/often’ or ‘never/rarely’ respectively, with the ‘sometimes/often’ group tending to the worst outcomes.
At age 2 years, children with hearing loss demonstrate delayed expressive vocabulary despite sophisticated systems of early detection and intervention. Our amplification data suggest both over-servicing and under-use may be occurring. Our data support the 1-2-3 month timeline for screening, identification and intervention, rather than the original 1-3-6 EHDI indicators.
Biography:
Dr Peter Carew is a Senior Lecturer in the Department of Audiology and Speech Pathology at The University of Melbourne and a post-doctoral researcher at the Murdoch Children’s Research Institute. Peter holds a Master in Clinical Audiology, PhD and Graduate Certificate in University Teaching. pcarew@unimelb.edu.au or peter.carew@mcri.edu.au