Early Detection Improved Vocabulary Scores in Kids with Hearing Loss

By Molly Walker

Children with hearing loss in both ears had improved vocabulary skills if they met all of the Early Hearing Detection and Intervention guidelines, a small cross-sectional study found.

Those children with bilateral hearing loss who met all three components of the Early Hearing Detection and Intervention guidelines (hearing screening by 1 month, diagnosis of hearing loss by 3 months and intervention by 6 months) had significantly higher vocabulary quotients, reported Christine Yoshinaga-Itano, PhD, of the University of Colorado Boulder, writing in Pediatrics.

The authors added that recent research reported better language outcomes for children born in areas of the country during years where universal newborn hearing screening programs were implemented, and that these children also experienced long-term benefits in reading ability. The authors said that studies in the U.S. also reported better language outcomes for children whose hearing loss was identified early, who received hearing aids earlier or who began intervention services earlier. But those studies were limited in geographic scope or contained outdated definitions of "early" hearing loss.

"To date, no studies have reported vocabulary or other language outcomes of children meeting all three components of the [Early Hearing Detection and Intervention] guidelines," they wrote.

Researchers examined a cohort of 448 children with bilateral prelingual hearing loss between 8 and 39 months of age (mean 25.3 months), who participated in the National Early Childhood Assessment Project -- a large multistate study. About 80% of children had no additional disabilities that interfered with their language capabilities, while over half of the children with additional disabilities reported cognitive impairment. Expressive vocabulary was measured with the MacArthur-Bates Communicative Development Inventories.

While meeting all three components of the Early Hearing Detection and Intervention guidelines was a primary variable, the authors identified five other independent predictor variables into the analysis:

• Chronological age

• Disability status

• Mother's level of education

• Degree of loss

• Adult who is deaf/hard of hearing

They wrote that the overall model was significantly predictive, with the combination of the six factors explaining 41% of the variance in vocabulary outcomes. Higher vocabulary quotients were predicted by higher maternal levels of education, lesser degrees of hearing loss and the presence of a parent who was deaf/or hard of hearing, in addition to the absence of additional disabilities, the authors said. But even after controlling for these factors, meeting all three components of the Early Hearing Detection and Intervention guidelines had "a meaningful impact" on vocabulary outcomes.

The authors also said that mean vocabulary quotients decreased as a child's chronological age increased, and this gap was greater for older children. They argued that this complements previous findings, where children with hearing loss fail to acquire vocabulary at the pace of hearing children.

Overall, the mean vocabulary quotient was 74.4. For children without disabilities, the mean vocabulary quotient was 77.6, and for those with additional disabilities, it was 59.8.

Even those children without additional disabilities who met the guidelines had a mean vocabulary quotient of 82, which the authors noted was "considerably less" than the expected mean of 100. They added that 37% of this subgroup had vocabulary quotients below the 10th percentile (<75).

"Although this percentage is substantially better than for those who did not meet [Early Hearing Detection and Intervention] guidelines ... it points to the importance of identifying additional factors that may lead to improved vocabulary outcomes," they wrote.

Limitations to the study included that only expressive vocabulary was examined and the authors recommended that future studies consider additional language components. Other limitations included that disability status was determined by parent, with the potential for misclassification.

The authors said that the results of their study emphasize the importance of pediatricians and other medical professionals to help identify children with hearing loss at a younger age, adding that "only one-half to two-thirds of children met the guidelines" across participating states.

This article was republished with permission from MedPageToday. 

My Daughter, My Inspiration

By JoAnn Wood, Au.D.

It's been 15 years since my daughter Georgie was born and her hearing loss discovered. At that time, I couldn't picture that she would ever hear me say "I love you,” or that I would ever hear her call me "Mommy.” When I found out that my daughter was deaf I imagined her struggling to learn speech and language, working hard to get good grades and having difficulty making new friends. That's not at all what Georgie's story has been like.

Since I had two sons without hearing loss, my daughter's hearing loss was unexpected. At 1 day old, Georgie failed the Universal Newborn Hearing Screening at the hospital where she was born. Two weeks later additional testing revealed that Georgie had a moderate to severe sensorineural hearing loss in her right ear and a severe to profound loss in the left ear. This was very difficult news for me and my family to hear.

After the diagnosis my husband, who also has hearing loss, and I decided to get her hearing aids right away. At 7 weeks old, Georgie was fit with her first set of digital behind-the-ear hearing aids. She wore them consistently for three years while getting extensive speech and language services and attending special programs at schools for the hearing impaired.

Unfortunately, Georgie's hearing loss progressively got worse. Even with the hearing aids, at 3 years old Georgie’s limited speech and language was far behind that of her peers. She was saying some words but only I could understand her. That made me feel sad, and I could see that it was frustrating for her. Other children her age were talking in complete sentences.

It was then that the cochlear implant became a better option for Georgie. She received an implant in her left ear at age 3 and continued to wear a hearing aid in the right ear. Within three months of implantation, Georgie's speech and language began to take off! People were able to understand her, and she became less frustrated. Georgie began to take dance classes, the start of a lifelong love.

When she was 5, and the Food and Drug Administration approved bilateral cochlear implants for young children, Georgie underwent cochlear implant surgery again, but this time on the right side. It improved her hearing and communication even more. That same year Georgie started kindergarten in the mainstream. By the end of kindergarten, she was disqualified for any speech and language services because she had completely caught up to her peers. 

Universal Newborn Hearing Screening wasn’t an option when my two older sons were born, so I am grateful that when Georgie was born it was required. Her hearing loss was detected immediately.

The experience with Georgie led me to go back to school starting when she was a toddler, to get a bachelor’s, master's, and ultimately a doctorate in audiology. I have had my own practice for the past six years and I am a professor at a local private college. In fact, Georgie comes to my class each semester to talk openly to future speech pathologists and audiologists about her experiences.

Georgie will be starting 10th grade in September and takes all honors classes.  She has received high honors every semester since 6th grade. She is a well-rounded and very social young lady. Georgie's love for dance has taken her to a competitive level, having won several regional awards in many genres of dance such as ballet, lyrical, contemporary, hip-hop, tap, and jazz. 

Looking back I wish I knew then how well Georgie would do and that everything was going to be okay. She has worked hard for all that she has accomplished and I am very proud of her. She is truly an inspiration! 

My Story

By Taylor Thompson

As an infant, I loved when my aunts and uncles brought out the pots and pans. They banged them as loudly as they could and I would giggle away—unlike a typical baby, who would likely be startled by loud sounds. My failure to react was one of the early signs my family noticed that I was different. In fact, my mother had a gut feeling I was deaf and took me to a doctor.

At first doctors dismissed my mother's intuition because I babbled and made noises like typical babies do, and was not mute as many deaf babies are. However, she remained persistent and took me to more doctors until finally at age 18 months I was diagnosed with bilateral sensorineural hearing loss.

Originally, I was fitted with behind-the-ear hearing aids. After some time and further hearing tests, it was evident that hearing aids were not enough. Doctors determined that I was a candidate for the then-new cochlear implant in 1995. At 2 ½ years old I received a cochlear implant (CI) at the Riley Hospital for Children by Dr. Richard T. Miyamoto, who is an HHF Honorary Board Member.

My mother made sure I received the CI as soon as possible because she wanted to ensure I had the best chances for developing speech and hearing. Although it seems young, 2 ½ years old is a late age to begin speech development, so I attended speech therapy throughout elementary school until I reached a proficiency comparable to my age group (which was around 5th grade). 

Until I could learn to speak effectively and comprehend spoken language, I used Exact English sign language. I learned Exact English because it’s structure closely resembles the spoken and written language structure, so my transition would be easier when I began to speak and read. At some point, I am not sure when, I stopped utilizing Exact English and completely transitioned to understanding others through a combination of lip-reading and hearing.

When I was younger, I attended a mainstream school that had a hard-of-hearing program. This was unique because I was able to interact with peers ranging from hearing to completely deaf—like myself. While growing up in this program brought wonderful opportunities, it still did not come without hardships.

During my time in this school, I was mocked for not being able to hear as well as the other students in my class who also had hearing loss, but not by those with full hearing. Being bullied by my hard-of-hearing peers and not my hearing peers was very confusing; it was easier to comprehend why someone might have trouble accepting me if they could not relate to me, but these peers were also struggling with hearing issues.

This became my biggest struggle growing up—understanding my identity—as I was ridiculed for being deaf while having this thing (my cochlear implant) on my head. I spent a lot of time after school exploring questions such as: Am I really deaf because I can hear with this thing (CI)? What does it mean to be deaf? Am I a disabled person or do I just do things differently?

Being deaf with only one CI has limitations since my hearing loss affects both my ears. To overcome some of these limitations, I have a wonderful hearing service dog named Zoë. Her most important role is to alert me by nudging me with her nose when a sound goes off, such as door knocks, a kitchen timer buzzing, and the noise of a pedaling bike. These alerts are especially helpful when I am not wearing my implant at night or when I cannot distinguish white noise from a specific noise, like a passing car.

Taylor, with her dog, Zoë

Despite the challenges I have faced, with the support of my family, friends, and a loyal dog, I persevered and became the person I am today—resilient, confident, and proud. And little did I know but appreciation for my loyal childhood dog inspired me to work with animals for the rest of my life.

Through diligence and determination, I was accepted to Purdue University College of Veterinary Medicine, where I am currently in my second year studying to become a small-animal veterinarian. I hope someday to combine veterinary work with giving back to the community, including disabilities awareness and advocating for hearing health.

Taylor Thompson is a 23-year-old veterinary student at Purdue University College of Veterinary Medicine in Indiana. 

Support HHF This Mother's Day

By Heather Friedman

Laura (second from left) with her sister in-law Liza, her maternal Grandmother and Aunt, with Heather on the far right.

For three and a half years my daughter, Laura, attempted to hear and to be understood. As her mother, I struggled to make sense of her difficulties—which I knew in my heart did not stem from developmental or attention deficit disorders.

Prior to her diagnoses at three and a half, Laura had a very difficult time communicating. I took her to specialists and started her on speech therapy, with little result. When Laura was finally diagnosed and fitted with hearing aids, things began to fall into place.

When Laura finally received the correct diagnosis—hearing loss—I was relieved. Parents and children should not have to wait over three years to have this condition detected, struggling all the while with delays hampering social and emotional growth. Parents should not have to go through the pain of knowing something is holding their baby back, when it could be so easily detected.

In 1993, four years after Laura was born, Hearing Health Foundation’s steadfast advocacy work led to the passing of Universal Newborn Hearing Screening Legislation. As a result—today, 97% of American babies are tested for hearing loss at birth. This means newborns with hearing loss can immediately get the help they need through technology such as hearing aids and cochlear implants, as well as speech and language therapy. This means an easier life, from birth, for children with hearing loss.

Today, I am proud to say that Laura is a happy and successful adult. In fact, she is such a staunch champion for people with hearing loss that when a job became available at Hearing Health Foundation, she jumped at the chance to work there! As Hearing Health Foundation’s Communications and Programs Manager, Laura works hard to advocate for those with hearing loss, to prevent hearing loss, and most importantly to raise funds to research for a cure.

It is my hope that she can one day benefit from her tireless efforts. Your support can make my dream for her, and other people living with hearing loss, a reality. A gift to this amazing organization is a gift to all people with hearing loss, as well as to their families!

This Mother's Day, Hearing Health Foundation would like to shine a light on all Mothers for all they do for their children and families.

Please consider giving a gift in Honor or in Memory of a wonderful Mother you know. Your gift will be used to fund groundbreaking research to prevent and cure Hearing Loss and Tinnitus and to promote hearing health.

HHF Provides Free Hearing Screenings for Students

http://nymetroparents.com/article/hearing-health-foundatin-and-gordon-hearing-conservation-provide-free-hearing-tests-for-students

NYC schools no longer offer hearing screenings for its students, so on May 2, the Hearing Health Foundation and Gordon Hearing Conservation partnered to provide free hearing screenings for students at the Speyer Legacy School on Manhattan's Upper West Side in honor of May's Better Hearing and Speech month.

On May 2, 2013, Hearing Health Foundation, a non-profit dedicated to finding a cure for hearing loss, partnered with Gordon Hearing Conservation and The Speyer Legacy School to provide a “Safe and Sound” presentation and free hearing screenings for its third-fifth graders.

Serving as the kickoff to May’s “Better Hearing & Speech Month,” the Hearing Health Foundation fulfilled a dire need, as NYC schools no longer offer hearing screening for their students. By providing this service, Hearing Health Foundation, Gordon Hearing Conservation, and The Speyer Legacy School are ensuring the protection of children’s hearing.

While hearing screenings are an overlooked necessity, they test whether an individual has normal hearing or some degree of hearing loss.

A rampant issue, hearing loss statistics can be shocking:

• 1 in 5 Americans have hearing loss in at least one ear.

• 20% of the US population aged 12 years and older has hearing difficulties severe enough to impact communication.

• There is a direct link between age and hearing loss: about 18% of American adults between the ages of 45 and 54, 30% of adults between ages 65 and 74, and 47% of adults ages 75 and older have hearing impairments.

• In the USA, three out of every 1,000 children are born deaf or hard-of-hearing.

• About 26 million Americans between ages 20-69 have high frequency hearing loss due to exposure to loud noises at work or in leisure activities.

• About 60% of deployed military service men and women have noise induced hearing loss, tinnitus and other hearing injuries.

About Hearing Health Foundation

Hearing Health Foundation is the largest private funder of hearing research, with a mission to prevent and cure hearing loss through groundbreaking research. Since 1958 Hearing Health Foundation has given almost $30 million to hearing and balance research, including work that led to cochlear implant technology. In 2011 Hearing Health Foundation launched the Hearing Restoration Project, a consortium of scientists working on cell regeneration in the ear. HRP's goal is a biologic cure for most types of acquired hearing loss within the next ten years.

Hearing Health Foundation also publishes Hearing Health magazine, a free consumer resource on hearing loss and related technology, research, and products. To learn more, to subscribe to our magazine, or support this work, visit hearinghealthfoundation.org.
 
Follow the Foundation on Twitter at @HearingHealthFn and Like the organization on Facebook at facebook.com/hearinghealthfoundation.

Ten Clues Your Child Has Hearing Loss

Ten clues your child has hearing loss

Universal hearing testing for newborns has helped to identify most children with hearing issues quickly and accurately. With a simple test, 80 to 90 percent of hearing loss can be detected, and children can begin early intervention with the best possible outcomes for language development.

“Even if your child passed the newborn screening at birth, however, keep in mind that hearing loss that is genetic or progressive in nature can manifest when your child is a toddler or older,” says Dr. Barbara Jenkins, an audiologist and writer of this article, with Hearing Health Magazine. “It’s important to identify signs that may suggest possible hearing loss in your child, so that testing can be done and treatment and management undertaken.”

Delayed or absent speech development is the most important clue indicating a possible hearing loss in the very young child. Identifying hearing loss in the infant and young child requires watching for critical developmental milestones.

Use the following milestones from Hearing Health Foundation as a guideline, and always discuss any concerns with your pediatrician.

* By 3 months, your baby recognizes and quiets to your voice, makes cooing noises, and is startled by sudden, loud noises.

* By 6 months, your baby recognizes speech sounds and familiar voices, turns his head toward interesting sounds, plays with his own voice, and laughs. Your baby uses his voice to indicate pleasure and discomfort, and has speech-like conversations with caregivers.

* By 9 months, your baby can understand simple words like “mommy,” “daddy,” “no,” “bye-bye” and his own name.

* By 10 months, your baby’s babbling should sound speech-like with strings of single syllables (“da-da-da-da”).

* By 12 months, one or more real, recognizable spoken words emerge.

* By 18 months, your toddler should understand simple phrases, retrieve familiar objects on command (without gestures), and point to body parts when asked, “where’s your ... ears, nose, mouth, eyes,” etc. Your toddler has a spoken vocabulary of between 20 to 50 words and short phrases (“all done,” “go out,” “mommy up”) and is learning new words each week.

* By 24 months, your toddler’s spoken vocabulary should be 200 to 300 words and simple sentences can be spoken. Adults not with your child on a daily basis can understand your child’s speech. A toddler at this age should be able to sit and listen while being read books.

Children who have developed speech skills are more difficult to identify. Use these guidelines from Hearing Health Foundation to discern a possible newly acquired hearing loss.

1. Your child seems to hear fine some of the time and then not respond at other times.

2. Your child wants the TV volume louder than other members of the family.

3. Your child says “what” more often than he used to.

4. Your child moves one ear forward when listening, or he complains that he can only hear out of his “good ear.”

5. Your child’s grades fall, or his teacher notes that he doesn’t seem to hear or respond in the classroom as well as other children.

6. Your child says that he didn’t hear you. This may seem obvious, but many parents assume that their children are not paying attention when in fact there may be an unidentified hearing loss.

7. It seems as though your child is just not paying attention.

8. Your child starts to speak more loudly than previously.

9. Your child looks at you intently when you speak to him. He may be depending more on visual cues for interpreting speech.

10. You just have a feeling. Sometimes you just can’t put your finger on what your concern is. Don’t let that stop you. Ask your child’s doctor for a referral to ease your mind.

There are many possible causes of acquired hearing loss that present themselves months or years after birth. Most hearing loss in children without obvious risk factors (such as premature birth) has a genetic cause. If you have any concerns, contact your pediatrician for a referral to a hearing health care provider for a complete hearing evaluation.

To learn more about genetic hearing loss, visit Hearing Health Foundation to read the Summer 2012 issue of Hearing Health magazine, available online at hearinghealthfoundation.org/hearing-health-magazine.  

To learn more about the types of newborn hearing screenings and the importance of early detection and early intervention, visit hearinghealthfoundation.org/newborn-screening-information.