Journal of early hearing detection and intervention最新文献

Background: Early enrollment in Part C Early Intervention (EI) before age 6 months is linked to improved language and kindergarten readiness in children who are deaf or hard of hearing (DHH), but the effect on later academic outcomes is unclear. This study examines whether earlier (< 6 months) versus later (> 6 months) enrollment of children who are DHH in early intervention programs influences third-grade reading proficiency.

Method: This study used data linked from three Ohio state agencies for infants identified with permanent hearing loss born 2008-2014 who received EI. The sample consisted of 412 children who were DHH and had scores on third grade standardized reading tests. Reading levels were categorized from limited to advanced. Logistic regression assessed the association between enrollment timing and reading proficiency, adjusting for potentially confounding variables.

Results: Children enrolled in EI programs before 6 months of age (n = 231; 56.1%) were more likely to achieve advanced reading levels (19.9% vs. 12.2%) and less likely to score at limited levels (27.7% vs. 36.5%) than those enrolled later. Earlier enrolled children had reading performance comparable to all Ohio third graders. Earlier enrollment was statistically significantly associated with proficient or better reading levels compared to later enrollment (OR 1.64 95% CI [1.06, 2.57]).

Conclusion: Benefits of earlier EI enrollment extend into elementary school, supporting healthy developmental trajectories and reducing risk for later academic challenges in children who are DHH.

Background: Previous position statements by the Joint Committee on Infant Hearing (JCIH) have recommended the presence of hyperbilirubinemia requiring exchange transfusion as a risk factor for childhood hearing loss. This article examines the strength of the evidence to support this recommendation.

Methods: A PubMed^® query using the keywords hyperbilirubinemia and hearing loss identified 77 original papers. All abstracts were reviewed for consideration of full article review and 44 articles were reviewed for consideration of inclusion and grading, with 21 articles graded using structured evidence-grading forms. Nineteen articles were included to provide supporting rationale for recommendations. Evidence grading was completed by recommendation.

Results: A moderate level of evidence supports hyperbilirubinemia requiring exchange transfusion as a risk factor for elevated hearing thresholds among infants and young children. It is recommended to employ Automated Auditory Brainstem Response screening in this population of infants. These recommendations are based on the findings across multiple graded studies where the net benefit is moderate or substantial. Intervals for on-going monitoring of hearing previously recommended by JCIH are supported by expert consensus.

Conclusion: If an infant with hyperbilirubinemia requiring exchange transfusion passes the newborn hearing screening, close monitoring of hearing, speech, and language milestones are important and should lead to improved outcomes for the child.

The Joint Committee on Infant Hearing guidelines recommend that children who are deaf and hard of hearing should begin early intervention by six months of age. However, prior work has revealed a substantial percentage of children who receive a diagnosis of hearing loss by three months of age, but do not enroll in early intervention by six months of age (Grey et al., 2022). To further understand barriers to enrollment in early intervention for these families, we completed qualitative semi-structured interviews with 10 caregivers whose children were diagnosed with hearing loss by three months of age but did not begin early intervention by six months. We recruited from participants in Grey et al. (2022). Interviews were coded using the Bioecological Model of Human Development (Bronfenbrenner & Morris, 2006) as a guiding framework. The interviews revealed widespread barriers encountered by families of children who are deaf and hard of hearing across ecological systems, ranging from child characteristics to macro-level issues like insurance coverage. To ensure that all children who are diagnosed with hearing loss have timely access to early intervention, changes to current policy and practice are needed across multiple ecological systems.

Guidelines created by the American Academy of Pediatrics ([AAP], 2010) and the Joint Committee on Infant Hearing ([JCIH], 2019) were designed to aid in the early identification of infant hearing loss. Despite these guidelines, a quarter of children who do not pass their initial screening are lost to the follow-up process and many more do not receive care in line with the 1-3-6 guidelines (Centers for Disease Control and Prevention [CDC], 2018; JCIH, 2019). To acquire more information about the experiences of families and identify specific barriers to timely diagnosis and intervention, interviews were conducted with 13 parents of children who are deaf or hard of hearing whose children were enrolled in a larger longitudinal study. These interviews revealed common themes regarding delayed identification, frustrations about timely intervention, and confusion when choosing communication modalities. Common themes amongst families who felt well-supported were also identified.

Objective: The COVID-19 pandemic impact on Early Hearing Detection and Intervention (EHDI) programs is unknown. This research evaluated sociodemographic factors influencing adherence to EDHI diagnostic testing and the incidence of infant hearing loss during the pandemic.

Method: We evaluated EHDI adherence and incidence of hearing loss in Kentucky before and during the COVID-19 pandemic. Using univariate and multivariate analysis, we evaluated the association of these outcomes to sociodemographic variables.

Results: There were 71,206 births and 1,385 referred infant hearing screening tests during the study period. Infants during the pandemic had a 24% lower odds of hearing testing adherence (OR = 0.76, p = 0.05, 95%CI: 0.57-1). Hispanic infants have 45% lower odds of EHDI adherence (OR = 0.55, p = 0.03, 95%CI: 0.31-0.96) and infants of Swahili speaking families have 90% lower odds of EHDI adherence (OR = 0.10, p = 0.001, 95%CI: 0.02-0.42). Infants of mothers with a high school degree had a higher odds of adherence (OR = 1.50, p = 0.02, 95%CI: 1.06-2.17), presented earlier for testing (p = 0.003, 95%CI: -15.73- [-]3.32), and had a higher odds of normal hearing (OR = 1.63, p = 0.03, 95%CI: 1.06-2.51).

Conclusion: EHDI adherence is influenced by the COVID-19 pandemic and sociodemographic factors. EHDI programs are encouraged to use this data to promote timely and equitable access and use of diagnostic services.

The study compares receipt and timeliness of newborn hearing screening and follow-up diagnostic services between the pre-pandemic birth cohort and the pandemic birth cohort in four participating states. Findings from this study will help inform state Early Hearing Detection and Intervention (EHDI) programs in the future should a major public health event occur again.

This perspective aims to highlight aspects of the Early Hearing Detection and Intervention (EHDI) newborn hearing screening and follow-up processes that were impacted by the COVID-19 pandemic and considers factors that likely impacted follow-up after failing newborn hearing screening among infants born in the United States during 2020. Efforts to minimize the potential impact of missed or delayed identification of hearing loss in infants and young children will also be discussed to help guide future program improvement activities.

Purpose: To evaluate the impact of hearing screening, diagnosis, and early intervention (EI) by 3 months or 6 months of age on language growth trajectories for children with hearing loss (HL) relative to children with normal hearing (NH).

Method: We recruited 133 children with mild to severe HL through universal newborn hearing screening records and referrals from audiologists in the United States and 116 children with NH who served as a comparison group. Examiners administered a battery of developmentally appropriate language measures between 12 months and 8 years of age. We constructed latent growth curve models of global language, grammar, and vocabulary using Bayesian statistics.

Results: Children with HL demonstrated no significant differences in initial language skills compared to children with NH. Children in the 1-3-6 group also showed no difference in language growth compared to children with NH. The slope for the 1-2-3 group was significantly steeper than children with NH for global language and grammar.

Conclusions: This study documents the positive impact of EI on language outcomes in children with congenital HL. It is among the first to provide evidence to support the potential effects of very early intervention by 3 months of age.

Purpose: To describe an evaluation conducted by 39 state Early Hearing Detection and Intervention (EHDI) programs on the reporting process and system usability for audiologists when reporting the hearing test results to the EHDI program and the barriers encountered during reporting.

Method: Each author independently extracted numbers, percentages, and texts from the evaluation reports into an Excel spreadsheet, which then became the dataset. Authors then compared and cross-checked the datasets before coding. Texts conveying similar concepts were coded with the same name and organized into categories. Finally, thematic identification and analysis were performed when a theme(s) or concept(s) that pertained to similar challenges encountered by audiologists was identified and organized under a higher-order domain.

Results: Some audiologists reported no barriers when reporting hearing test results to the state EHDI programs. Among those audiologists who reported barriers, the most recurrent barrier was a non-user-friendly data system design. The second most recurrent barrier was not having adequate administrative time to report data as a busy clinician. The third most recurrent barrier was an incomplete understanding of the state EHDI reporting requirements. Finally, the method audiologists were required to use when reporting results also posed some challenges, such as no internet connection in rural areas when required to report via an internet portal.

Conclusion: Because of the wide variety of barriers faced by audiologists, multiple strategies to improve the reporting process would likely be beneficial.