UCEDD – Slide of the Week

UCEDD - Slide of the Week

Title: Early Identification of Hearing Loss and Language Development at 32 Months of Age

Legend: Predicted mean Developmental Quotients* in children when hearing loss was identified before (solid lines) and after (dashed lines) the age of 3 months. 1 represents the developmental quotient at Phase 1 when children were around 15 months of age, considered to be their starting point. 2 represents the developmental quotient at Phase 2 when children were around 32 months of age.  N= 86. The predicted values suggest that children whose hearing loss was identified by 3 months of age had less decrease in their overall score between Phase 1 and Phase 2 for these four outcome variables.

*LQ or Q = Language Quotient or Quotient calculated from assessment scores as:
(Developmental Age/Chronological Age) x 100 = Developmental Quotient
CDI = Minnesota Child Development Inventory (General/overall Q and subscales)
Mac = MacArthur-Bates Communicative Development Inventories

Rec_LQ: CDI language.
Soc_Q: CDI social skill.
Gen_Q: CDI general development.
Mac_LQ: MacArthur vocabulary.

The shaded area shows the range < 80 for quotients indicative of developmental delay.  A quotient of 100 indicates a child’s developmental age is exactly commensurate with their chronological age. Quotients below 80 are considered to indicate a clinically significant delay relative to other children of the same age. Additionally, the manual for the CDI indicates that scores between 70-80 are suggestive of borderline delay. (references available upon request)

Interpretation: Using statistical modeling, predictive values in the Figure show that language quotients decreased on the standardized assessments between Phase 1 (average age of 15 months) and Phase 2 (average age of 32 months), both for children who were identified with hearing loss by 3 months of age and for children identified later. Despite better language outcomes associated with early hearing loss identification and access to intervention, language development for children with hearing loss still lagged behind their hearing peers.

Citation: Harris, A.B.; Seeliger, E.; Hess, C.; Sedey, A.L.; Kristensen, K.; Lee, Y.; Chung, W. Early Identification of Hearing Loss and Language Development at 32 Months of Age.  J. Otorhinolaryngol. Hear. Balance Med. 2022, 3, 8. https://doi.org/10.3390/ohbm3040008

Abstract: This study examines the relationship between the early identification of hearing loss and language outcomes for deaf/hard of hearing (D/HH) children, with bilateral or unilateral hearing loss and with or without additional disabilities. It was hypothesized that hearing loss identified by 3 months of age would be associated with better language outcomes. Using a prospective, longitudinal design, 86 families completed developmental instruments at two time points: at an average age of 14.8 months and an average age of 32.1 months. Multiple regression examined how hearing loss identified by 3 months of age contributed to later language outcomes while controlling for developmental level at the first time point. Hearing loss identified by 3 months of age was positively associated with better language outcomes for D/HH children at 32 months of age; however, D/HH children still exhibited language delays, compared to normative scores for same-aged hearing peers for reported measures. Language outcomes of children with unilateral hearing loss were not better than those of children with mild-to-moderate bilateral hearing loss. Children with additional disabilities and more severe bilateral hearing loss had lower language scores than those without.

About the UCEDD: The mission of the Waisman Center’s University Center for Excellence in Developmental Disabilities (UCEDD) is to support the full inclusion and self determination of people with developmental disabilities and their families.

Authors: Anne B Harris, Elizabeth Seeliger, Christi Hess, Allison L Sedey, Kayla Kristensen, Yen Lee and Winnie Chung

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