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- Deaf Early Intervention in Puerto Rico: A Qualitative Study
Authors: Jesús O. Barreto Abrams et al.
Abstract: Deaf children can develop similarly to hearing children with appropriate intervention. However, when Deaf and hard of hearing children have deferred access to services, they can experience significant delays in language, socioemotional development, and cognition that can lead to problematic behaviors. While early intervention services are free in the United States starting at birth, there is often a lag in Deaf and hard-of-hearing children receiving services, especially when residing in US territories such as Puerto Rico. The current qualitative study was to explore the lived early intervention experiences of three parents and three professionals of Deaf and hard of hearing children under the age of six-years-old. Questions explored the lived experiences and perceptions of both professionals and parents regarding their access and delivery of early intervention services in Puerto Rico for Deaf and hard-of-hearing toddlers. Several salient themes emerged to include support for sign language, barriers to services, and family support.
PubDate: Wed, 11 May 2022 11:33:18 PDT
- Outcome Of Newborn Hearing Screening Programme in A Tertiary Care Centre,
South India.
Authors: Dr Sija S Assistant Professor et al.
Abstract: ObjectiveTo determine the coverage and outcome of Universal Newborn Hearing Screening (UNHS) Program in Government Medical College Manjeri, South India. To study the prevalence of hearing loss (HL) among those children screened, to describe the characteristics of confirmed cases, and the status of speech and language development acquired by them at follow up.DesignHospital based retro prospective study. MethodsData were collected from all newborns who underwent Universal Newborn Hearing Screening (UNHS) over a four-year period (November 2014 to October 2018). Cases with confirmed hearing loss were studied by pre-structured questionnaire and telephonic interview. Speech and language assessments of 10 confirmed cases were conducted after a period of intervention. ResultsOut of 17,260 babies, 16,625 were screened (96.3%). HL was confirmed for 13 of these, resulting in a prevalence rate of 0.08%. Risk factors for HL were not present in 61.5% of these cases. Confirmation was done at a median age of 6 months with an Interquartile Range (IQR) (4; 12). Interventions in the form of speech therapy and hearing aid were started at a median age of 17.5 months with an IQR (13;25) and the median duration of intervention till the time of assessment was 30 months with an IQR (17;43) Out of 13, five children were managed with hearing aid. Another five required cochlear implant at a median age of 24 months with an IQR (17.5; 33). All received speech therapy. Three children were lost during follow up. On assessment using ISD and REELS, eight out of the remaining 10 children showed a lag in the speech and language development, with a median delay of 19.3 months with an IQR (2; 34.5)ConclusionsCoverage of the program was optimal, with almost all newborns successfully screened. More than half of the confirmed children did not exhibit risk factors for HL and therefore might not have been identified early without UNHS. The observed median age of starting intervention for confirmed cases was higher than the age recommended by AAP guidelines and most of the children had language development below those of typically hearing age mates after months of intervention.Key words: Universal Newborn Hearing Screening, Outcome, Oto Acoustic Emission, Hearing loss, Neonates.
PubDate: Wed, 11 May 2022 11:33:04 PDT
- Usability and feasibility of a Spoken Language Outcome Monitoring
Procedure in a Canadian Early Hearing Detection & Intervention Program:
Results of a 1-Year Pilot
Authors: Olivia Daub University of Western Ontario et al.
Abstract: Purpose: Best practice recommendations for Early Hearing Detection and Intervention (EHDI) programs include routine spoken language outcome monitoring. The present article reports on pilot data that evaluated the usability and feasibility of a spoken language outcome monitoring procedure developed for Ontario’s Infant Hearing Program (IHP). This procedure included both Program-level monitoring using omnibus language tests from birth to 6;0 and individual vulnerability monitoring of key domains of spoken language known to be at risk in children who are deaf/hard-of-hearing.Methodology: Speech-language pathologists (SLPs) in the IHP piloted the new procedures for one year and provided feedback on the procedure through surveys at the end of the pilot.Results: Data was suggestive that the Program-level procedure might be sensitive to change over time and known predictors of spoken language outcomes. Some, but not all, Program-level test scores were predicted by the presence of additional developmental factors. None of the test scores were significantly predicted by severity of hearing loss. Depending on the tests and scores used, some aspects of the Program-level procedure to change over time. There was insufficient evidence to support individual vulnerability monitoring. SLPs reported significant concerns about the time involved in implementing both procedures.Conclusions: This article describes preliminary evidence suggesting that the Program-level procedure might be feasible to implement and useful for evaluating EHDI programs. Future evaluations are needed to determine whether the procedure can be accurately implemented to scale in the IHP, and whether the data that results from the procedure can meaningfully inform stakeholders’ decision-making.
PubDate: Wed, 11 May 2022 11:32:52 PDT
- Association Between Craniofacial Anomalies and Newborn Hearing Screening
Refer Rate
Authors: Kaitlyn Sheapp et al.
Abstract: Purpose: Increased knowledge of the prevalence of various craniofacial anomalies and their associated risks for hearing loss can help guide 1) development of evidence-based practice regarding detection and documentation of risk factors at birth and 2) health care professionals to make appropriate recommendations for follow-up testing and monitoring.Method: Records were reviewed for 39,813 infants born at Adventist HealthCare Shady Grove Medical Center and White Oak Medical Center between January 1, 2014 and December 31, 2019 to determine the association between the presence of craniofacial anomalies and newborn hearing screening fail rates, as well as the prevalence of confirmed hearing loss for infants born with and without risk factors. Additionally, surveys were sent to state EHDI programs and newborn hearing screening program coordinators across the United States to determine how facilities document risk factors for hearing loss, specifically craniofacial anomalies.Results: Study outcomes revealed four primary conclusions: (1) Infants with craniofacial anomalies are at greater risk for failing their newborn hearing screening; (2) There is a need to better delineate craniofacial anomaly risk factors into subgroups; (3) Follow-up audiologic evaluations are not warranted for infants with preauricular sinuses/tags and; (4) A universal protocol needs to be developed for recording risk factors for all infants.Keywords: newborn hearing screening (NBHS), risk factors, craniofacial anomalies, hearing loss, Early Hearing Detection and Intervention (EHDI), Neonatal Intensive Care Unit (NICU)
PubDate: Wed, 11 May 2022 11:32:39 PDT
- Adaptation of the Conditioned Assessment of Speech Production in Spanish
Authors: Alliete R. Alfano et al.
Abstract: Purpose: The purpose of this article is to describe the adaptation of the Spanish adaptation of the CASP.Method: The authors adapted each segment into Spanish, then had 41 participants complete a survey to determine if each adapted segment was representative of the Spanish phonologic system. Thirty-six children (half with typical hearing, half with hearing loss) completed the CASP in English and Spanish. Paired samples t-tests were run to compare English and Spanish CASP scores between children with hearing loss and those with typical hearing.Results: All segments were adapted as needed into Spanish. There was no statistical difference between the English CASP scores (18.61 ± 2.03) and Spanish CASP scores (18.78 ± 1.99) for the children with typical hearing. Similarly, there was no statistical difference between the English CASP scores (16.78 ± 3.44) and Spanish CASP scores (16.67 ± 3.41) for the children with hearing loss. Children with typical hearing scored statistically significantly higher on the English and Spanish CASP than children with hearing loss.Discussion: The CASP-S is an appropriate Spanish adaptation of the CASP, which has been field-tested for use with young Spanish-speaking children with hearing loss.
PubDate: Wed, 11 May 2022 11:32:27 PDT
- Improving Newborn Hearing Screening Through Collaboration and
Communication
Authors: Mary Duncan
Abstract: Purpose: Hearing loss is the number one birth defect among children. There are significant consequences of delayed diagnosis and failure to obtain timely intervention, particularly for a child’s speech and language development. Design and implementation of successful newborn hearing screening (NHS) programs can be challenging. The purpose of this paper is to demonstrate improved efficiency and effectiveness of a large NHS program through the implementation of a team approach engaging both ambulatory and hospital services.Methodology: A Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis was used to develop an improved NHS program focused on improving patient care. The SWOT analysis outcomes were used to determine several key factors to be implemented, including dedicated technicians solely assigned to the NHS program and purchase of new equipment to improve accuracy and reduce disposable costs. In addition, a two-tiered approach was implemented whereby the dedicated technicians performed initial screenings, with all rescreens performed by an audiologist.Results: Implementation of the new NHS program demonstrated numerous successes including a significant reduction in the failure rate, improved care coordination, and increased communication between ambulatory and hospital services.
PubDate: Wed, 11 May 2022 11:32:17 PDT
- “It gives me confidence”: Caregiver Coaching From the Perspective of
Families of Children Who Are Deaf or Hard of Hearing
Authors: Dorie Noll et al.
Abstract: Caregiver coaching is utilized in early intervention services with families of children who are deaf or hard of hearing to increase caregivers’ skills and confidence in supporting their child’s language development, but few studies have examined coaching from the perspective of the caregivers. The purpose of this study was to increase understanding of caregivers’ experiences of coaching in the context of listening and spoken language intervention services. Using semi-structured, qualitative interviews, this study examined 13 caregivers’ perspectives at three intervention sites in the US and Canada. Results indicate that caregivers perceive that practitioner characteristics, expectations, and the evolution of the coaching relationship over time contribute to a positive caregiver coaching relationship. This study contributes to the understanding of the caregiver coaching experience and has implications for new and experienced practitioners working to improve their practice by establishing and strengthening collaborative caregiver coaching relationships with the families they serve.
PubDate: Wed, 11 May 2022 11:32:03 PDT
- Hearing Screening in North Carolina's NICU and Well-Baby Nurseries:
Impacts of JCIH 2019 and COVID-19
Authors: Jackson Roush Jackson et al.
Abstract: Purpose: Over an 18-month period in 2020–2021, the North Carolina Early Hearing Detection and Intervention (EHDI) program in collaboration with the North Carolina Leadership Education in Neurodevelopmental and Related Disabilities (LEND) program conducted a statewide examination of newborn hearing screening practices in North Carolina’s 24 Neonatal Intensive Care Units (NICU) and 86 well-baby nurseries to determine how current protocols and procedures conform to those recommended by the Joint Committee on Infant Hearing (JCIH) in its Year 2019 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs. The COVID-19 pandemic emerged during the study period and motivated a second aim, to examine the impact of the pandemic on infant hearing screening.Results: Our findings revealed that the hospitals in North Carolina are fully committed to their hearing screening programs as demonstrated by a 100% response rate and numerous strengths in both the NICU and well-baby nurseries. Even so, for many hospitals we identified opportunities for program development or improvement based on JCIH 2019 recommendations, especially those concerning oversight of the screening program by a pediatric audiologist, direct referral to an audiologist for NICU babies who fail the in-hospital screening, and audiology referral for well babies who fail the outpatient rescreen. Following the investigation, the NC-EHDI program has worked in partnership with hospitals to provide information, technical assistance, and resources based on our findings and recommendations. The authors would be happy to share the survey instruments and other resources developed for this project with EHDI programs in other states interested in conducting a similar study.
PubDate: Wed, 11 May 2022 11:31:53 PDT
- Language growth in children with mild to severe hearing loss who received
early intervention by 3 months or 6 months of age
Authors: Elizabeth Ann Walker et al.
Abstract: 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; 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.
PubDate: Wed, 11 May 2022 11:31:36 PDT
- The Journal of Early Hearing Detection and Intervention: Volume 7 Issue 1,
Pages 1-120
PubDate: Wed, 11 May 2022 11:31:30 PDT
- Factors Associated with the Psychosocial Wellbeing Among Parents of
Children who are Deaf or Hard-of-hearing
Authors: Karen F. Munoz et al.
Abstract: Purpose: To identify factors associated with low psychosocial wellbeing among parents of children who are deaf or hard-of-hearing.Method: A cross sectional survey that included instruments to measure psychological distress, functional impairment, and psychological inflexibility. Two hundred and ninety-six parents completed the survey.Results: Analyses revealed that lower income, presence of additional disabilities, younger child age, and psychological inflexibility were factors associated with low parent psychosocial wellbeing.Conclusions: Parents of younger children who are deaf or hard-of-hearing with low income, have children with additional disabilities, and higher psychological inflexibility may experience lower psychosocial wellbeing. Clinicians serving families may need to provide additional and/or different support for parents in adapting to and managing their child’s hearing loss.
PubDate: Thu, 21 Oct 2021 14:13:02 PDT
- Readability of Online Hearing-Based Early Intervention Materials
Authors: Torri Ann Woodruff et al.
Abstract: Purpose: A quantitative readability assessment of currently accessible online materials for parents of children who are D/deaf and hard of hearing.Design: Consistent with current recommendations discussing “grade-level” of materials, Flesch-Kincaid Grade Level (FKGL) analysis, along with five other related measures, was conducted for each website. These analyses provide a readability score for each of the websites analyzed.Study sample: The first five pages of results from a Google search of “early intervention deaf” and “early intervention hear” were compiled for readability assessment.Results: Sixty-three websites were included in the analysis. Following article modification, inter- and intra-rater reliability were excellent (p th-grade reading level (m=12.62, SD=2.65). There was no significant impact of the search page, intended audience, or producer on FKGL (p>.1).Conclusion: Currently accessible online resources for parents looking at early intervention for children who are D/deaf and hard of hearing are written at a level that may not be accessible. Materials may benefit from being revised and edited with readability and health literacy recommendations in mind.
PubDate: Thu, 21 Oct 2021 14:12:49 PDT
- Theory of mind acquisition in children who are deaf: The importance of
early identification and communication access
Authors: Kimberly A. Peters et al.
Abstract: Objectives: The aim of this study was to compare Theory of Mind (ToM) acquisition in typically-hearing preschool-age children (TH), and deaf children of hearing parents (DCHP) who received a cochlear implant by 18 months of age, to determine if early access to spoken language via a cochlear implant affected ToM acquisition.Methods: Participants included 25 children with cochlear implants ages 3.0 to 6.5 years and 25 age-matched children with TH all of whom were enrolled in preschools with typical peer models. The test battery included measures of expressive and receptive language and ToM.Results: There were no differences between DCHP and TH peers on language or ToM performance. Hearing age was significantly different; DCHP had been exposed to spoken language for less time than their hearing counterparts by approximately 12 months. Language skills were correlated with ToM after controlling for chronological age.Discussion: Early cochlear implantation may ameliorate some of the deleterious effects of congenital, profound deafness on oral language development; this could positively influence the development of social cognition.Conclusions: Children who are deaf who receive a cochlear implant early and who have good oral language skills are more likely to acquire ToM in a typical time frame.Key words: Cochlear implants, theory of mind, social cognition, language
PubDate: Thu, 21 Oct 2021 13:59:50 PDT
- Exploring speech and language intervention for preschoolers who are deaf
and hard of hearing: A scoping review
Authors: Hillary Ganek et al.
Abstract: Purpose: The objective of this study was to summarize the extant literature on the effectiveness of speech and spoken language interventions for young children who are deaf or hard of hearing (DHH) in order to determine which types of speech-language interventions might be most effective, for which hearing levels and types of hearing losses, and at which dosage.Methods: Using a scoping review methodology, a database search identified 10,360 studies of which 16 met the requirements for inclusion. Data was extracted from each for analysis.Results: Due to the limited number of studies available, high variability in the nature of the studies, and insufficient details about the interventions and sample in many of the papers, fully addressing the study objectives was difficult. However, common themes included the positive effect of caregiver-centered approaches on language outcomes, the equal effectiveness of virtual versus in person intervention, the addition of other speech and language intervention techniques to Auditory-Verbal Therapy may improve outcomes, and the effect of speech and language therapy on auditory skills is unclear.Conclusions: This scoping review offers an initial step in analyzing and implementing evidence-based speech and language treatment protocols for children who are DHH.
PubDate: Thu, 21 Oct 2021 13:59:38 PDT
- Audiologist Perception on Reporting Hearing Assessment Results to State
Early Hearing Detection and Intervention Programs
Authors: Winnie Chung
Abstract: PurposeTo describe an evaluation conducted by 39 state EHDI programs on how acceptable the reporting process and system audiologists had to use when reporting the hearing test results to the EHDI program and the barriers encountered during reporting.MethodsEach 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.ResultsSome 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.Keywords: reporting hearing result, EHDI program, barriers to reporting, audiologist
PubDate: Thu, 21 Oct 2021 13:59:27 PDT
- Impact of Face Masks on Audiovisual Word Recognition in Young Children
with Hearing Loss During the Covid-19 Pandemic
Authors: Erin Lipps et al.
Abstract: Objective: To investigate effects of surgical and transparent face masks during the Covid-19 pandemic on audiovisual speech recognition of words for deaf and hard-of-hearing children.Design: Recorded Word Intelligibility by Picture Identification test (WIPI) was presented in quiet via a computer monitor to children in a quiet test room. The acoustic power spectra of each mask type were compared to the baseline no mask condition. Percent correct word recognition was recorded for four mask conditions (no mask, surgical mask, transparent apron mask and ClearMask) in counterbalanced order. Repeated measures ANOVA was used to test for significant differences in word recognition scores across mask types.Study Sample: Thirteen children (3 to 7 years) in a private auditory oral school wearing hearing aids, bone-anchored hearing aids or cochlear implants. Children were excluded if English was not their primary language or if they had a severe speech-language delay, uncorrected vision loss, or developmental disorder that would affect the results. No children had been exposed to or had contracted the Covid-19 virus.Results: Acoustic spectra showed a decrease in the 2000-8000 Hz region for the transparent apron mask. The surgical mask and ClearMask showed fewer acoustic effects. Children with hearing aids performed similarly to children with cochlear implants. Word recognition was significantly poorer for surgical masks and transparent apron masks. The ClearMask condition was not significantly worse than the no mask condition for words in quiet.Conclusions: Standard surgical and custom apron shield masks significantly hampered word recognition, even in quiet conditions. The commercially available ClearMask did not significantly affect scores in quiet for young deaf and hard-of-hearing children, but scores were highly variable.
PubDate: Thu, 21 Oct 2021 13:59:11 PDT
- The Impact of the COVID-19 Pandemic on Newborn Hearing Screening Programs
in Western States
Authors: Nathan A. Blaseg et al.
Abstract: The primary objective of this study was to determine the impact of the COVID-19 pandemic on newborn hearing screening guideline adherence and the respective rates of screening, diagnosis, and intervention. This was a review of newborn hearing screening data compiled from the Departments of Health of six states for the time periods of March-September 2019 and March-September 2020. Endpoints included the numbers of live births as well as the numbers and timeframes of screening, diagnostic, and intervention events. Two-tailed paired t-tests were performed to determine statistical significance. 181,662 births in six states were assessed. Compared to March-September 2019, March-September 2020 had a significantly lower mean rate of screening before 1 month of age (97.3% vs. 96.2%, p < 0.001) and mean screen rate overall (98.9% vs. 98.0%, p < 0.001). Additionally, the 2020 time period had a significantly higher mean rate of patients lost to follow up for referral to early intervention (14.7% vs. 28.9%, p = 0.005). The COVID-19 pandemic has had a significant impact on the newborn hearing screening programs of several states in the Western US. This information holds significant implications for the current evaluation of these newborn hearing screening programs.
PubDate: Thu, 21 Oct 2021 13:58:58 PDT
- Hearing loss diagnosis provision of information and support: audiologist
and parent perspectives
Authors: Brandi Davis et al.
Abstract: When a child is diagnosed with hearing loss, the parents are faced with many decisions that will impact their child’s future. This study aimed to obtain data to determine viewpoints on information being provided to parents of children with hearing loss from both audiologist and parent perspectives. Topics of information surveyed included information on modes of communication, Deaf culture, cochlear implants, emotional support, and state resources/laws. A survey was created and shared in Facebook groups for audiologists and parents of Deaf/hard of hearing children. The survey was completed by 91 audiologists and 111 parents. Audiologist and parent survey data was analyzed and compared to look for similarities, differences, and possible biases. The data obtained in the study showed that overall, information on the topics investigated is being provided to parents when their child is initially diagnosed with hearing loss. However, many parents felt that the information that was provided was insufficient; therefore, they did not feel confident in their decision-making process. Audiologists have the responsibility to provide parents with unbiased, extensive information for parents to successfully make informed decisions for their child. Provision of practical, comprehensive information and recommendations may lead to improved parent knowledge and confidence.
PubDate: Thu, 21 Oct 2021 13:58:45 PDT
- Advancing Clinical Practice through Integration of Congenital
Cytomegalovirus (cCMV) Testing with Newborn Hearing Screening at Mayo
Clinic
Authors: Joscelyn R. K. Martin et al.
Abstract: Although cCMV is the leading non-genetic cause of childhood hearing loss in the United States, neither targeted nor universal screening protocols have been well established to identify cCMV in newborns. Moreover, until cCMV testing is universal, clinical protocols need to account for the complexities of individualized care in partnership with interprofessional care teams. This work addressed an immediate clinical practice need to identify cCMV with subsequent hearing monitoring of babies who test positive for cCMV. This effort focused on three primary objectives to: 1) define interprofessional, team-based approach to facilitate care pathways; 2) develop a clinical workflow for all babies who refer on inpatient hearing screening to be tested for cCMV by 21 days of age; 3) develop a hearing monitoring plan for all babies who test positive for cCMV. The development and integration of our interprofessional, team-based approach to institute cCMV testing by 21 days of age on all babies who refer inpatient newborn hearing screening and subsequent monitoring is described. Our observed referral rate was lower than predicted (2.7%) from existing literature with only one positive cCMV outcome noted in the two-year span. This study demonstrates the feasibility of a hearing-targeted cCMV testing paradigm in our clinic practice.
PubDate: Thu, 21 Oct 2021 13:58:29 PDT
- Intervention and Outcomes of Children in Different Types of Listening and
Spoken Language Programs
Authors: Jace Wolfe et al.
Abstract: This study explores the impact of the type and dosage of listening and spoken language (LSL) services on speech and language outcomes in children with cochlear implants or hearing aids in two LSL programs. Identical demographic variables were collected across the two programs for use in the statistical analyses. Speech and language outcomes were examined at ages 3 and 5 using standardized test measures. At age 3, significant differences in LSL outcomes existed between programs for children using cochlear implants but not for children using binaural hearing aids. However, at age five, outcomes were similar between the different LSL programs for children with hearing aids and cochlear implants. Total hours of LSL services do not serve as a predictor of LSL outcomes at five years of age. However, early identification of hearing loss, early amplification, and early enrollment in a LSL program were highly influential factors affecting LSL outcomes at three and five years of age. Non-verbal IQ and maternal education levels also influence LSL outcomes. Children with earlier access to hearing technology and LSL intervention may need fewer hours of LSL services to achieve age-appropriate LSL outcomes. Overall, both of these LSL programs supported age-appropriate speech and language outcomes by age 5.
PubDate: Thu, 21 Oct 2021 13:58:16 PDT
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