Language and health-related quality of life outcomes of children early-detected with unilateral and mild bilateral hearing loss

Peter Carew; Daisy A Shepherd; Libby Smith; Qi Rui Soh; Valerie Sung

doi:10.3389/fped.2023.1210282

Language and health-related quality of life outcomes of children early-detected with unilateral and mild bilateral hearing loss

Front Pediatr. 2023 Aug 14:11:1210282. doi: 10.3389/fped.2023.1210282. eCollection 2023.

Authors

Peter Carew^{1

2}, Daisy A Shepherd^{1

3}, Libby Smith¹, Qi Rui Soh¹, Valerie Sung^{1

3

4}

Affiliations

¹ Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia .
² Department of Audiology and Speech Pathology, The University of Melbourne, Parkville, VIC, Australia .
³ Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia .
⁴ Centre for Community Child Health, Royal Children's Hospital, Parkville, VIC, Australia.

Abstract

Introduction: We aimed to describe the language and health-related quality of life (HRQoL) outcomes of children early-identified with unilateral or mild bilateral permanent hearing loss. This was a cross-sectional community-based study of children with mild bilateral or unilateral permanent hearing loss (including unilateral auditory neuropathy spectrum disorder (ANSD)), drawn from a population-based databank in Victoria, Australia.

Methods: Enrolment in this databank is independent of early intervention and amplification approaches. Language and caregiver-reported HRQoL outcomes are described by type and degree of loss at three timepoints across child development: at age 2 years (n = 255), 5-7 years (n = 173) and 9-12 years (n = 45).

Results: Across all age groups, average language outcomes were poorer than population normative scores by between a half to two thirds of a standard deviation. Children with mild bilateral hearing loss demonstrated poorer average language outcomes than children with unilateral hearing loss, particularly at younger ages. Children with unilateral ANSD showed language outcomes comparable to their peers with unilateral profound hearing loss. Children had poorer HRQoL psychosocial scores compared to physical scores, without obvious patterns of outcomes linked to degree or type of hearing loss.

Discussion: This study demonstrates children with early-identified unilateral or mild bilateral hearing loss have average language and HRQoL outcomes poorer than population normative expectations from an early age. These outcomes are observed at later ages across childhood. These findings provide a contemporary description of language and quality of life outcomes for children identified but not targeted by universal newborn hearing screening and raise questions of how to provide better support for these populations of children and their families.

Keywords: early-identified; health-related quality of life; language outcomes; mild bilateral hearing loss; unilateral auditory neuropathy spectrum disorder; unilateral hearing loss.

Grants and funding

Shepherd was supported by The Lorenzo and Pamela Galli Medical Research Trust. A Sung was supported by Australian National Health and Medical Research Council (NHMRC) Early Career Fellowship 1125687, a Melbourne Children's Clinician Scientist Fellowship 2021 and a L'Oréal-UNESCO Australian & New Zealand For Women in Science Fellowship 2019. Research at the Murdoch Children's Research Institute is supported by the Victorian Government's Operational Infrastructure Support Program. The funding organizations are independent of all researchers. The VicCHILD project received funding from the Royal Children's Hospital Foundation [2018–999] & [2014–430]; the Murdoch Children's Research Institute; the Phyllis Connor Memorial Trust; the Deafness Foundation; the National Health and Medical Research Council (NHMRC) Centre of Research Excellence Grant [1023493]; the Kyle Patrick Lamsam Convery Foundation; the Nelson Alexander Charitable Foundation; and a Royal Australasian College of Physicians Cottrell Research Establishment Fellowship.