Early Hearing Diagnosis Key to Language Skills Children born with hearing impairment can develop the same language skills as others if diagnosed early and provided early intervention soon after diagnosis, preliminary data from a world-first Australian study has found. The study, which started in 2005, is the largest and most comprehensive prospective investigation to examine the effects ... Features
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Features  |   October 01, 2006
Early Hearing Diagnosis Key to Language Skills
Author Notes
  • Dee Naquin Shafer, an assistant managing editor of The ASHA Leader, can be reached at dshafer@asha.org.
    Dee Naquin Shafer, an assistant managing editor of The ASHA Leader, can be reached at dshafer@asha.org.×
Article Information
Hearing & Speech Perception / Special Populations / Early Identification & Intervention / Attention, Memory & Executive Functions / Features
Features   |   October 01, 2006
Early Hearing Diagnosis Key to Language Skills
The ASHA Leader, October 2006, Vol. 11, 5-33. doi:10.1044/leader.FTR3.11142006.5
The ASHA Leader, October 2006, Vol. 11, 5-33. doi:10.1044/leader.FTR3.11142006.5
Children born with hearing impairment can develop the same language skills as others if diagnosed early and provided early intervention soon after diagnosis, preliminary data from a world-first Australian study has found. The study, which started in 2005, is the largest and most comprehensive prospective investigation to examine the effects of early hearing detection and intervention (EHDI) and predictors of outcomes in children with hearing impairment on a population basis. It also benefits from the unique Australian research environment.
Teresa Ching from Australian Hearing, the government-funded national service provider, said preliminary results of 49 children out of a study of 200 show that early intervention is the key to developing typical speech and language skills. Although it is widely believed that earlier intervention leads to better long-term speech, language, and educational outcomes of children who have hearing impairments, systematic reviews of literature show a scarcity of well-controlled studies. Ching noted that evidence to date is inconclusive because of methodological limitations in the published studies (USPSTF, Thompson et al., 2001; Puig et al., the Cochrane Library, 2005).
“To provide evidence on whether earlier intervention leads to better long-term outcomes, it is necessary to conduct a population-based, prospective comparison of outcomes of children with or without access to universal newborn hearing screening (UNHS),” she said. Australia’s research environment facilitates the conduct of a study to investigate the effectiveness of UNHS and early intervention for improving outcomes. In other countries where UNHS already is in place, it would not be possible to conduct such studies because of ethical concerns.
Free Hearing Services
Australian UNHS programs are state-funded and different states currently are at different stages of implementing newborn hearing screening. This provides a time-window to find sufficient numbers of children with or without access to UNHS. In addition, Australian Hearing provides all children with free hearing services ensuring that once hearing loss is diagnosed, children receive consistent and uniform services across the country.
The initial results strongly suggest that after controlling for the degree of hearing loss, children who receive amplification and intervention early in life have better language ability than those who receive later intervention. The performance of children who receive early intervention is more in keeping with their chronological age than for children who receive intervention later in life, Ching said.
Awaiting Longitudinal Data
These data are very preliminary, and there currently are insufficient data to perform multi-linear regression analyses to take into account multiple factors that are potentially important in affecting performance. These will be investigated at a later stage of the study when data from all subjects are available. When all the longitudinal data come in, the relationship between short-term performance levels and longer-term outcomes will be investigated, and the impact of age of intervention on long-term development will be examined.
Although states in Australia are at different stages of implementation of UNHS, it is possible that funding may not continue if there is insufficient evidence on the effectiveness of UNHS in improving outcomes. The results from this outcomes study will provide the evidence base to guide best-practice intervention following diagnosis of hearing impairment, and to demonstrate the short-term and longer-term outcomes affected by newborn hearing screening and early intervention, Ching said.
“As part of the outcomes study, we are also examining the effects of different hearing aid prescriptions (NAL and DSL), different implant characteristics, and different devices (hearing aids and cochlear implants) on outcomes for children,” she said.
Teresa Ching is a senior research scientist at the National Acoustic Laboratories, the research division of Australian Hearing, in Sydney, Australia. Contact her by e-mail at teresa.ching@nal.gov.au.
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October 2006
Volume 11, Issue 14