Hearing-impaired Children Research Articles

Parenting Stress in Mothers of Children with Permanent Hearing Impairment

Permanent childhood hearing impairment (PCHI) represents the most frequent sensory pathology at birth. PCHI has a relevant psychological impact on the life of both the affected children and their families. Thus, the aim of this work is to explore the degree of parental distress felt by mothers of a deaf or hard-of-hearing child, to determine if this stress is associated with variables related to the children's health (e.g., the severity of hearing loss, presence of other conditions, difficulty with treatment options, difficulty with rehabilitation) or family characteristics such as socio-economic and educational status. The study used the Parenting Stress Index-Short Form (PSI-SF) questionnaire administered to mothers. The results were analyzed in relation to variables such as parents' education level, number of children, severity of hearing loss, presence of other chronic conditions, presence of cognitive delay, familiarity with hearing loss, time of diagnosis, use of prosthetics, and start in a rehabilitation program. The data indicate a correlation between maternal stress levels and low-educational levels, as well as the presence of congenital infections and cognitive delay. These results highlight the need for a comprehensive physical and psychological approach for hearing-impaired children, as stress factors can affect the adherence to effective rehabilitation.

The Knowledge Hearing Impairment Children Have About Common Public Signs

This study aimed to examine sign recognition in children with hearing impairment ages 6 - 9 years old from Al-Zarqa city in Jordan. Public signs were shown to the children and they were asked to say what the sign represented. Results were that children have difficulty recognizing a sign’s meaning, as reflected in their answers. Results also showed that children can identify iconic signs like a mosque the most, and the index of a skull for danger or symbol such as the letter H to indicate a hospital the least. For signs they did not correctly identify, they viewed the sign as a picture, not a sign that has meaning. The study shows hearing impaired children’s familiarity with signs in public spaces.
 
 Received: 15 November 2022 / Accepted: 16 February 2023 / Published: 5 March 2023

Genetics of pediatric hearing loss

With the rapid development of sequencing technology and bioinformatics, the genetic research and related clinical practice of pediatric hearing loss have also made significant progress. This review summarized and analyzed the genetic causes of hearing impairment in children and the research progress of related genetic diagnosis and screening, in order to provide reference for the prevention and treatment of pediatric hearing loss and related research.

The association between exposome score for schizophrenia and metabolic parameters in individuals with schizophrenia and healthy controls: Findings from the EUGEI study

IntroductionExposome is all nongenetic exposures from the prenatal period to death. Exposome score for schizophrenia (ES-SCZ) is a cumulative measure of environmental liability for schizophrenia. Our previous studies showed that the ES-SCZ is associated with mental and physical health outcome.ObjectivesThe aim of the study is to investigate the association of the ES-SCZ with metabolic parameters in individuals with schizophrenia and healthy controls.MethodsThis study obtained 124 individuals with schizophrenia and 440 healthy controls from the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions, Work Package 6 (Vulnerability and Severity) Turkey dataset. The ES-SCZ was calculated by summing log-odds weighted environmental exposures (childhood adversities, winter birth, hearing impairment and cannabis use). Linear regression analysis was used to investigate the association between ES-SCZ and metabolic parameters. After that analysis age and sex were added as covariates.ResultsThere was an association between ES-SCZ and diastolic blood pressure (B = -2.69 [95% CI -4.74; -.65], P-value = 0.010) in schizophrenia. ES-SCZ was associated with the fasting glucose level (B = -6.23 [95% CI -11.59; -.87], P-value = 0.023); high density lipid level (B = 1.77 [95% CI .27; 3.27], P-value = 0.021) in control and these results remained significant after adjusting for age and sex.ConclusionsES-SCZ was associated with important metabolic parameters. These findings show that ES-SCZ is not only related to increasing the risk for psychosis development but may also influence comorbidities. This result is important since it may increase our knowledge of ES-SCZ and contribute to the importance and framework of its clinical implementation.Disclosure of InterestNone Declared

RISK FACTORS OF HEARING LOSS IN CHILDREN UNDER 10 YEARS OF AGE - A CLINICAL STUDY IN A TERTIARY CARE CENTRE

Background: Hearing impairment in children constitutes a particularly serious obstacle to their optimal development. Early detection of hearing impairment is vital since early intervention including hearing aids and speech therapy can be initiated at the earliest. The aim of the study was to determine the risk factors associated with children with hearing loss and to assess degree of hearing loss using BERA. Materials and methods: 50 patients below 10 years of age attending ENT OPD with h/o hearing loss were taken for the study from January 2021 to January 2022 and were subjected to detailed history taking and clinical examination. Then the patients were subjected to BERA and the results were analysed. Result: The most common risk factor for hearing loss in this study is h/o consanguinity (40%) followed by birth asphyxia(9%) and then hyperbilirubinemia(8%). The other risk factors include h/o ototoxic drug intake(5%), low birth weight(4%), h/o intracranial infections(3%) and family h/o congenital hearing loss(1 %) Conclusion:Newbornscreening is mandatory to identify hearing loss in the prelinguistic period to reduce the burden of handicap in the society. BERA should be carried out as a routine procedure to detect hearing impairment in high risk children and rehabilitative measures should be started as early as possible.

Objective measurement of prosodic features of speech of hearing-impaired Egyptian children with cochlear implants

BackgroundProsody is an important acoustic and linguistic component of speech that greatly contributes to speech intelligibility. Speech of hearing-impaired children shows various deviations from their normal-hearing counterparts due to complex physiological mechanisms.MethodsAcoustic analysis of the prosodic production of hearing-impaired, cochlear-implanted, Egyptian children, and comparing them to a normal group of normal-hearing peers, using objective measures. Cases group included 30 hearing-impaired verbal children from the age of 6 to 10 years using cochlear implant devices. The controls group included 30 normal-hearing children within the same age range. Recording and analysis of both groups’ speech samples were done using real-time pitch software, generic syllabic rate, and intonation stimulability software.ResultsSignificant differences were found between the two studied groups where decreased pitch range, increased loudness variability, increased pause duration, and decreased syllabic rate were found in hearing-impaired children.ConclusionProsodic differences between hearing-impaired children with cochlear implants and normal-hearing children could be measured objectively giving a numeric profile that could be used as a measure to monitor the progress of their speech with therapy.

Childhood Hearing Impairment in Senegal.

We recently showed that variants in GJB2 explained Hearing Impairment (HI) in 34.1% (n = 15/44) of multiplex families in Senegal. The present study aimed to use community-based nationwide recruitment to determine the etiologies and the clinical profiles of childhood HI in Senegal. Participants with early onset HI were included after clinical examination, including audiological assessment by pure tone audiometry and/or auditory brainstem response. We investigated a total of 406 participants from 295 families, recruited from 13/14 administrative regions of Senegal. Male/female ratio was 1.33 (232/174). Prelingual HI was the most common type of HI and accounted for 80% (n = 325 individuals). The mean age at medical diagnosis for congenital HI was computed at 3.59 ± 2.27 years. Audiological evaluation showed sensorineural HI as the most frequently observed HI (89.16%; n = 362 individuals). Pedigree analysis suggested autosomal recessive inheritance in 61.2% (63/103) of multiplex families and sporadic cases in 27 families (26.2%; 27/103), with a consanguinity rate estimated at 93% (84/90 families). Genetic factors were likely involved in 52.7% (214/406) of the cases, followed by environmental causes (29.57%; 120/406). In 72 cases (17.73%), the etiology was unknown. Clinically, non-syndromic HI was the most common type of HI (90.6%; n = 194/214 individuals). Among families segregating syndromic cases, type 2 Waardenburg syndrome was the most common (36.3%; 4/11 families). This study revealed putative genetic factors, mostly associated with high consanguinity rate, as the leading causes of early-onset HI in Senegal. The high consanguinity could provide a good opportunity to identify variants in known and novel genes involved in childhood HI.

Anxiety Rating Scale for Speech and Hearing-impaired Children.

It has been observed that children with special healthcare needs exhibit higher dental anxiety levels because of various barriers. In the literature, there is no anxiety assessment scale for speech and hearing-impaired children. A new concept of pictorial representation of common emotions observed during dental treatment was used to design an innovative scale, thereby helping to improve communication and in bringing out positive behavior among the children. This study aimed to assess and validate the efficacy of an anxiety rating scale for speech and hearing-impaired children. A total of 36-12-year-old children with speech and hearing impairments from a special school were selected for this study. The pretreatment anxiety score among the children was assessed using the pictorial anxiety rating scale. The anxiety rating scale was well accepted by speech and hearing-impaired children. It was well-supported by expert opinions and equal distribution of anxiety scores. The pictorial scale is a valid anxiety assessment scale for measuring dental anxiety among speech and hearing-impaired children. It can be used independently to assess dental anxiety in clinical settings and epidemiological studies as well. Shivashankarappa PG, Kaur J, Adimoulame S. Anxiety Rating Scale for Speech and Hearing-impaired Children. Int J Clin Pediatr Dent 2022;15(6):704-706.

Acquisition of Pragmatic Skills in Paediatric Cochlear Implant Users.

Pragmatic language skills are one of the most complex language skills. Children with hearing loss face difficulty in social participation and effective communication during mainstreaming. Without mastery of these skills, children may encounter significant challenges with abstract conversational communication and literacy. This study aimed to explore the age and pattern of acquisition of pragmatic skills in hearing-impaired children. Twelve (12) children with Cochlear Implants (CI) in the age range of 5 to 10years with minimum 1-year post-implantation regular therapy and twelve (12) age-matched normal hearing children participated in the study. All participants were administered the 'Test of Pragmatic Skills' (Shulman, 1986) comprising different domains of pragmatics. Their responses were rated on a six-point rating scale from 0 to 5. A qualitative analysis of various domains revealed that paediatric cochlear implant users used varied pragmatic skills at approximately 3years on average during the post-implantation period compared to the typically developing children who acquired the skills well below 3 years on average. Pragmatics is very well correlated to the child's cognition; hence, the higher the cognitive age, the earlier the acquisition of pragmatic skills. The results prove that pragmatic skills developed proportionately to their implant age but need to be at par with their cognitive age. Rehabilitation of CI children, thus, should levy heavy focus on varied pragmatic domains, which will facilitate contextually appropriate communication at the earliest possible time during the post-implantation period.

Vestibular Loss in Children Affected by LVAS and IP2 Malformation and Operated with Cochlear Implant.

This is a single center cohort study regarding the prevalence of vestibular loss in hearing impaired children affected by large vestibular aqueduct syndrome (LVAS) with incomplete cochlear partition malformation type II (IP2), fitted with cochlear implant (CI). Twenty-seven children received CI operations at 0.4-13 years on one or both ears and tested for vestibular loss with head impulse test, video head impulse test, mini ice-water test and cervical VEMP. Vestibular loss was found in 19% of operated ears and in 13.9% of non-operated ears. The difference was not statistically significant and was not significantly modified by age at implantation, age at testing, sex, presence of SLC26A4 gene mutation or bilaterality. However, the presence of anatomic anomalies at the level of the vestibulum or semicircular canals was significantly associated with a higher incidence of vestibular loss in CI operated children but not in those non-operated. No other factors, such as the surgical access, the electrode type, the presence of Gusher perioperatively, or post-operative vertigo modified significantly the prevalence of vestibular loss. In conclusion, LVAS/IP2 appears to be the major determinant of vestibular loss in these children, with a less obvious impact of CI, excluding the cases with vestibulum/canal anomalies: this group might have a higher risk for vestibular loss after CI surgery.

Language development of Chinese-speaking hearing-impaired children: The roles of home literacy resources and shared book reading

The present study aimed to explore the specific components of home literacy resources (HLR) and parental behaviours during shared book reading (SBR) that may contribute to the language development of Chinese-speaking hearing-impaired children. A total of 90 Chinese-speaking hearing-impaired children aged 3 to 6 years, along with their parents, participated in this study. Following the design of previous studies, we required the parents to complete a questionnaire regarding HLR and parental SBR behaviours, and their hearing-impaired children received a standardised language test. The results showed that such HLR components as storybook capacity at home, weekly frequency of SBR, duration per SBR session, starting age of SBR, and the parental SBR behaviour, parent and child discussing opinions with each other, could significantly account for an additional portion of the variance in children's receptive, expressive, and overall language beyond the demographic variables. It is thus recommended that clinicians share this evidence-based information with parents who have hearing-impaired children to help their children develop language to their fullest potential.

Oral health problems and dental service utilization in children with hearing impairment: a narrative review

Children with hearing disability face challenges on accessing healthcare services caused by their lack of ability to express their oral health problems and affect their oral health status. This narrative review aims to explore oral health status in hearing impaired children and discuss in detail about dental service utilization in children with hearing impairment. Many studies assessed oral health status of children with hearing impairment. A comprehensive retrieval of the English literature from 2012 to 2022 was done in PubMed, ScienceDirect and ProQuest. Oral health assessments including dental caries, gingival problems and periodontal condition. Healthcare seeking behavior of the parents of hearing-impaired children is reflected by dental service utilization. Hearing impaired children have a high prevalence of caries, high caries activity and poor gingival condition compared to their counterparts. There are unmet dental treatment needs due to their dependence on parents or caregiver on decision making. Proper oral health educational method for hearing impaired children and their parents or caregiver is needed to improve oral health status and dental service utilization.

Newborn hearing screening in the UK

The newborn hearing screening programme (NHSP) exists to identify permanent childhood hearing impairment (PCHI) in babies born in the UK. Early identification of hearing loss facilitates the provision of hearing aids or a prompt referral for cochlear implantation to ensure children optimise speech, language and communication skills, with the hope that this translates to the best possible educational, mental health, social and quality of life outcomes. Diagnosis of hearing impairment allows aetiological investigations to be offered to look for a potential cause of the PCHI, and given the recent advances in genomic testing, this can facilitate testing for additional family members and future children if a genetic cause is identified. In this article, the authors describe the structure of the NHSP and illustrate referral pathways into the programme from primary care for the few babies that may have been missed or fallen outside the remit of the programme.

A Novel Approach to Identify Difficult Words in English to Promote Vocabulary Acquisition of Children Dually Diagnosed with Autism Spectrum Disorder and Hearing Loss

Usage of complex words causes significant problems not only in reading but in writing as well and eventually leads to poor academic achievement of students, poorer particularly for hearing impaired children. The dual diagnosis of Autism Spectrum Disorder (ASD) and hearing impairment pose additional challenges mainly due to the difficulties that come with making accurate decisions. Hence, parents must be provided with the information about the signs and symptoms of ASD and deafness or partial hearing loss, as well as appropriate intervention strategies. Although different learning activities can be used to enlarge such children’s vocabulary, if the presented words are difficult to learn, it will be very hard to realize this. Identifying difficult words and replacing them with simple ones both make the readability of a text easier and help such children enhance their vocabulary knowledge in a shorter period of time. Therefore, in this study we propose a classification approach that identifies difficult words among a given set of words in English. The lexical and semantic features of the words in the dataset were extracted based on the language rules specific to hearing impaired children. In the classification approach, five popular classification algorithms were used and the algorithms' performance in identifying difficult words was evaluated using various performance metrics. As the results show, the K-Nearest Neighbors algorithm is the most suitable algorithm for identifying difficult words in English for the target group.

Developing and validating a parenting program based on the lived experiences of mothers with hearing impaired children

Aim: The purpose of the research was to develop and validate a parenting program based on the lived experiences of mothers with hearing impaired children. Method: The research was conducted in a qualitative-quantitative way. The research community consisted of mothers with hearing impaired children in Sari and Miandorud cities. In the qualitative part, the purposeful sampling method was used until saturation. Sampling method was available in quantitative section and 16 mothers were selected. The interview tool was unstructured. In order to ensure validity and reliability, the recorded interviews along with the content obtained from them were provided to the interviewees and the method of reliability of extracted data according to the conducted interviews was used. Transferability method was used to provide validity. The total efficiency of two encoders is equal to 0.90. SPSS 26 and Amos software were used to determine the validity and suitability of program components. Results: Based on the interviews and the background of the research, the mentioned parenting program was compiled in 10 sessions, which consists of: accepting the child's deaf problem, using the experiences of mothers with deaf children, familiarizing mothers with how to care for a deaf child, Acquaintance with methods of emotion control, familiarization with ways to relieve the feeling of helplessness, familiarization with ways to communicate with a deaf child, interaction with the child, familiarization with ways to relieve the feeling of fatigue, relief from the feeling of hopelessness, relief from the child's feeling of loneliness. Conclusion: The research results showed the validity and appropriateness of the compiled components of the parenting program based on the lived experiences of mothers.

Awareness and Perceptions of University Nursing Students in Samoa Towards Childhood Hearing Impairment and Hearing Healthcare: A Cross-Sectional Study.

Pacific Islands have among the highest prevalence of pediatric hearing impairment in the world. Given the limited availability of ear and hearing specialists in the Pacific region, the broader health professional community plays a vital role in the prevention of avoidable pediatric hearing impairment. Nurses emerge as one of the ideal candidates for task-sharing in the administration of ear and hearing care at the public and primary healthcare levels. The aim of this study is to evaluate the awareness and perceptions of university nursing students in Samoa to pediatric hearing impairment and hearing healthcare. This study employed a cross-sectional study design. A 10-item questionnaire was administered to university nursing students in Samoa (N = 100). The statements aimed to evaluate perceptions towards childhood hearing impairment, as well as awareness of causal factors of permanent childhood hearing loss and available hearing healthcare. Participants were required to provide a response based on the five-point Likert scale "Strongly Agree," "Agree," "Neutral/Don't know," "Disagree," and "Strongly Disagree." Overall, 79% of participants responded "Disagree/Strongly Disagree" to the item "Hearing loss is not that important because it does not kill." Overall, 52% of respondents were aware of hearing impairment as a public health concern in Samoa. Early identification and intervention services for newborns with hearing impairment are nonexistent in Samoa, and awareness was low for the importance of early detection (62%) and amplification suitability for babies (49%). Overall, awareness was also low for causal factors of permanent sensorineural hearing loss. A borderline neutral/positive perception was found among our future nursing professionals to engage with pediatric hearing impairment in Samoa. Awareness regarding the causes of permanent childhood hearing impairment, as well as early identification and intervention services, could be integrated in the university curriculum.

Состояние слуховой функции у детей-воспитанников детских домов, эвакуированных из зоны военных действий

In this study, the structure and frequency of hearing impairment in children who lived at various times in the territories of military operations were studied. The high prevalence of otorhinolaryngological diseases, combined with low detectability, entails formidable complications, leads to a decrease in the quality of life of the child and the family as a whole, and negatively affects the general level of public health. In total, during the study, 398 children aged 5 to 16 years old were examined, who were in the temporary accommodation center of the Romashka children’s resting camp. The children are students of orphanages in the Donetsk People’s Republic (DPR) and the Luhansk People’s Republic (LPR) evacuated from the war zone in the first days of the Special Operation. There were 216 girls (54.3%) and 182 boys (45.7%) among them. The average age of children was 8.5 years. Hearing loss was detected in 33 children (8.3%). Two children (0.5%) had a severe form of sensorineural hearing loss of 3–4 degrees. Two children (0.5%) had a mild form of sensorineural hearing loss of 1–2 degrees. Four children (1%) had unilateral chronic sensorineural hearing loss. The diagnosis of otitis media with effusion was established in 20 children (5%), tubo-otitis, in three patients (0.8%). Suspicion of an anomaly in the development of the middle ear, in 2 children (0.5%). Examination of children in orphanages evacuated from the DPR and LPR did not reveal a high prevalence of hearing impairment. Sensoneural hearing loss: 2%, conductive hearing loss: 6.3%. The results of the work demonstrate a wide potential for improving hearing health in the examined children. Active diagnostics of hearing pathology is shown to all children in orphanages. After treatment of conductive hearing pathology, mandatory audiological monitoring is indicated, despite the subjective improvement in hearing.

Hearing-related problems in children with cleft palate: A single-center cross-sectional study in the sub-Himalayan population

Purpose: Cleft palate is known to cause recurrent otitis media with hearing loss. Various studies have stated the incidence of middle ear disease in patients with cleft palate is around 90%. The anomalous position of the Eustachian tubes in patients with cleft palate leads to otitis media with effusion. If left uncorrected this leads to complications such as cholesteatoma, retraction pockets, and atelectasis leading to permanent hearing loss. In this study, we evaluated the children presenting to our institute with cleft palate for hearing-related issues. Materials and Methods: The study was conducted in our institute from January 2017 to September 2020. It was a cross-sectional study, where 45 children with cleft palate were compared with 36 children with cleft lip who were considered the control group. Hearing of all children was assessed using tympanometry, otoscopy, and brainstem evoked response audiometry (BERA). Results: About 93.3% of children in the cleft palate group had an abnormal tympanic membrane on otoscopy, whereas in the control group only 11.1% of children had an abnormal tympanic membrane on otoscopy. About 97.8% of children in the cleft palate group had a hearing threshold greater than 25 decibels, whereas only 13.9% of children in the control group had a hearing threshold of above 25 decibels. More children in the cleft palate group had an abnormal tympanogram (42.2% had a type B tympanogram and 46.7% had a type C tympanogram) compared to the control group (5.6% had a type B tympanogram and 2.8% had a type C tympanogram). Conclusion: Our study adds to the evidence that there is a high incidence of hearing impairment in children with cleft palate. Hence, we advocate that early identification by screening measures such as otoscopy, tympanometry, auditory brainstem response, and pure tone audiometry during the first visit itself in these children so that early treatment can be initiated.

Comparison of Minimum Muscular Fitness of Congenital Hearing Loss and Normal Children using Kraus-Weber Test: A Cross-sectional Study

Introduction: Muscular Fitness (MF) is a potent indicator and reliable marker of children’s and adolescents’ general health and well-being. Further, MF is a significant predictor of biopsychosocial well-being among children. Aim: To compare Hearing Impaired (HI) and normal hearing childrens’ minimum MF utilising the Kraus-Weber (K-W) test. Materials and Methods: This was a cross-sectional study conducted at Holy Cross School for the Hearing Impaired and Sacred Heart High School at Vellore, Tamil Nadu, India. The duration of the study was from July 10, 2018 to 20 December, 2018. A total of 167 children of both genders aged 12 to 16 years, from a boarding school in southern India with congenital hearing loss (n=82) and normal hearing (n=85) children were included in this study. The demographic information of the participants, anthropometric measures, and six subtests of the K-W tests for minimum MF were evaluated. JASP (Jeffreys’s Amazing Statistics Program) version 0.16.1 was used for all statistical analyses. Descriptive statistics and Chi-squared test compared K-W test item success and failure rates. MannWhitney test evaluated physical differences. The level of significance was fixed 0.05. Results: The current research found that children with HI had a significantly lower minimum level of MF than children with normal hearing on K-W Test-3 (Abdominal minus psoas), K-W Test-5 (Lower back muscles), and K-W Test-6 (Back and Hamstrings) (p-value<0.001). Conclusion: The outcomes of this study revealed that HI children had lower minimal MF as measured by the K-W test than normal-hearing children. It highlighted the need for enhanced physical activity as well as education about the importance of maintaining minimum physical fitness.

Visual Perception and Attentional Skills in School-age Children: A Cross-Sectional Study of Reading Proficiency in the Hearing Impaired.

Auditory impairment is one of the common sensory deficits that occur in humans. Hearing loss affects students' ability to communicate and read, which eventually causes social and scholastic stigma. Reading relies heavily on phonics as well as visual attention. Students with normal hearing read by transforming phonic sounds into words. Hearing impaired has little to no phonic ability, making them visual readers who rely on visual cues while reading. Present study sought to investigate factors that affect reading skills in hearing-impaired children. A cross-sectional study was conducted in hearing- and hearing-impaired schools of Ludhiana, Punjab, India. After vision screening among all students, sixty students were enrolled via convenient sampling. Higher order of visual perception, attention, and reading ability was investigated. A total of 60 students were evaluated (30 hearing impaired and 30 age-matched hearing). The hearing group was statistically better than the hearing impaired (p = 0.001), Hearing impaired were better in visual attention (p = 0.001), whereas a correlation was found between reading ability and visual perception, attention skill of hearing- and hearing-impaired students (r = 0.80, P = 0.001). Present study concludes that hearing-impaired students exhibit issues with visual-motor integration, visual-spatial relationships, and visual sequential memory. Higher visual attention was demonstrated by hearing-impaired students. The results of the current investigation revealed a correlation between visual perception and attention skills and reading competency. Thus, the present study demands that the newly enrolled hearing-impaired students must undergo a thorough ocular evaluation.