Children's Hearing Status Research Articles

Exploration of preschool hearing screening at primary healthcare centers in Riyadh, Saudi Arabia: A cross-sectional study

The hearing status of children should be examined throughout early childhood, even if they have passed the newborn hearing loss because hearing loss can occur at any time and may affect their ability to learn. Preschool hearing screening (PHS) is vital to continue screening throughout early childhood. The current practice of PHS in the primary healthcare centers (PHCs) in Saudi Arabia is unknown. The purpose of this study was to investigate PHS in the PHCs. This cross-sectional descriptive study used an in-person-administered questionnaire to collect data. A total of 106 out of 120 participants (male = 61; female = 45) representing the PHCs in Riyadh were interviewed. Most of the participants were aged 31–40 years and held a bachelor's degree as the highest academic qualification with limited years of experience. PHS was mostly performed through subjective measures by asking the parents (71.7%) and the child (65.1%). The audiometric evaluation was conducted for preschool children in only half of the PHCs. General practitioners and nurses usually perform PHS. Substantial gaps in the practice of PHS were identified. The lack of training and appropriate instruments and the need for audiological services were the main challenges. Incorporating robust and objective protocols for PHS into the educational system is a valuable strategy for identifying hearing loss early and reducing its impact through the establishment of effective intervention plans.

Clinical and Audiological Outcome of Surgical Treatment in Patients with Adenoid Hypertrophy

Background: Adenoid hypertrophy is a common condition in childhood, which may be associated with recurring acute otitis media, otitis media with effusion (OME), and obstructive sleep apnoea syndrome. There is close relationship between adenoids and possible middle ear pathology leading to conductive deafness. Objective: To find out the outcome of surgery regarding clinical features and hearing status in children with adenoids. Methods: This hospital based prospective study was conducted at the Department of Otolaryngology& Head-Neck Surgery, Shaheed Suhrawardy Medical College & Hospital, for a period of 6 months following approval from IRB. Patients having enlarged adenoids with or without OME of 3-12 years and both sex group were approached for inclusion of the study. Informed written consent was taken from the guardian. Proper surgical intervention was chosen according to condition of the child. Before and after intervention, data were collected by the researcher himself. Data were recorded into the case record form. Following collection, data were analyzed by the SPSS 26 (SPSS Inc, Chicago, IL, USA). Results: Among 100 patients, 66% were males and 34% were females. Mean age was 7.2±2.34 SD (years). Of all, 60% underwent adenoidectomy (AT), 20% underwent adenoidectomy with myringotomy (AM), and remaining 20% underwent adenoidectomy with myringotomy with grommet insertion (AMG). The PTA findings (baseline) of adenoidectomy, adenoidectomy with myringotomy, and adenoidectomy with myringotomy with grommet insertion group were 15.466±1.395, 37.8±3.349 and 38.2±3.548 db, respectively. Similarly, significant improvement was noticed in all of the three groups as evidenced by PTA value in three groups were 11.91±1.12, 18.65±.933 and 17.45±1.31 db, respectively (p<0.05). Improvements in PTA among different groups also showed significant changes following operation (p<0.05). Conclusion: Clinical improvement are noticed following surgical intervention in both ............

The role of lexical and prosodic characteristics of mothers' child-directed speech for the early vocabulary development of Italian children with cochlear implants.

Variability in the vocabulary outcomes of children with cochlear implants (CIs) is partially explained by child-directed speech (CDS) characteristics. Yet, relatively little is known about whether and how mothers adapt their lexical and prosodic characteristics to the child's hearing status (before and after implantation, and compared with groups with normal hearing (NH)) and how important they are in affecting vocabulary development in the first 12 months of hearing experience. To investigate whether mothers of children with CIs produce CDS with similar lexical and prosodic characteristics compared with mothers of age-matched children with NH, and whether they modify these characteristics after implantation. In addition, to investigate whether mothers' CDS characteristics predict children's early vocabulary skills before and after implantation. A total of 34 dyads (17 with NH, 17 with children with CIs; ages = 9-32 months), all acquiring Italian, were involved in the study. Mothers' and children's lexical quantity (tokens) and variety (types), mothers' prosodic characteristics (pitch range and variability), and children's vocabulary skills were assessed at two time points, corresponding to before and 1 year post-CI activation for children with CIs. Children's vocabulary skills were assessed using parent reports; lexical and prosodic characteristics were observed in semi-structured mother-child interactions. Results showed that mothers of children with CIs produced speech with similar lexical quantity but lower lexical variety, and with increased pitch range and variability, than mothers of children with NH. Mothers generally increased their lexical quantity and variety and their pitch range between sessions. Children with CIs showed reduced expressive vocabulary and lower lexical quantity and variety than their peers 12 months post-CI activation. Mothers' prosodic characteristics did not explain variance in children's vocabulary skills; their lexical characteristics predicted children's early vocabulary and lexical outcomes, especially in the NH group, but were not related to later language development. Our findings confirm previous studies on other languages and support the idea that the lexical characteristics of mothers' CDS have a positive effect on children's early measures of vocabulary development across hearing groups, whereas prosodic cues play a minor role. Greater input quantity and quality may assist children in the building of basic language model representations, whereas pitch cues may mainly serve attentional and emotional processes. Results emphasize the need for additional longitudinal studies investigating the input received from other figures surrounding the child and its role for children's language development. What is already known on the subject Mothers' CDS is thought to facilitate and support language acquisition in children with various language developmental trajectories, including children with CIs. Because children with CIs are at risk for language delays and have acoustic processing limitations, their mothers may have to produce a lexically simpler but prosodically richer input, compared to mothers of children with NH. Yet, the literature reports mixed findings and no study to our knowledge has concurrently addressed the role of mothers' lexical and prosodic characteristics for children's vocabulary development before implantation and in the first 12 months of hearing experience. What this study adds to the existing knowledge The study shows that mothers of children with CIs produce input of similar quantity but reduced variety, and with heightened pitch characteristics, compared to mothers of children with NH. There was also a general increase in mothers' lexical quantity and variety, and in their pitch range, between sessions. Only their lexical characteristics predicted children's early vocabulary skills. Their lexical variety predicted children's expressive vocabulary and lexical variety only in the NH group. What are the practical and clinical implications of this work? These findings expand our knowledge about the effects of maternal input and may contribute to the improvement of early family-centred intervention programmes for supporting language development in children with CIs.

The use of hearing tests to assess otitis media with effusion in children with Down syndrome

BackgroundDown syndrome is associated with an increased risk for otitis media with effusion (OME), a childhood condition in which fluid accumulates in the middle ear, potentially leading to hearing loss. The American Academy of Pediatrics Down syndrome guidelines and the American Academy of Otolaryngology – Head and Neck Surgery OME guidelines recommend hearing testing to assess the hearing status of children with Down syndrome diagnosed with OME. MethodsThrough an Institutional Review Board approved retrospective chart review at Children's Mercy, this project assessed how clinical factors affect the frequency in which children with Down syndrome receive hearing testing after diagnosis of OME. The study included data from all children with Down syndrome between 1 and 8 years old diagnosed with OME in the Down syndrome, general pediatrics, and otolaryngology clinics between 2018 and 2020. Demographics and clinical factors, including clinic setting, were collected. ResultsOf the 124 patients identified, 91.1 % were diagnosed with OME in the otolaryngology clinic and 33.1 % received hearing testing. While most diagnoses occurred in the otolaryngology clinic, a higher proportion of hearing testing at the time of diagnosis occurred in the Down syndrome clinic. This could be explained by the fact that the Down syndrome clinic is a multidisciplinary clinic, where yearly visits include hearing screening. Bivariate analysis using chi-square or Fisher's tests showed that clinic setting had a significant association (p-value <0.001) with hearing testing. However, logistic regression depicted all clinical factors had an insignificant effect on hearing testing at 5 % significance. ConclusionWhile results indicate hearing testing is largely not performed to assess OME early in otolaryngology clinics, they may be used to assess intervention efficacy post-diagnosis. Results point to the importance of Down syndrome clinics in early diagnosis of hearing loss leading to timely referrals to otolaryngology clinics which diagnose and manage OME in children with Down syndrome.

Broadening understanding of executive function in children with different hearing histories: The roles of fathers and coparenting

Fathers and family-level characteristics are understudied but potentially impactful contributors to at-risk outcomes for deaf and hard-of-hearing (DHH) children who use spoken language. We investigated associations between paternal parenting stress, paternal self-efficacy for supporting language, and executive function (EF) development in DHH children and children with typical hearing (TH). Main and moderating effects of the coparenting relationship were also investigated. TH fathers of DHH children (n = 44) and TH children (n = 46) completed the Parenting Stress Index-4-Short Form, the Scale of Parental Involvement and Self-Efficacy, and the Coparenting Relationship Scale. Child EF was assessed via the Behavior Rating Index of Executive Function. Regression analyses revealed that paternal parenting stress was significantly associated with child EF difficulties regardless of child hearing status. Coparenting undermining moderated relations between paternal parenting stress and child difficulties with inhibition in the full sample. Coparenting undermining was associated with greater child difficulties with set-shifting for DHH children only. Paternal parenting stress represents a possible risk factor for child EF development, particularly in families with higher levels of coparenting undermining. DHH children might also be susceptible to adverse coparenting relations. Fathers of DHH children have previously been shown to be less involved and integrated during intervention, and a better understanding of the important contributions fathers have to child development could lead to novel, father-embedded intervention models.

Identifying reduced hearing in children who have developmental disabilities: Insights for inclusive research practices with electronic health records.

Recent advancements in big data analytics and the formation of large-scale clinical data repositories provide a unique opportunity to determine the current state of pediatric hearing health care for children who have developmental disabilities. Before answering unresolved questions about diagnostic practice, it is paramount to determine a standard and reliable method for identifying children who have reduced hearing because clinical management is affected by hearing status. The purpose of this study was to compare 5 different methods for identifying cases of reduced hearing from pure-tone thresholds based on developmental disability status. Using retrospective clinical data from 100,960 children (0-18 years), hearing status was determined for a total of 226,580 encounters from three clinical sites. 9% of the children had a diagnosis of intellectual disability, autism spectrum disorder, Down syndrome, or cerebral palsy. Results revealed that encounters from children who have developmental disabilities were more likely to have insufficient data to allow hearing status to be determined. Moreover, methods with higher data demands (i.e., number of thresholds and ear-specific thresholds) resulted in fewer classifiable encounters. The average child age when hearing status was classified for the first time was older for children who have developmental disabilities than for children in the comparison group. Allowing thresholds to build up over multiple test sessions did result in more children who have developmental disabilities being classified than for single-encounter methods, but a meaningful decrease in child age at the time of classification was not seen for this strategy. Compared to the comparison group, children who have developmental disabilities were more likely to have reduced hearing that was stable over time, yet their hearing status was determined at older ages. Results provide key guidance to researchers for how to determine hearing status in children for big data applications using electronic health records. Furthermore, several assessment disparities are spotlighted for children who have developmental disabilities that warrant further investigation.

Characterization of hearing status in children under 3 years of age with cleft palate.

To describe the hearing thresholds of children under 3 years of age with cleft palate with or without cleft lip. This retrospective study from a tertiary care children's hospital included children with cleft palate±cleft lip born between January 01, 2008, and December 31, 2015. All patients who had the initial palate repair at our institution and at least one behavioral audiogram were included. Behavioral audiograms collected either in the sound field or under insert earphones showed results from the better hearing ear. We collected demographic information, cleft type, parent report of newborn hearing screen, syndrome diagnosis, comorbid conditions, and dates of tympanostomy tube placement and palatoplasty. The main outcome measure was hearing status as measured by behavioral audiograms, and, for a subset of patients, brainstem auditory evoked responses (BAER). Results were grouped by test type (behavioral vs BAER) and characteristics at time of testing (pre- or post-palatoplasty, with or without tympanostomy tube placement) to evaluate the range of severity of hearing loss. Three hundred and sixty patients were included in the cohort. The cohort had two groups: Group 1 included 37 patients who had BAER results prior to surgery and behavioral audiogram results post-surgery; Group 2 included 322 patients who had behavioral audiograms pre-surgery (n=206) and/or post-surgery (n=215). The median age of patients at time of BAER in Group 1 was 3.00 months [IQR: 1.00,3.75]; pre-surgery BAER results showed mild (45.9%, n=17) or moderate hearing loss (29.7%, n=11) by this age. Patients in Group 2 with pre-surgery behavioral audiograms had a median age of 12.00 months [IQR: 11.00, 14.00] at time of audiogram. Most patients had a mild (33.5%, n=69) or moderate hearing loss (31.1%, n=64). Post-surgery, patients had a median age of 13.00 months [IQR: 11.00, 15.00] at time of hearing assessment and typically had normal hearing (86.0%, n=185). In most patients, hearing improved after palate repair with concurrent tympanostomy tube placement. Most patients with cleft palate±cleft lip had evidence of mild or moderate hearing loss prior to cleft palate repair, and hearing loss was evident from early infancy. Hearing improved after concurrent tympanostomy tube placement and palatoplasty. Further research is needed to understand the clinical significance of untreated transient hearing loss during the first year of life in this patient population.

Applications of the Grading Scales for the Detection of Ototoxicity in Children after Treatment of Neuroblastoma and Extracranial Germinal Tumor

Introduction: Advances in treatment have resulted in a significant increase in survival rates for patients cured of malignant diseases such as neuroblastoma (NBL) and extracranial germ cell tumor (GCT). NBL is one of the pediatric cancers during which potentially ototoxic cytostatic drugs (cisplatin and carboplatin) are used for treatment. Other cancers include germinal tumors, hepatoblastoma, sarcomas, and brain tumors. Often, this very aggressive treatment has a high risk of causing long-term side effects, including hearing loss. Hence, the present study aimed to evaluate the usefulness of the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), Brock, Chang, and International Society of Pediatric Oncology (SIOP) Boston scales in terms of detecting the high-frequency nature of hearing loss induced by ototoxic drugs and monitoring hearing status in children after completion of oncological treatment. Additionally, the frequency of hearing loss in children treated for NBL and extracranial GCT was assessed, and the principles of monitoring hearing in these patients were indicated. Methods: The study group consisted of 78 patients diagnosed with NBL (n = 47) and GCT (n = 31). There were 23 boys and 24 girls in the NBL group, aged 0–16 years, and 21 boys and 10 girls in the GCT group, aged 0–18 years. The control group consisted of 54 patients who had never received oncological treatment, were not taking potentially ototoxic drugs, and appeared socially efficient in the subjective audiological assessment. Audiometric examinations and DP-acoustic otoemission measurements were performed. Additionally, impedance audiometry tests were done to exclude a possible conductive component of the hearing loss. Results: The analysis shows that ototoxicity-induced hearing loss was observed in 13.8–65.5% of children. 75.9% of patients showed hearing loss in the 16 kHz frequency range, and at least 56.8% of patients showed hearing loss in the frequency range above 12.5 kHz. Hearing impairment, relevant to speech understanding, was displayed by more than 40% of children treated for NBL and GCT. Conclusions: The confirmation of hearing loss in nearly 65% of cases in both patients indicates the necessity to monitor the long-term side effects of anticancer treatment. Acoustic otoemission measurements, the adoption of articulatory indices based on an audiogram, or the use of arbitrary ototoxicity assessment scales such as Brock, Chang, or SIOP Boston are fully justified techniques for studying ototoxicity induced by cytostatic drugs. However, they all require continuous improvement to increase their sensitivity and specificity, especially in the pediatric group.

Development and Evaluation of Pediatric Versions of the Vanderbilt Fatigue Scale for Children With Hearing Loss.

Growing evidence suggests that fatigue associated with listening difficulties is particularly problematic for children with hearing loss (CHL). However, sensitive, reliable, and valid measures of listening-related fatigue do not exist. To address this gap, this article describes the development, psychometric evaluation, and preliminary validation of a suite of scales designed to assess listening-related fatigue in CHL: the pediatric versions of the Vanderbilt Fatigue Scale (VFS-Peds). Test development employed best practices, including operationalizing the construct of listening-related fatigue from the perspective of target respondents (i.e., children, their parents, and teachers). Test items were developed based on input from these groups. Dimensionality was evaluated using exploratory factor analyses (EFAs). Item response theory (IRT) and differential item functioning (DIF) analyses were used to identify high-quality items, which were further evaluated and refined to create the final versions of the VFS-Peds. The VFS-Peds is appropriate for use with children aged 6-17 years and consists of child self-report (VFS-C), parent proxy-report (VFS-P), and teacher proxy-report (VFS-T) scales. EFA of child self-report and teacher proxy data suggested that listening-related fatigue was unidimensional in nature. In contrast, parent data suggested a multidimensional construct, composed of mental (cognitive, social, and emotional) and physical domains. IRT analyses suggested that items were of good quality, with high information and good discriminability. DIF analyses revealed the scales provided a comparable measure of fatigue regardless of the child's gender, age, or hearing status. Test information was acceptable over a wide range of fatigue severities and all scales yielded acceptable reliability and validity. This article describes the development, psychometric evaluation, and validation of the VFS-Peds. Results suggest that the VFS-Peds provide a sensitive, reliable, and valid measure of listening-related fatigue in children that may be appropriate for clinical use. Such scales could be used to identify those children most affected by listening-related fatigue, and given their apparent sensitivity, the scales may also be useful for examining the effectiveness of potential interventions targeting listening-related fatigue in children. https://doi.org/10.23641/asha.19836154.

HEARING STATUS OF CHILDREN WITH BEHÇET’S DISEASE: A PROSPECTIVE PRELIMINARY STUDY

Objective: We aimed to evaluate the hearing status of children with Behçet’s Disease (BD). Materials and Method: It is a prospective, cross-sectional, controlled study. Pure-tone audiometry including high-frequencies and distortion product otoacoustic emission (DPOAE) were performed in 15 children with BD and 13 healthy controls. Results: Although both groups had normal hearing levels, the pure tone average of the study group was higher than the healthy controls. Hearing thresholds at 500 Hz and 4000 Hz were statistically significantly higher in children with BD. There was a significant difference in DPOAE levels at 1000 Hz and 4000 Hz. Children with BD had lower levels at these frequencies. Conclusion: In spite of the statistical differences in pure tone audiometry between the two groups, the delta was about 5 dB, which might not have clinical importance. However, this is the first study in children, and further studies are required.

Barriers to Receiving Necessary Hearing Care Among US Children.

We aim to clarify the national scope of unmet pediatric hearing care needs and identify specific barriers to hearing care. Cross-sectional study of a nationally representative data set. This study is based on the combined 2016 and 2017 National Survey of Children's Health. This survey covers the physical and emotional health, access to care, and social context of US children and adolescents aged 0 to 17 years. Analysis of parent-reported responses of children's hearing status, access to care, and perceived barriers. Overall, 0.3% (n = 206,200) of US children surveyed reported needing hearing care, which was not received. A further 1.3% (n = 934,000) reported deafness or problems with hearing, and of these, 6.4% (n = 60,000) reported not receiving necessary hearing care. Rates of insurance coverage between children with deafness/hearing problems and the general population were similar (91.7% vs 93.9%); however, deaf or hard-of-hearing children with unmet hearing care needs were more likely to be from non-White backgrounds (P = .009) and to lack health insurance coverage (P = .001). Rates of unfulfilled hearing care by reason were as follows: 57.5% without eligibility for the service, 45.4% reporting the service was not available in their area, 53.7% with difficulty obtaining an appointment, and 53.5% reporting issues with cost. Over 200,000 children annually do not receive necessary hearing-related care despite high rates of insurance coverage, and nearly 60,000 of these children are deaf or hard of hearing. Cost, eligibility for and distribution of services, and timely appointments are the primary barriers to hearing health care.

Organizational Aspects and Outcomes of a Hearing Screening Program Among First-Grade Children in the Mazovian Region of Poland.

Purpose The purpose of this study is to describe and assess a hearing screening program of first-grade children in Poland. The program aimed to detect hearing disorders and increase awareness among parents of hearing problems. Method A hearing screening program was conducted in all elementary schools of the biggest region in Poland. A total of 34,618 first-graders were screened. The hearing screening protocol included video otoscopy and pure-tone audiometry. The program also included an information campaign directed to the local community and educational meetings between parents and medical staff. Results The estimated prevalence of hearing loss was 11%. Unilateral hearing loss was more common than bilateral hearing loss. Mild hearing loss was more frequent than moderate (or worse) hearing loss. In otoscopy, the most common positive result was otitis media with effusion. Parents and medical staff took part in 1,608 educational meetings, broadening the parents' knowledge of how to care for hearing. Conclusions A hearing screening program not only provides data on the prevalence of childhood hearing problems but is also an avenue for providing the local community with valuable knowledge about how to care for hearing. This study demonstrated the importance for systematic monitoring of children's hearing status and of increasing awareness among parents and teachers of the significance of hearing loss. The hearing screening of children starting school should become a standard part of school health care programs.

Hearing Status of Children and Adolescents With Familial Adenomatous Polyposis.

Chemopreventative therapeutics may be helpful in familial adenomatous polyposis (FAP) management; however, prospective chemopreventative studies are complicated by potential ototoxicity and pre-existing hearing loss. The aim of this study was to establish and compare baseline hearing status of children and adolescents with FAP and their unaffected siblings. Twenty FAP pediatric patients with documented mutation of the adenomatous polyposis coli (APC) gene and nine unaffected sibling controls underwent baseline hearing evaluation, including audiometry, speech perception testing, and middle and inner ear physiologic measures. Results of the FAP cohort were compared to the unaffected sibling cohort. Two (5%) children with FAP presented with baseline hearing loss of unknown etiology, likely unrelated to their FAP diagnosis. No significant differences were found in any of the hearing measures between groups. Mutation of the APC gene is not necessarily indicative of higher risk for baseline hearing loss in the pediatric population.

Pilot Hearing Screening of School-age Children in Lagos, Nigeria.

The aim of this pilot study is to assess the prevalence of hearing disorders in school-age children in Lagos, Nigeria. The study group consisted of 236 children aged 5 to 11 years old. Children were assessed by otoscopy, transiently evoked otoacoustic emissions, and pure-tone audiometry screening. Abnormal audiograms were found in 46 (19.5%) of the tested children. Otoscopy data suggest that the most frequent hearing abnormalities were related to cerumen and otitis media. Low agreement (55%) was found between otoacoustic emissions outcomes and pure-tone audiometry data. Given the high prevalence of hearing problems in this group of primary school students, there is a strong need to monitor the hearing status of children in this geographical area.

Effects of familial Mediterranean fever on the middle ear

ObjectiveTo evaluate middle and inner ear function and hearing status of children with familial Mediterranean fever (FMF). MethodsWe assigned 56 patients with FMF to the study group and 52 healthy volunteers to the control group. The mean age of patients in the study and control groups were 10.10 ± 3.70 and 9.77 ± 3.74 years, respectively. Physical examination and hearing evaluation were performed in both groups. The audiological test battery included 226-Hz tympanometry, pure tone audiometric evaluation, acoustic stapedial reflex measurements, distortion product otoacoustic emission recording, and wide-band tympanometry assessment. ResultsThe groups were similar in age and sex ratio (p > 0.05 for both comparisons). Pure tone audiogram and distortion product otoacoustic emission results were also similar for both groups (p > 0.05). The ipsilateral acoustic stapedial reflex were present in both of the groups and all participants had Type A tympanogram. The contralateral acoustic stapedial reflex thresholds were significantly higher in the familial Mediterranean fever group (p < 0.05 for all comparisons). The ambient and peak pressure absorbance values of wide-band tympanometry were significantly lower at 2000 Hz and significantly higher at 4000 Hz in the familial Mediterranean fever group (p < 0.05 for both comparisons). The severity and duration of disease adversely affected the absorbance values of wide-band tympanometry at 2000 and 4000 Hz (p < 0.05). ConclusionTo our knowledge, this is the first study to demonstrate the adverse subclinical effects of familial Mediterranean fever on the middle ear. We recommend that children diagnosed with FMF should be closely monitored for future clinical middle ear pathologies.

Hearing status of children under five years old in Jatinangor district

Background: Hearing is one of the most influential factors in children developmental process. The critical period of hearing and speech development begins in the first 6 months of life and continues until the age of 3 years. World Health Organization estimates that one to three in a thousand births have sensorineural hearing loss (SNHL). Early detection of hearing loss is substantial so that the diagnosis can be established and appropriate intervention can be done earlier. Purpose: To determine the hearing status in children under five years of age in Jatinangor. Method: A cross-sectional observational study with 240 subjects under the age of five in 12 Integrated Healthcare Center (Posyandu) in Jatinangor. Examinations included parental interviews, Behavioral Observation Audiometry (BOA), Otoacoustic Emissions (OAE), and tympanometry tests. Result: One child (0.4%) had moderate conductive hearing lossin the left ear, 1 child (0.4%) had bilateralsevere SNHL, and 7 children (2.9%) had profound bilateral SNHL. Conclusion: The incidence of hearing loss in children under five in Jatinangor was 3.8%, with bilateral profound SNHL asthe highest number, and the most common cause were prenatal Toxoplasma, Rubella, Cytomegalovirus (CMV) dan Herpes simplex virus (TORCH) infections.Keywords: children under-five, early detection, hearing status ABSTRAKLatar belakang: Pendengaran merupakan salah satu faktor yang sangat berpengaruh dalam proses perkembangan anak. Periode kritis perkembangan pendengaran dan berbicara dimulai dalam 6 bulan pertama kehidupan dan terus berlanjut sampai usia 3 tahun. Badan kesehatan dunia memperkirakan satu sampai tiga dalam seribu kelahiran terdapat kejadian gangguan dengar jenis sensorineural. Deteksi dini gangguan dengar penting untuk dilakukan sehingga diagnosis dapat ditegakkan dan intervensi yang tepat dapat dilakukan sedini mungkin. Tujuan: Untuk mengetahui status pendengaran pada anak usia bawah lima tahun di kecamatan Jatinangor. Metode: Penelitian observasional potong lintang dengan subjek penelitian 240 anak usia bawah lima tahun di 12 Pos Pelayanan Terpadu (Posyandu) Kecamatan Jatinangor. Dilakukan pemeriksaan meliputi wawancara orangtua anak, tes Behavioral Observation Audiometry (BOA), tes Otoacoustic Emissions (OAE) dan tes timpanometri. Hasil: Didapatkan 1 anak (0,4%) mengalami gangguan dengar konduktif derajat sedang pada telinga kiri, 1 anak (0,4%) mengalami gangguan dengar sensorineural derajat berat bilateral, dan 7 anak (2,9%) mengalami gangguan dengar sensorineural derajat sangat berat bilateral. Kesimpulan: Angka kejadian gangguan dengar pada balita di kecamatan Jatinangor sebesar 3,8% dengan gangguan dengar terbanyak berupa sensorineural derajat sangat berat bilateral, dan latar belakang penyebab terbanyak adalah infeksi prenatal Toxoplasma, Rubella, Cytomegalovirus dan Herpes simplex virus (TORCH).

Parental Use of Multimodal Cues in the Initiation of Joint Attention as a Function of Child Hearing Status

ABSTRACT In the current study we examine how hearing parents use multimodal cuing to establish joint attention with their hearing (n = 9) or deaf (n = 9) children during a free-play session. The deaf children were all candidates for cochlear implantation who had not yet been implanted, and each hearing child was age-matched to a deaf child. We coded parents’ use of auditory, visual, and tactile cues, alone and in different combinations, during both successful and failed bids for children’s attention. Although our findings revealed no clear quantitative differences in parents’ use of multimodal cues as a function of child hearing status, secondary analyses revealed that hearing parents of deaf children used shorter utterances while initiating joint attention than did hearing parents of hearing children. Hearing parents of deaf children also touched their children twice as often throughout the play session than did hearing parents of hearing children. These findings demonstrate that parents differentially accommodate the specific needs of their hearing and deaf children in subtle ways to establish communicative intent.

Lexical Repetition Properties of Caregiver Speech and Language Development in Children With Cochlear Implants.

Purpose Early language input plays an important role in child language and cognitive development (e.g., Gilkerson et al., 2018; Hart & Risley, 1995). In this study, we examined the effects of child's hearing status on lexical repetition properties of speech produced by their caregivers with normal hearing (NH). In addition, we investigated the relationship between maternal lexical repetition properties and later language skills in English-learning infants with cochlear implants (CIs). Method In a free-play session, 17 mothers and their prelingually deaf infants who received CIs before 2 years of age (CI group) were recorded at two post-CI intervals: 3 and 6 months postactivation; 18 hearing experience-matched infants with NH and their mothers and 14 chronological age-matched infants with NH group and their mothers were matched to the CI group. Maternal speech was transcribed from the recordings, and measures of maternal lexical repetition were obtained. Standardized language assessments were administered on children with CIs approximately two years after CI activation. Results The findings indicated that measures of lexical repetition were similar among the three groups of mothers, regardless of the hearing status of their infants. In addition, lexical repetition measures were correlated with later language skills in infants with CIs. Conclusions Infants with CIs receive the language input that contains similar lexical repetition properties as that in the speech received by their peers with NH, which is likely to play an important role in child speech processing and language development. These findings provide the knowledge for professionals to coach parents to implement specific language intervention strategies to support language development in infants with hearing loss. Supplemental Material https://doi.org/10.23641/asha.11936322.

Aetiology and Hearing Status of Children under 12 years in a School for Hearing Impaired

Objective: To assess degree, type and cause of hearing loss in children under 12 years of age in preschool for hearing impaired children.&#x0D; Methods: This cross sectional study was carried out in children of integrated preschool for hearing impaired children (IPSHIC) of SAHIC, Mohakhali, Dhaka, from September 2010 to March 2011. 50 deaf children were included with age 3-12 years and clinically detected hearing impairment. Data were collected by detailed history, clinical examination and audiometric findings and result were expressed in table form.&#x0D; Results: Most of the children presented with bilateral profound hearing loss and majority of patients presented with sensorineural type of hearing loss. Family history positive in 36% cases and consanguineous marriage were found in 34%.Commonest causes of deafness was infection.&#x0D; Conclusion: Early detection with universal neonatal screening should be practiced in our country and early rehabilitation reveals better out come.&#x0D; Bangladesh J Otorhinolaryngol; April 2016; 22(1): 36-39

Vocal Turn-Taking Between Mothers and Their Children With Cochlear Implants.

The primary objective of the study was to examine the occurrence and temporal structure of vocal turn-taking during spontaneous interactions between mothers and their children with cochlear implants (CI) over the first year after cochlear implantation as compared with interactions between mothers and children with normal hearing (NH). Mothers' unstructured play sessions with children with CI (n = 12) were recorded at 2 time points, 3 months (mean age 18.3 months) and 9 months (mean age 27.5 months) post-CI. A separate control group of mothers with age-matched hearing children (n = 12) was recorded at the same 2 time points. Five types of events were coded: mother and child vocalizations, vocalizations including speech overlap, and between- and within-speaker pauses. We analyzed the proportion of child and mother vocalizations involved in turn-taking, the temporal structure of turn-taking, and the temporal reciprocity of turn-taking using proportions of simultaneous speech and the duration of between- and within-speaker pauses. The CI group produced a significantly smaller proportion of vocalizations in turn-taking than the NH group at the first session; however, CI children's proportion of vocalizations in turn-taking increased over time. There was a significantly larger proportion of simultaneous speech in the CI compared with the NH group at the first session. The CI group produced longer between-speaker pauses as compared with those in the NH group at the first session with mothers decreasing the duration of between-speaker pauses over time. NH infants and mothers in both groups produced longer within- than between-speaker pauses but CI infants demonstrated the opposite pattern. In addition, the duration of mothers' between-speaker pauses (CI and NH) was predicted by the duration of the infants' between-speaker pauses. Vocal turn-taking and timing in both members of the dyad, the mother and infant, were sensitive to the experiential effects of child hearing loss and remediation with CI. Child hearing status affected dyad-specific coordination in the timing of responses between mothers and their children.