Identification Of Hearing Loss Research Articles

A retrospective audit of audiology encounters in patients undergoing Cisplatin treatment at a large Australian tertiary cancer care centre.

To identify the number and timing of audiology encounters for adult oncology patients in a tertiary care setting in Australia. A retrospective case review was completed for 149 patients who received Cisplatin chemotherapy (CT) at a large, publicly funded tertiary hospital in Brisbane, Queensland, Australia between 1st January and 31st December 2019. Patient data was extracted from the Queensland Oncology Repository (QOR) provided by Cancer Alliance Queensland (CAQ). The number of audiology encounters was low overall with a median of 0 and interquartile range (IQR) of 0-1. Of the entire patient cohort, there was a mean of 1.2 encounters with 56% of patients not engaging with audiology. Where audiology did occur, encounters were most likely before or early in the CT treatment period. This study has demonstrated engagement with audiology services for patients undergoing CT treatment was limited with the few audiology engagements occurring before or early in the CT treatment period. Further research is needed to identify the barriers and facilitators to accessing audiological ototoxic monitoring (OtoM) during chemotherapy treatment in hospitals in Australia. Early identification of ototoxic hearing loss offers the opportunity to minimise further exposure to the ototoxic agent, minimise functional and communication impacts for the patient and provide early opportunity for discussion, education and counselling with patients, carers and their treating team. This, in turn, is expected to improve health related quality of life.

Situational assessment of age of suspicion, diagnosis, and intervention of hearing loss in pediatric population in India and factors that influence them

ObjectiveIn the absence of newborn hearing screening, identification of childhood hearing loss is primarily mediated by parents’ help-seeking behaviour. This study attempted to measure the variables age of suspicion, diagnosis, and intervention of congenital hearing loss in India in a large cohort to verify the efficiency of this approach. It aimed to study the influence of parental perceived awareness, accessibility, and affordability on these milestones. MethodData were collected through a survey method of research using a pre-developed questionnaire as the instrument. The study involved 384 parents of children with hearing loss receiving hearing healthcare services from various healthcare institutions and clinics in Karnataka, India. ResultsThe mean age of suspicion, diagnosis, and intervention of hearing loss after data analysis were 18.6, 25.0, and 30.6 months, respectively. Earlier parental suspicion of hearing loss was associated with earlier diagnosis and intervention in the child. While less than 4 % of the cohort was diagnosed before three months, less than 1 % received intervention within six months of age. Lack of awareness, accessibility, and affordability significantly delayed these milestones. Among the participants, 15.03 % had experienced at least one of the three barriers (lack of awareness, accessibility, and affordability), whereas 35.28 % had reported two barriers, and 41.71 % had reported all three barriers for their help-seeking behavior. ConclusionsRelying on parental help-seeking behaviour cannot result in early identification and intervention required for optimum pediatric hearing healthcare. India should implement comprehensive early hearing detection and intervention program that includes universal newborn hearing screening and addresses awareness, accessibility, and affordability of hearing healthcare services as critical components.

Genetic screening of newborns for deafness over 11 years in Beijing, China: More infants could benefit from an expanded program.

Genetic screening of newborns for deafness plays an important role in elucidating the etiology of deafness, diagnosing it early, and intervening in it. Genetic screening of newborns has been conducted for 11 years in Beijing. It started with a chip to screen for 9 variants of 4 genes in 2012; the chip screened for 15 variants of those genes in 2018, and it now screens for 23 variants of those genes. In the current study, a comparative analysis of three screening protocols and follow-up for infants with pathogenic variants was performed. The rates of detection and hearing test results of infants with pathogenic variants were analyzed. Subjects were 493,821 infants born at 122 maternal and child care centers in Beijing from April 2012 to August 2023. Positivity increased from 4.599% for the chip to screen for 9 variants to 4.971% for the chip to screen for 15 variants, and further to 11.489% for the chip to screen for 23 variants. The carrier frequency of the GJB2 gene increased from 2.489% for the chip to screen for 9 variants and 2.422% for the chip to screen for 15 variants to 9.055% for the chip to screen for 23 variants. The carrier frequency of the SLC26A4 gene increased from 1.621% for the chip to screen for 9 variants to 2.015% for the chip to screen for 15 variants and then to 2.151% for the chip to screen for 23 variants. According to the chip to screen for 9 variants and the chip to screen for 15 variants, the most frequent mutant allele was c.235delC. According to the chip to screen for 23 variants, the most frequent mutant allele was c.109G>A. The chip to screen for 15 variants was used to screen 66.67% (14/21) of newborns with biallelic variants in the SLC26A4 gene for newly added mutations. The chip to screen for 23 variants was used to screen 92.98% (53/57) of newborns with biallelic variants in the GJB2 gene (52 cases were biallelic c.109G>A) and 25% (1/4) of newborns with biallelic variants in the SLC26A4 gene for newly added mutations. Among the infants with pathogenic variants (biallelic variants in GJB2 or SLC26A4), 20.66% (25/121) currently have normal hearing. In addition, 34.62% (9/26) of newborns who passed the hearing screening were diagnosed with hearing loss. Findings indicate that a growing number of newborns have benefited, and especially in the early identification of potential late-onset hearing loss, as the number of screening sites has increased. Conducting long-term audiological monitoring for biallelic variants in individuals with normal hearing is of paramount significance.

Newborn hearing screening in Eastern Saudi Arabia: A tertiary hospital experience.

To analyze the performance of a leading institution in implementing newborn hearing screening and address two key areas: the knowledge gap in screening practice and the prevalence of permanent sensorineural hearing loss in Saudi Arabia. We analyzed the prevalence of hearing impairment in all live births at King Fahad Hospital of the University, Al Khobar, Saudi Arabia, from September 2018 to June 2022. Automated auditory brainstem response was used for both initial screening and rescreening. Newborns who failed the rescreening underwent a diagnostic evaluation. We assessed the coverage of initial screening, the rate of lost follow-up, referrals for rescreening and diagnostic evaluation, and the prevalence of hearing impairment. A total of 5,986 newborns were born. Of these, 96.5% were screened. The passing rate for the initial screening and rescreening was 71.8%. However, 27.5% of newborns were lost to follow-up. Only 0.7% required referral for a diagnostic evaluation. The overall prevalence of hearing impairment was 2.6 per 1,000 newborns. Early identification of hearing loss through newborn screening improves the lives of affected individuals. Our program currently meets the World Health Organization's 1-3-6 benchmark goals. However, the underestimation of permanent hearing loss due to the 30% lost-to-follow-up rate is a limitation. Emphasizing the importance of the screening program is crucial to raising awareness and improving the accuracy of prevalence rates.

Ear disease, hearing loss, and cognitive outcomes in high school children who were previous participants in a randomized placebo controlled trial of an 11 valent conjugate pneumococcal vaccine administered in infancy

The WHO estimates that close to 1.7 billion people worldwide have hearing loss; 34 million of whom are children, with 90% residing in low- and middle-income countries. While the effects of ear disease and hearing loss on language, academic, and behavioral development are established, there is remarkably little data on intellectual and other cognitive differences. Here we report results from an extension of a randomized controlled vaccination trial originally carried out between 2000 and 2004. Primary caregivers completed demographic and household questionnaires. Beginning in 2016, children were followed up for a hearing and ear disease evaluation. Participants also completed extensive cognitive testing, which included the domains of IQ, language, attention and processing speed, visual and visuospatial skills, and learning and memory. The association between ear disease and hearing loss and each of the cognitive outcomes was examined using multivariate linear regression models. We followed up 8926 children ages 14-19 years old. Children with hearing loss or ear disease had lower socioeconomic status compared to children without. However, even after controlling for a high number of covariates, all levels of ear disease or hearing loss were associated with clinically relevant reductions across all cognitive domains, though effect sizes were small. Even mild ear disease or hearing loss was associated with a-0.15 (95% CI:-0.20,-0.11) and a-0.23 (95% CI:-0.32,-0.14) standard deviation reduction, respectively, in IQ. The effects of ear disease and hearing loss were additive as children with both had the lowest cognitive scores. Untreated ear disease and hearing loss exert measurable effects on cognition that are able to be detected into the teenage years. Early identification of hearing loss and chronic ear disease may have lifelong benefits. Individuals with ear disease and/or hearing loss may require supports and services in addition to those related to speech and language therapy. The Bill and Melinda Gates Foundation OPP1142570.

The Medicare annual wellness visit: An opportunity to improve health system identification of hearing loss?

Hearing loss is prevalent and consequential but under-diagnosed and managed. The Medicare Annual Wellness Visit (AWV) health risk assessment elicits patient-reported hearing concerns but whether such information affects documentation, diagnosis, or referral is unknown. We use 5 years of electronic medical record (EMR) data (2017-2022) for a sample of 13,776 older primary care patients. We identify the first (index) AWV indication of hearing concerns and existing and subsequent hearing loss EMR diagnoses (visit diagnoses or problem list diagnoses) and audiology referrals. For a 20% random sample of AWV notes (n = 474) we compared hearing loss EMR diagnoses to documentation of (1) hearing concerns, (2) hearing loss/aid use, and (3) referrals for hearing care. Of 3845 (27.9%) older adults who identified hearing concerns (mean age 79.1 years, 57% female, 75% white) 24% had an existing hearing diagnosis recorded. Among 474 patients with AWV clinical notes reviewed, 90 (19%) had an existing hearing loss diagnosis. Clinicians were more likely to document hearing concerns or hearing loss/aid use for those with (vs. without) an existing EMR diagnosis (50.6% vs. 35.9%, p = 0.01; 68.9% vs. 37.5%, p < 0.001, respectively). EMR diagnoses of hearing loss were recorded for no more than 40% of those with indicated hearing concerns. Among those without prior diagnosis 38 (9.9%) received a hearing care referral within 1 month. Subgroup analysis suggest greater likelihood of documenting hearing concerns for patients age 80+ (OR:1.51, 95% confidence interval [CI]: 1.03, 2.19) and decreased likelihood of documenting known hearing loss among patients with more chronic conditions (OR: 0.49, 95% CI: 0.27, 0.9), with no differences observed by race. Documentation of hearing loss in EMR and AWV clinical notes is limited among older adults with subjective hearing concerns. Systematic support and incorporation of hearing into EMR and clinical notes may increase hearing loss visibility by care teams.

Detecting Hearing Loss Through Targeted Surveillance: Risk Registry and Surveillance Timeframe Recommendations.

The purpose of this study was to inform the revision of a targeted surveillance risk registry by identifying which risk factors predict postnatally identified hearing loss (PNIHL) in children who pass newborn hearing screening and to determine whether hearing surveillance beyond the age of 1 year is warranted. We used retrospective analysis of the audiological outcomes of children born in the state of Queensland, Australia, between January 1, 2010, and December 31, 2019, who passed the newborn hearing screen with risk factors. Approximately one third of children were lost to follow-up and could not be included in the analysis. Risk factors that predicted PNIHL in the analyzed cohort were as follows: syndromes associated with hearing loss, craniofacial anomalies, perinatal infections, and family history of permanent childhood hearing loss. Severe asphyxia did not predict PNIHL but yielded some cases of significant bilateral hearing loss. Hearing loss in children with a history of prolonged ventilation was mild and/or unilateral in nature (except in cases where the hearing loss was due to an unrelated etiology). There were no cases of PNIHL in children with hyperbilirubinemia or neonatal bacterial meningitis. For the risk factors that predicted PNIHL, nearly all hearing losses were detected by 1 year of age, except for children with family history where one quarter of hearing losses had a later onset. The four risk factors recommended for efficient postnatal identification of hearing loss are as follows: syndromes associated with hearing loss, craniofacial anomalies, perinatal infection, and family history of permanent childhood hearing loss. Hearing surveillance through to 1 year old is sufficient except for children with a family history, where a second phase assessment is indicated. Alternative targeted surveillance protocols and models of care are required to minimize loss to follow-up.

Barriers to Meeting National Early Hearing Detection and Intervention Guidelines in a Diverse Patient Cohort.

To determine our audiology clinics status in meeting the Joint Committee on Infant Hearing recommended 1-3-6 benchmarks for identification and intervention for congenital sensorineural hearing loss and identify those factors contributing to delay in identification and intervention. This is a retrospective case series. Children with sensorineural hearing loss who underwent auditory brainstem response (ABR) testing, hearing aid evaluation, or cochlear implant mapping at our tertiary pediatric medical center between January 2018 and December 2021 were included. Simple and multiple linear regression analyses were used to identify social, demographic, and health factors associated with primary outcomes, defined as age at hearing loss identification, age at intervention (here defined as amplification start), and interval between identification and intervention. Of 132 patients included, mean age was 2.4 years, 48% were male, and 51% were Hispanic. There was significant association between each Hispanic ethnicity (p = 0.005, p = 0.04, respectively), insurance type (p = 0.02, p = 0.001, respectively), and later age at identification and intervention. In multivariable analyses, Hispanic ethnicity was significantly associated with both delays in identification and intervention (p = 0.03 and p = 0.03, respectively), and public insurance was associated with delays in intervention (p = 0.01). In addition, the total number of ABRs was significantly associated with both older age of identification and intervention (p < 0.001, p < 0.001, respectively). Mediator analysis demonstrated that the effect of ethnicity on age at identification is mediated by the total number of ABRs performed. A significant association between total number of ABRs and age at identification and intervention for children with hearing loss exists. Hispanic ethnicity was associated with delays in meeting milestones, further mediated by the number of ABRs, providing a potential avenue for intervention in addressing this disparity.

Cochlear implantation in pediatrics: Impact of newborn hearing screening on intervention time

ObjectivesThe newborn hearing screening (NHS) program was globally established for early hearing loss (HL) identification and intervention. Early intervention is essential to minimize or prevent the negative consequences of HL. In Saudi Arabia, the NHS was officially implemented in 2016. Currently, its impact on the timing of cochlear implantations (CIs) in Saudi Arabia remains unclear, and information on potential hospital-related delays affecting early implantation is lacking. Thus, this study aimed to evaluate the effect of implementing the NHS on age at CI in children with prelingual deafness in a CI center in Saudi Arabia, and to evaluate the hospital timing in the CI process. MethodsAll pediatric CI users who presented for the first time to the CI committee (CIC) at a tertiary center and received their implants between 2015 and 2022 were enrolled in this study. Date of birth (DOB), date of presentation to the CI committee (DOCIC), and date of CI surgery (DOCIS) were retrospectively reviewed. ResultsIn total, 304 CI children were included in the analysis. Approximately 55 % of the children (n = 167) were screened for HL through the NHS, whereas 45 % of the children (n = 137) were born before the launch of the NHS. Both age at the presentation to the CIC (i.e. difference between DOCIC and DOB) and age at implantation (i.e. difference between DOCIS and DOB) were significantly earlier in children who were screened for HL through the NHS than those who were not screened (P < 0.0001). The time difference between the DOCIC and DOCIS was not significantly different between the screened and unscreened children (P > 0.05). ConclusionThe implementation of the NHS in the tertiary center has a significant positive effect on age at presentation to the CIC and age at implantation, but not on the actual CI surgery. Further research is needed to reduce the hospital delays before the actual surgery in order to increase the likelihood of children receiving implantation early in their life.

Functional Outcomes from Cochlear Implants in Children with Acquired Hearing Loss: Case Studies

Purpose: Early identification of postlingual hearing loss (HL) and knowing its probable cause is of great significance. Causes that result in irreversible profound HL require immediate radiological investigation and intervention to decide the best listening device.Methods: Case reports of three children with acquired HL using cochlear implant (CI) are being presented to understand the functional outcomes in domains of audition and language skills after 12 months of CI use. The age of onset of deafness and implantation were not identical. Etiology of deafness was meningitis in two cases and viral infection in the other. Consent was obtained from the parents for participating in the study. Case history review was conducted to collect demographic and audiological details of the participants. Functional benefits from CI in those children were assessed in the domains of auditory and language skills using standardized assessment tools respectively.Results: Improvements in all domains of auditory and language skills were observed. However, the degree of benefits depended on the duration of deafness, etiology of deafness, age at onset of deafness, age at implantation and effectiveness of intervention.Conclusions: The results of the study can be used during pre-implant CI counselling to facilitate development of real expectations about the functional benefits of CI in children with acquired HL due to various reasons and showed the importance of early cochlear implantation following the diagnosis. These case presentations give an understanding of the various factors that can affect the functional outcome from CI in children with post-lingual HL.

Family-Perceived Barriers and Facilitators Toward a Tele-Audiology Infant Diagnostic Testing Approach in Victoria, Australia.

Background: Universal newborn hearing screening programs allow for early identification of congenital hearing loss. However, some families experience difficulties accessing diagnostic audiology services following a refer screen result. Methods: This study aimed to assess the opinions of families who had experienced infant diagnostic audiology assessments regarding a telehealth option for these appointments within Victoria, Australia. Families who attended in-person infant diagnostic audiology appointments were sent a questionnaire exploring their experiences of the service and their opinion regarding a proposed telehealth option for infant diagnostic audiology (50 responses received). These results were also compared to those of families who were surveyed following testing in 2020, where the audiologist conducted the appointment remotely to comply with COVID-19-related social distancing recommendations at the time (10 responses received). Results: There were not significant differences between the duration or number of appointments, perceived understanding of results, or concerns regarding a tele-audiology model between families who experienced face-to-face and tele-audiology infant diagnostic audiology appointments. Opinions of infant diagnostic audiology appointments utilizing telehealth technology were largely positive, and minimal technological difficulties were identified. Conclusion: Overall positive attitudes of many families with infant diagnostic appointment experiences toward a tele-audiology option of this service suggest that offering a telehealth model of appointments may be an appropriate model to improve service access for families requiring infant diagnostic audiology in Victoria.

Postponement of the Newborn Hearing Screening during the COVID-19 Pandemic; Parental Experiences and Worries.

Early identification of hearing loss through newborn hearing screening followed by an early start of intervention has proven to be effective in promoting speech and language development in children with hearing loss. During the COVID-19 pandemic, newborn hearing screening was postponed for a group of newborns in the Netherlands. Therefore, meeting the guidelines for early identification was at risk. In this study, we examine parental attitudes, beliefs, and experiences concerning the hearing screening during the COVID-19 pandemic. Our results indicated that parents (n = 1053) were very positive about newborn hearing screening and their experiences with the screening, even during the COVID-19 pandemic. Parents' beliefs on the information provision around newborn hearing screening were more inconsistent. The results showed that parents with a postponed hearing screening felt less informed about the hearing screening than parents without a postponed screening. Furthermore, child and family characteristics affected how parents experienced newborn hearing screening. Parents with a premature child were more worried about the hearing abilities of their child before the screening took place. The results also indicate that deafness in the family might lead to parental worries around newborn hearing screening.

Retesting of Neonatal Hearing Screening Before and During the COVID-19 Pandemic: A Longitudinal Study

Introduction: Universal Newborn Hearing Screening (UNHS) plays an essential role in the early identification of hearing loss in neonates. Risk factors for hearing impairment may include family history, prematurity, and exposure to ototoxic substances. Coronavirus Disease 2019 (COVID-19) might be a significant contributing factor affecting the structures of the inner ear. Objective: To assess the auditory follow-up process of retesting for UNHS before and during the COVID-19 pandemic among neonates from an Outpatient Auditory Health Service (SASA) in the state of Santa Catarina with SUS (Unified Health System) assistance. Methods: A retrospective longitudinal study analyzed data from neonates attended at a SUS Auditory Health Service (SASA) from January 2018 to December 2022. Information related to UNHS and retest outcomes was assessed. Data were analyzed using Microsoft Excel® and MedCalc® Statistical Software version 22.006, utilizing statistical measures and regression analyses to identify factors associated with UNHS failures and retesting. Results: A failure to retest rate of 2.6% in the right ear and 2.2% in the left ear was observed among evaluated neonates. The average age of mothers of neonates who did not pass the test was 33 years, while the overall average was 27 years. Failure to pass the retest and a longer interval between UNHS and retesting were associated with UNHS Initial Retest Default (IRD). There was an increase in dropout rates for UNHS retesting, and the time interval between UNHS and retesting was extended during the pandemic. Conclusion: Several factors, including the interval between tests, mothers' age, and medical conditions, influenced the retest outcomes. The pandemic led to a significant increase in dropout rates and extended time for retesting.

Evaluation of newborn hearing screening program in Jordan.

The Newborn Hearing Screening (NHS) program was officially launched in Jordan in 2021. Since its inception, no studies have examined the effectiveness of the program. This study seeks to assess the effectiveness and outcomes of the NHS program in Jordan. A retrospective cross-sectional study was conducted to investigate the program coverage rate, referral rate, loss to follow-up rate and the hearing status of newborns who successfully completed the necessary diagnostic assessment. Live births in all hospitals administered by the Ministry of Health (MoH) in Jordan from July 2021 to November 2023 were included. Out of 25,825 newborns delivered, 99.4% (25,682) were screened. A referral rate of 0.7% (189) was recorded. Approximately 61.9% of those referred (n = 117) had normal hearing, while 31.7% (60 infants) were diagnosed with hearing loss. The prevalence of congenital hearing loss was 0.14%, and the mean age for identifying hearing loss was 11 months. The current status of the NHS program in Jordan is promising. The program has achieved most benchmarks recommended by the Joint Committee on Infant Hearing (JCIH), demonstrating encouraging outcomes. There is a need to investigate and address the factors causing delays in the identification of hearing loss in Jordan.

The public healthcare sector of Mauritius: knowledge of and attitudes toward hearing loss among community health workers.

Mauritius does not have community health workers trained in identifying risk factors for hearing loss or in referring patients for diagnostic testing. It is crucial to gather information about the knowledge of and attitudes toward hearing loss among community health workers before involving them in the identification and intervention of hearing loss in Mauritius. To describe the knowledge of and attitudes toward hearing loss among community health workers in Mauritius. A descriptive survey design with quantitative analysis was used. Using non-probability purposive sampling, 125 community health workers which included 94 community health officers and 31 community-based rehabilitation officers were recruited from the five catchment areas of the public healthcare sector. Participants filled in a 15-item paper-based questionnaire on the knowledge of and attitudes toward hearing loss. The questionnaire was internally consistent, with Cronbach alpha scores of 0.759 and 0.863. The overall knowledge of community health workers regarding risk factors and the identification of hearing loss was poor (38.3%). 92.6% of community health workers reported positive attitudes toward hearing loss. General knowledge of hearing loss (P=0.015) and knowledge of risk factors and identification of hearing loss (P=0.005) were significant predictors of attitudes toward hearing loss. Knowledge of and attitudes toward hearing loss were significantly associated with working experience and practice setting (P=0.004). There remains a need to educate community health workers about the risk factors and identification of hearing loss to ensure timely diagnosis and management of hearing loss at the community level.

The Association of Race With Decreased Access to Pediatric Hearing Healthcare in the United States.

Successful intervention to support a child with congenital hearing loss requires early identification and consistent access to frequent professional services. In the early 2000s, the United States implemented an initiative, Early Hearing Detection and Intervention (EHDI), to provide timely identification and treatment of congenital hearing loss. This national program aims to screen hearing by 1 month of age, diagnose hearing loss by 3 months of age, and provide intervention to infants with hearing loss by 6 months of age. To date, the United States is successfully implementing hearing screening by 1 month of age but continually struggling to diagnose and treat congenital hearing loss promptly for many infants. This article begins by exploring the current state of American children and families, focusing on social determinants of health, specifically race and poverty. The objective is to understand how race affects social determinants of health, and ultimately hearing healthcare access for children. A narrative literature review spanning public health, sociology, and hearing research was completed to inform this work. The current body of literature supports the conclusion that race and racism, separate from poverty, lead to decreased access to pediatric hearing healthcare. Interventions targeting these issues are necessary to improve timely access to hearing loss diagnosis and treatment for American children.

Risk Factors Associated with Delays in Hearing Loss Identification in Pediatric Patients.

To identify sociodemographic factors associated with pediatric late-identified hearing loss (LIHL) and classify novel subgroups within the LIHL population. Retrospective cohort. Tertiary children's hospital. Our cohort included children with permanent hearing loss (HL) between 2012 and 2020 (n = 1087). Patients with early-identified HL were compared to patients with LIHL (>6 months of age at diagnosis), and 3 subgroups: (1) late-identified congenital HL: failed NHS but had a diagnostic audiogram >6 months old; (2) late-onset HL: passed NHS and identified with HL after 6 months old; (3) late-identified, unknown-onset: unknown NHS results, identified after 6 months old. Geospatial analysis was performed using ArcGIS Pro. Compared with early-identified children, children with LIHL were more likely to have more comorbidities (odds ratio [OR] = 1.12, [1.01, 1.23]), be an under-represented minority (URM) (OR = 1.92, [1.27, 2.93]) and have a higher social vulnerability index (SVI) (adjusted odds ratio [AOR] = 2.1, [1.14, 3.87]). However, subgroups in the LIHL cohort had variable associations. Children with late-identified unknown onset hearing loss were uniquely associated with a primarily non-English speaking household (AOR = 1.84, [1.04, 3.25]), whereas children with late-onset hearing loss were less likely to have public insurance (AOR = 0.47, [0.27, 0.81]. There were no significant associations for children with late-identified congenital hearing loss. Neighborhood disadvantage, as measured by SVI, had an increased association with late-identified unknown onset HL (AOR = 4.08, [2.01, 8.28]) and a decreased association with late-onset HL (AOR = 0.40, [0.22, 0.72]). Sociodemographic factors serve as proxies for health care access, and these factors vary across LIHL pathways. Understanding the risk factors associated with each LIHL subgroup may help address disparities in pediatric HL identification.

Help-seeking behaviour of parents of children with hearing loss in India: a qualitative analysis

Objective The age of identification of hearing loss in children is highly influenced by the hearing help seeking behaviour of their parents, particularly in countries without universal newborn hearing screening programs. In this study, an attempt was made to identify the factors associated with help seeking behaviour in parents of children with hearing loss, and the relationship of such factors with the age of identification of hearing loss. Design Focus group discussions based on the framework of health belief model were carried out. The discussions were transcribed and the transcripts were thematically analysed. Study sample Participants were 35 parents of children with hearing loss from the state of Karnataka in India. Results The findings revealed 30 factors related to their awareness about hearing loss, geographical location, socio-economic status, family, and society. The factors differed between early and late help seekers. Conclusions Awareness, accessibility, and affordability are the key factors that influenced the hearing help seeking behaviour of the participants. Effective public awareness programs, newborn hearing screening programs, and provisions to make hearing healthcare affordable to all can reduce the age of identification of paediatric hearing loss in India.

Hearing perception by cochlear implantation

Cochlear implantation is a unique development in the field of prosthetics of human sensory systems. Due to the electrical stimulation of the auditory nerve, auditory sensations close to natural occur. Despite significant progress in the engineering design of cochlear implants (CI), the quality of auditory perception when used is significantly limited. CI users experience the greatest difficulties in communication tasks such as understanding speech in noise or in multi-talkers environment. There are many factors, both technical and physiological, to reduce speech intelligibility in CI users. Speech perception in CI users is limited due to low frequency resolution, perceptual distortion of pitch, and compression of dynamic range. Low frequency resolution is the reason a decrease in speech intelligibility and the ability to perceive music. To realize these ability the question about the state of central hearing mechanisms, especially for children with congenital deafness, is crucial Neuroplasticity with ages decreases and the central auditory processing deficiency develops, therefore, it is desirable to carry out cochlear implantation as early as possible after hearing loss identification. Analysis of the auditory perception features in case of the auditory nerve is electrically excited allows not only to propose innovative approaches to improve the auditory abilities of CI users, but also to study auditory processing disorders.

Screening for hearing loss using the electronic whisper test: A prospective cross-sectional study.

Hearing screening is a method for early identification of hearing loss. Hearing screening is widely used in hospitals as part of physical examination. However, some of them are difficult to operate outside the hospitals regarding portability and user-friendliness. Therefore, we developed a simple yet easy-to-use portable electronic whisper test (EWT) for field deployment, particularly on many subjects. The EWT validity is a hearing screening method compared to pure-tone audiometry. This study was a cross-sectional comparative with a prospective approach. The subjects were outpatients at the Audiology Clinic of Dr. Soetomo Academic Medical Center, Surabaya, Indonesia, who met the inclusion and exclusion criteria. Statistical analysis made sensitivity and specificity tables using a 2 × 2 table, positive and negative predictive values. Samples of 50 participants (100 ears) obtained a sensitivity value of 83%, specificity of 78%, positive predictive value of 45%, and negative predictive value of 95%. The EWT is valid for use as a hearing screening method.