Hearing Children Research Articles

Assessment of Linguistic Profile of Oral-Language-Proficient Hearing-Impaired Children Using Clinical Evaluation of Language Fundamentals: Fifth Edition (CELF5)

Background/Objectives: Specific tests for the assessment of language development and language skills in deaf children are scarce. For this reason, parent inventories and/or standardized tests that are reliable and valid in the hearing population are used. The main aim of this study was to assess the usefulness of the Clinical Evaluation of Language Fundamentals 5 (CELF5) in determining the language skills of hearing-impaired children in a comprehensive way in comparison to their hearing peers. Methods: The sample consisted of 70 deaf and 73 hearing children aged 5–11 years. Although the results show statistically significant differences in language skills between deaf and hearing children, deaf children scored around average on 8 of the 12 subtests of the CELF5. Results: Children using total communication modality had the highest scores, followed by those using oral language and sign language. The CELF5 subtests showed high internal consistency in the deaf group. A percentile scale was also developed for this population group. Conclusions: The CELF5 showed to be a reliable test for the assessment of receptive and expressive language in children with deafness who are competent in oral language. However, further research is needed to develop language assessment tests adapted to the deaf population that are sensitive to different communication modalities.

The story so far: scoping review of narratives in deaf children.

Narrative language samples can be used to measure language development in children, but research on narrative development in deaf and hard-of-hearing (DHH) children is scarce, limiting knowledge of developmental stages and best practices for collection and analysis. This scoping review included 39 articles that explored recent methodologies and achievements in oral or signed narratives of DHH children, including comparisons with hearing peers and within-group analyses of early auditory experience, device use, and other measures. Articles featured DHH participants aged < 4 to 18years, varying in device use, communication modalities, and educational settings. Most studies utilized story generation tasks with early elementary-aged children and analyzed either microstructure or macrostructure. Mixed results in comparisons with hearing children emphasized the need to consider individual differences (e.g., speech perception and age of spoken language access) in DHH narrative assessments. Findings also suggest that comparability across studies would be improved by more consistent terminology and procedures in narrative collection/analysis.

Social-Emotional Functioning of Children With Different Hearing Status and Diverse Cultural Background.

The study investigated the social-emotional functioning of children with typical hearing and deaf and hard of hearing (D/HH) children from diverse cultural backgrounds in Israel through parental reports. A total of 242 parents from both Arabic and Jewish communities participated: 130 were parents of D/HH children and 112 were parents of children with typical hearing. The Strengths and Difficulties Questionnaire and a background questionnaire were used. Results revealed increased total difficulties, emotional symptoms, and peer problems as reported by parents of D/HH children. Jewish parents of D/HH children reported greater total difficulties, conduct problems, and peer problems than Arab parents. Significant gender differences were found, with parents of boys reporting higher levels of hyperactivity/inattention and lower prosocial behavior. Among D/HH children, Arab parents reported higher peer problems among hearing aid users compared to cochlear implant users, whereas Jewish parents reported the opposite trend. These findings highlight the significant social-emotional challenges faced by D/HH children, particularly in peer interactions, and underscore the need for tailored interventions that consider cultural differences.

Discrimination analysis of quantitative indicators of understanding the written form of deaf children's communication through the use of types of words

In deaf students, there is no contextual understanding and recognition of word types through linguistic competence testing compared to the hearing population, because 67.10% do not understand, and 10.00% of deaf children partially understand the contextual application of word types in a written text task. The aim of the study is to determine the distance of language discourse between deaf and hearing respondents and to establish a discrimination factor that can be used for practical purposes in a classification sense, with the aim of determining the priority of linguistic education and language elements of deaf children in relation to their lagging behind hearing children. The study was conducted on a sample of 140 respondents. The first subsample of respondents, the experimental group consisted of 70 deaf students, and the second subsample, the control group of 70 hearing students, of the same chronological age and gender. The measuring instrument “Test of comprehension of the written form of expression” was applied. The collected data were processed using the discriminant analysis method. The results of the study showed that the discrimination factor is in the sequence of the use of words, adjectives, exclamations and adverbs. Nouns and prepositions have a negative correlation, which points to the fact that these four types of words are in direct implication with nouns and prepositions, and represents information that these four types of words must be more represented in the educational materials of written expression of deaf children. The results of the study also open up a series of questions focused on the quality of the educational processes of deaf children, as well as the level of lag in written communication compared to hearing children. The results of the study can influence the raising of general rehabilitation procedures to a higher level of responsibility in education centers where deaf children are educated.

Rates of socio-emotional difficulties among deaf and hard of hearing children in Ireland

ABSTRACT Higher rates of socio-emotional difficulties for deaf and hard of hearing (DHH) children have been reported compared with their typical hearing (TH) peers. Nonetheless, there has to date been limited examination on this issue internationally and no such examination in the Republic of Ireland. In this study, data was collected from parents using an online survey which included the Strengths and Difficulties Questionnaire to examine the socio-emotional development of 113 DHH children aged 5–16 in the Republic of Ireland. The results were compared with data from typically hearing (TH) children obtained from a large longitudinal study of childhood in Ireland – the Growing Up in Ireland study. The findings demonstrate that the prevalence of socio-emotional difficulties among this cohort of children is over three times that of the general population of children in Ireland, with 42% of the sample demonstrating clinically significant problem scores. Furthermore, DHH children had elevated subscale scores for the four problem scales in the SDQ when compared against the TH sample. These differences were statistically significant and had a range of effect sizes from small to large. The subscale of most concern was the peer problems subscale where the DHH sample had mean scores that were roughly double those of the TH sample, with a large effect size found. Finally, bivariate analysis revealed that several background variables were associated with elevated difficulty scores for DHH children, namely male gender, poorer communicative competency, and presence of an additional educational need.

Development and cultural adaptation of the Saudi pediatric speech intelligibility test.

To report the development and administration of the Saudi pediatric speech intelligibility (SPSI) test. This study was carried out at King Abdullah Ear Specialist Center, King Saud University, Riyadh, Saudi Arabia, between 2021 and 2023. A pilot study was carried out in 5 regions of Saudi Arabia including 100 normal hearing children aged 7-11 years old, with 20 children from each region. The final test materials were voice-recorded by a native Saudi radio announcer, and a software-based application for administering the SPSI was developed. During the pilot study, minor adjustments were carried out to the test for more clarity. The developed SPSI software is an android-based application that includes features like automatic result calculation, data saving, and individual user accounts for examiners to review results. The SPSI test comprises 4-word cards and 2 sentence cards, each with 5 pictures, and operates in 3 modes: quiet, background noise, and competing sentences. The SPSI test has been developed in an android-based software using the Saudi local dialects. It can facilitate comprehensive and accurate assessment of speech intelligibility, particularly in children with hearing impairments.

Understanding the sound environments of young children: potential implications for radio aid use

ABSTRACT The objectives of this study were to describe, analyse and compare the sound environments to which deaf and typically hearing children between 3 and 18 months are typically exposed, and identify issues to support the development of guidelines for the use of radio aids in this age group. Thirty parents of children aged 3–18 months (14 deaf children and 16 who were typically hearing) took part. An online survey was devised for this study and was intended to capture the “soundscape” (sounds in the environment) to which both deaf and typically hearing children between 3 and 18 months were usually exposed in their everyday lives at multiple points during the day. The purpose of the survey was to map everyday routine experiences and interactions with their families to assess auditory access and environmental awareness or unawareness. Conceptual content analysis was used to evaluate participant descriptions of sound environments. Differences in child awareness of sound and distances between children and their parents were also analysed. Results showed that both deaf and typically hearing children experience rich and complex soundscapes with plenty of opportunities for learning about the world. Parents of deaf children changed their child’s sound environment compared to parents of typically hearing children, particularly at home, in order to provide easier listening conditions. However, deaf children were often in noisy environments where hearing aids or cochlear implants alone were unlikely to be providing good access to speech and other salient sounds, and radio aids may be beneficial in these circumstances.

Prospective long-term follow-up after grommet insertion: Hearing and functional health outcomes in children

ObjectivesTo assess hearing levels and functional health outcomes of children two years after routine grommet surgery with standard care follow-up (discharge to General Practitioner (GP) care or Ear Nose and Throat (ENT) clinic appointment at 4–8 weeks). MethodsProspective cohort study of 89 children (average age of 7.98 years) recalled for audiological assessment 2 years after grommet surgery in a large ENT outpatient service in South Auckland, New Zealand. Functional health was assessed using parent-reported responses to the OMQ20 questionnaire. Results46 (51.7 %) children had hearing loss in at least one ear with 28 (31.5 %) children having bilateral hearing loss. Māori children had statistically higher odds compared to non-Māori children (odds ratio 5.491, p = .003) to have bilateral hearing loss after controlling for age, household deprivation, gender, season, and mode of follow-up. Most parents reported concerns with their child's hearing, speech, attention-seeking behaviours, and nasal symptoms, but not ear problems. Bilateral hearing loss (p < .001) was found to significantly predict functional health status (total OMQ20 score). ConclusionsThe high prevalence of hearing loss and functional health concerns suggest that the standard follow-up care is not adequately managing children after routine grommet insertion. Māori children are disproportionately impacted, and post-grommet follow-up schedules must consider individualised approaches to address these inequities in outcomes.

Hearing, speech, and language outcomes in school-aged children after cleft palate repair.

Following primary cleft palate repair, individuals face a heightened risk of hearing problems, particularly conductive hearing loss, compensatory articulation disorders (CADs), resonance disorders, delayed speech and language development, and voice disorders. This study aimed to investigate the prevalence and impact of these challenges in children with cleft palate with or without cleft lip (CP± L). This cross-sectional study included 38 children with CP± L aged 5 to 13 years. A comprehensive evaluation involved audiological assessments (audiograms, tympanograms) by an audiologist and speech-language pathology assessments (Thai Speech Parameters for Patients with Cleft Palate, Articulation Screening Test) by speech-language pathologists. The prevalence of hearing loss affected 27.63% of participants (21 out of 76 ears) and majority of cases involved conductive hearing loss. Velar substitution was the most common CAD, followed by nasalized voiced pressure consonants, phoneme-specific nasal air emission, and pharyngeal substitution. A moderate correlation was found between these CAD patterns and hypernasality at the word, sentence, and screening levels (r= 0.44, p< 0.01; r= 0.43, p< 0.01; and r= 0.40, p= 0.01). For summary, the most common type of hearing loss was conductive hearing loss. The predominant CAD pattern was velar substitution. The protocol could be designed to enhance early improvement in hearing and articulation, thereby supporting academic achievement and long-term quality of life.

Executive functioning and nonverbal cognitive factors associated with response to technology-assisted language intervention

ObjectiveTo explore potential differences in the relationship between executive function (EF) skills and language development when integrating augmentative and alternative communication technology into speech-language therapy for deaf/hard of hearing (DHH) children. MethodRandomized trial data were analysed to investigate this relationship among children who participated in a Technology-Assisted Language Intervention (TALI) compared to treatment as usual (TAU). Language samples were assessed for pre-post-intervention changes, including mean length of utterance in morphemes (MLU), mean turn length (MTL), and number of different words spoken (NDW). EF skills were measured with standardized parent-report assessment. ResultsThirty-seven DHH children were included (TALI n = 19 and TAU n = 18). Results of regression models indicated that higher EF skills were significantly (p < 0.05) associated with improvements in MLU, MTL, and NDW among children who received TAU. No significant associations between EF skills and any of the measures (MLU, MTL, NDW) were seen in children who received TALI. ConclusionThese results suggest that TALI may offer language learning support, particularly for DHH children with EF difficulties. Future research should investigate the direct relationship between EF measurements and language outcomes in TALI recipients. Establishing baseline EF measurements in DHH children could inform personalized strategies within language interventions and therapy.

The disease burden of untreated chronic otitis media in Indigenous children from remote communities does not improve over time. A longitudinal study.

In Australia, middle ear disease disproportionately affects Indigenous children, leading to poor hearing outcomes. This study aimed to determine the natural history of untreated chronic otitis media in Indigenous children in remote South Australia. Baseline and 3 year follow-up data was collected from Indigenous children aged 5-18 years living on the Anangu Pitjantjatjara Yankunytjatjara Lands. 4-frequency pure-tone audiometry was used to determine hearing levels. Middle ear pathology was determined by video-otoscopy with tympanometry and classified at baseline as group 1 (normal), group 2 (abnormal with intact tympanic membrane), or group 3 (perforated tympanic membrane). A total of 253 children were included in this study. Children in group 1 (20.6 ± 1.5 dBHL; Mean ± SD) had significantly better hearing outcomes at 3 year follow-up than children with abnormal ears (groups 2 and 3) (23.8 ± 7.0 dBHL), P < 0.001. The difference was greatest for group 1 versus 3 (27.6 ± 8.4 dBHL), P < 0.001, followed by 1 versus 2 (22.4 ± 5.8 dBHL), P = 0.009, and between 2 (22.4 ± 5.8 dBHL) and 3 (27.6 ± 8.4 dBHL), P < 0.001. Hearing in Indigenous children with untreated middle ear pathology remains poor at follow-up compared to those without pathology. Intervention is therefore critical to prevent persisting poor hearing outcomes.

Empatica E4 Assessment of Child Physiological Measures of Listening Effort During Remote and In-Person Communication.

Telepractice is a growing service model that delivers aural rehabilitation to deaf and hard-of hearing children via telecommunications technology. Despite known benefits of telepractice, this delivery approach may increase patients' listening effort (LE) characterized as an allocation of cognitive resources toward an auditory task. The study tested techniques for collecting physiological measures of LE in normal-hearing (NH) children during remote (referred to as tele-) and in-person communication using the wearable Empatica E4 wristband. Participants were 10 children (age range: 9-12 years old) who came to two tele- and two in-person weekly sessions, order counterbalanced. During each session, the children heard a short passage read by the clinical provider, completed an auditory passage comprehension task, and self-rated their effort as a part of the larger study. Measures of electrodermal activity and blood volume pulse amplitude were collected from the child E4 wristband. No differences in child subjective, physiological measures of LE or passage comprehension scores were found between in-person sessions and telesessions. However, an effect of treatment duration on subjective and physiological measures of LE was identified. Children self-reported a significant increase in LE over time. However, their physiological measures demonstrated a trend indicating a decrease in LE. A significant association between subjective measures and the passage comprehension task was found suggesting that those children who reported more effort demonstrated a higher proportion of correct responses. The study demonstrated the feasibility of collection of physiological measures of LE in NH children during remote and in-person communication using the E4 wristband. The results suggest that measures of LE are multidimensional and may reflect different sources of, or cognitive responses to, increased listening demand. https://doi.org/10.23641/asha.27122064.

Development and Standardization of an Arabic Test for spatial listening in Children

Development and Standardization of an Arabic Test for spatial listening in Children

Dilemma of family education for hearing‐impaired children in China: Responsibility or evasion?

AbstractDue to the difficulty in identifying and monitoring factors that cause hearing impairment during pregnancy, large numbers of new hearing‐impaired children are born every year. Children's hearing impairment can have an impact on all aspects of the family. Family education, as an important element of family function, plays a key role in the growth and development of hearing‐impaired children and in improving the interaction between hearing‐impaired children and their parents. Based on a qualitative study in central China, this article examines the current situation and dilemmas of family education for hearing‐impaired children. Results show that families of hearing‐impaired children generally have a tendency to avoid family education responsibilities, as demonstrated by the lack of family roles, low participation in specific family education, absence of communication and care functions and a laissez‐faire approach to bringing up their children. This evasive tendency cannot simply be attributed to parental irresponsibility; rather, it is the result of a combination of four factors and is closely related to insufficient social support. In the short term, a two‐pronged approach is needed: strengthening the government's responsibility and rendering assistance for families with hearing‐impaired children on the one hand, and establishing reliable links between home and school to provide professional support on the other. In the long run, it is necessary to build up a social support mechanism with social work intervention. This paper puts forward the need for collaboration among multiple parties and a family‐centred assistance model to promote a shift from the tendency towards evasion to active assumption of family responsibility.

Young student’s views of NAPLAN: impact on wellbeing through drawn responses

Standardized testing of academic knowledge is common in many developed countries. In Australia, the process implemented is the National Assessment Program for Literacy and Numeracy (NAPLAN). The stand-alone tests were introduced in 2008 for several educational and political reasons, and since that time, the results of this assessment have been used beyond their initial purpose and brought about an unintended consequence of making the tests high-stakes. The pressure of these assessments has the potential to impact student’s wellbeing, but little research has been done in this area and even less where the student’s perspectives are considered. This research examined the impact of NAPLAN testing on the wellbeing of 1,015 students in Years 3 and 5 across 23 school sites within metropolitan Perth in Western Australia through three iterations. This research gave students the opportunity to draw or write how they felt about NAPLAN as a participatory approach to hearing children’s voices in research. This paper reports on the two-stage analysis of the 917 drawn images provided. Stage 1 analysis by two researchers categorized the images as initially positive, negative, or mixed/neutral and identified the impact across the cohorts of students was not significantly negative with an average of 22.5% of the images coded as negative. Stage 2 involved detailed systematic content analysis examining the actors, locations, and emotions of the drawings, which indicated high levels of stress and anxiety for a small number of these students. It was evident that the tests can have a negative impact on the wellbeing of some students and this finding requires consideration by policymakers and curriculum teams engaged with writing, implementing, and assessing NAPLAN as well as those using the results for both intended and unintended purposes.

A longitudinal study on moral emotions and psychosocial functioning among preschool children with and without hearing loss.

Moral emotions such as shame, guilt and pride are crucial to young children's social-emotional development. Due to the restrictions caused by hearing loss in accessing the social world, deaf and hard of hearing (DHH) children may encounter extra difficulties in their development of moral emotions. However, little research so far has investigated the development trajectory of moral emotions during preschool years in DHH children. The present study used a longitudinal design to explore the development trajectories of shame, guilt, and pride, in a sample of 259 Chinese DHH and typically hearing (TH) preschoolers aged 2 to 6 years old. The results indicated that according to parent reports, DHH children manifested lower levels of guilt and pride compared to their TH peers, yet the manifested levels of shame, guilt, and pride increased throughout the preschool time at a similar pace in all children. Moreover, whilst guilt and pride contributed to increasing levels of psychosocial functioning over the preschool years, shame contributed to lower social competence and more externalizing behaviors in DHH and TH preschoolers. The outcomes imply that early interventions and adjustment to hearing loss could be useful to safeguard the social development of children with severe hearing loss, and cultural variances shall be taken into consideration when studying moral emotions in a Chinese cultural background.

Evaluation of the Curative Effects of Surgical Intervention in Cases of Congenital Malformation of the Ossicular Chain in Children.

Purpose: Congenital malformation of the ossicular chain results in challenges with hearing and language development in children. We aimed to analyze the clinical characteristics, prognosis, and surgical treatments of different types of congenital ossicular chain malformations in children. Methods: Eight cases (10 ears) treated between October 2019 and February 2022 were analyzed retrospectively. Patients were divided according to the location of the ossicular chain malformation and whether it was complicated by external ear malformation. Imaging, audiological examination, intraoperative exploration of the middle ear, and postoperative outcomes were recorded. Results: Group 1 incudostapedial joint deformity): 6 ears/60%; Group 2 (simple incus deformity): 2 ears/20%; Group 3 (simple malleus deformity): 2 ears/20%; Group A (with external ear malformations): 4 ears/40%; Group B (without external ear malformations): 6 ears/60%. The average hearing threshold before and after the operation was 51.25 ± 12.88 and 31.94 ± 12.96 dB, respectively. There were differences in the intervention effects of different malformed sites (Group 1: t = 5.139, P = .004; Group 2: t = 13.500, P = .047; Group 3: t = 15.000, P = .042). The effect of the intervention in cases of malformation with mobile stapes footplates was better than that with immobile stapes footplates (t = 4.082, P = .027). The effect of the intervention without external ear malformations was better than that with external ear malformations (t = 7.706, P = .001). Conclusions: The intervention yielded superior results in cases of malformation with mobile stapes footplates compared to those with immobile stapes footplates. Different intervention strategies should be determined through precise deformity assessments, with the degree of stapes mobility serving as a crucial factor in improving the prognosis.

Evaluating the effect of cochlear implantation age on pragmatic abilities before and after age of 3

Introduction The cochlear implant (CI) is crucial in developing hearing, speech, language, and communication skills in children with profound hearing loss (HL). The study aimed to assess how the age at which children receive a CI affects the development of pragmatic abilities between the ages of 5 and 8 for those who received a CI before or after the age of 3. Methods Forty children with CI were evaluated. The children between the ages of 5 and 8 were divided into two groups who received CIs before or after age 3. The Persian version of the Children’s Communication Checklist (CCC) was used to assess pragmatic abilities with a parent rating scale. Results Children implanted under 3 got higher scores in social relationships, using context, conversational rapport, syntax, and speech. Also, their performance in inappropriate and stereotyped conversations was better than those over 3 years. They have a significant difference in the pragmatic composite than those who received CI over 3 except for coherence and interest (p < 0.05). Conclusion According to the results, children with CI under 3 performed better in pragmatic composites, which means they have better pragmatic abilities. These findings suggest that early CI is important. Of course, other individual and environmental factors must also be considered.

Hearing Evaluations in Children With Retinoblastoma Treated With Intra-arterial Carboplatin Chemotherapy: A Single Institution Review.

To determine whether the administration of intra-arterial carboplatin affected the hearing of children with retinoblastoma. Children with retinoblastoma who were treated with intra-arterial carboplatin chemotherapy were included. Hearing tests before chemotherapy including tympanometry, distortion product otoacoustic emissions, and audiogram (if achievable) were performed and repeated 3 to 9 months after concluding intra-arterial therapy. The study was approved by the institutional review board. Patients were identified from the retinoblastoma clinic when the treatment plan included intra-arterial carboplatin chemotherapy. Children were excluded if they had previous intra-arterial carboplatin or preexisting hearing loss but were included if they had systemic carboplatin and dosing was available. Tympanometry was performed to rule out inner ear fluid. All examinations were performed by a certified audiologist with the same equipment, calibrated regularly by a certified technician. Twenty-two children (32 eyes) were evaluable. Because most children are diagnosed at a young age and are unable to participate in an audiogram, distortion product otoacoustic emission measurement was the primary measurement. No child displayed hearing loss. Intra-arterial chemotherapy with carboplatin did not cause ototoxicity in any child by distortion product otoacoustic emission measurement in contrast to systemic chemotherapy where ototoxicity is common. Distortion product otoacoustic emission levels were essentially unchanged from before to after intra-arterial chemotherapy in children with retinoblastoma. These findings suggest that intra-arterial carboplatin does not affect outer hair cell function, and distortion product otoacoustic emission tests can provide useful information when monitoring children at risk of developing carboplatin ototoxicity. [J Pediatr Ophthalmol Strabismus. 20XX;X(X):XXX-XXX.].

Tracking Listening Skill Development in Infants and Children with Hearing Loss: A Normative Dataset for the Functional Listening Index-Paediatric (FLI-P®).

Longitudinal studies highlight the importance of early intervention and timely device fitting for language development in children with congenital or early acquired hearing loss. Due to the variability in hearing loss, comorbidities, family circumstances, and service access, individualised monitoring of listening development is essential to inform decision-making. The Functional Listening Index-Paediatric (FLI-P), a 64-item hierarchical checklist of listening skills, has been validated for children with hearing loss aged 0-6 years. This study aimed to develop benchmarks for the FLI-P in typically hearing children, allowing for comparison with individual children with hearing loss. FLI-P scores were obtained from parents/caregivers of 561 typically hearing children aged 0-72 months. Each child's FLI-P score was categorised into a 6-month age block, with a minimum of 36 data points per block. Quantile regression was employed to establish percentiles of FLI-P scores by age. FLI-P scores were successfully recorded for all 561 children. Regression analysis determined that the 16th and 84th percentiles of FLI-P scores corresponded to approximately ±1 standard deviation from the median score for each age group. A graphical representation of these percentile trajectories was created to facilitate comparison between children with hearing loss and the normative data. A normative dataset of FLI-P scores from typically hearing children has been established, allowing for comparisons with the scores and developmental trajectories of individual children with hearing loss. The study demonstrates how FLI-P can guide early intervention decisions and effectively monitor progress.