Developmental outcomes of children with hearing loss born in Colorado hospitals with and without universal newborn hearing screening programs.

The developmental outcomes of children born in hospitals with universal newborn hearing screening programs were compared with children born in hospitals without universal newborn hearing screening programs. Eight-four percent of children born in screening hospitals were early-identified with hearing loss prior to 6 months of age as compared to 8% of the children in the non-screen group. The participants in the screen group had an average language quotient of 82 while the participants in the non-screen group had an average language quotient of 62. Children in the screen group had better receptive and expressive language quotients, more different consonants in the spontaneous phonetic repertoire, better speech intelligibility, and larger expressive vocabulary inventories. Odds risk ratio estimates indicate that 80% of the children with cognitive quotients 80 or greater or four out of five children had language quotients within the normal range, 80 or greater, when they were in the screen group.

The Colorado Newborn Hearing Screening Project: effects on speech and language development for children with hearing loss.

OBJECTIVE: To compare the speech and language development of children with bilateral hearing loss and normal cognition who were born in hospitals with universal newborn hearing screening to that of their peers who were born in hospitals without this screening program. STUDY DESIGN: Subjects for the major analyses are 50 Colorado children (25 matched pairs) from 9 to 61 months old who are participants in a study of the development of children birth to six with bilateral hearing loss. Analyses included parametric dependent t-tests and analysis of covariance, nonparametric chi-squared and Wilcoxon signed rank tests, descriptive statistics and odds ratios. RESULTS: Newborn screening programs for hearing loss are positively related to scores in expressive and receptive language (p < 0.001) and vocabulary production (p < 0.001) on standardized inventories; speech intelligibility (p = 0.015) from independent ratings; number of different simple consonants (p < 0.01) and consonant blends (p = 0.026) from phonological transcripts; and total number of intelligible words (p < 0.01) and number of different words produced (p < 0.01) from computer analysis of videotaped language samples. CONCLUSION: Hospital-based newborn hearing screening programs are positively related to language and speech performance for children in early intervention programs who are deaf and hard of hearing.

Benefits of early intervention for children with hearing loss.

This article discusses the relationship between language development and degree of hearing loss and how these factors relate to the age of identification of hearing loss. An interesting effect caused by the interaction of these variables has been discussed in this article. The relationship of speech production, degree of hearing loss, language development, and age of identification are also presented. Social-emotional development of deaf and hard-of-hearing children and the variables that impact this development, in particular the strong relationship with language development, is included.

The role of educators of the deaf in the early identification of hearing loss.

About 16,000 babies each year will be identified with hearing loss by age 3 months once universal newborn hearing screening becomes a reality. Identification of hearing loss in infancy, followed by appropriate intervention by age 6 months, can result in normal language development, regardless of degree of hearing loss. As the average age of identification of hearing loss moves downward toward 2 months, children with hearing loss will enter the educational system earlier and with language skills commensurate with those of their hearing peers. In order to provide appropriate services to children with hearing loss and their families, early interventionists will need to forge links to health care providers involved in universal newborn hearing screening programs, to have specialized training in deafness and hearing loss, and to have expertise in providing services to very young children and to children with hearing loss in the broad range from mild to profound.

The efficacy of early identification and intervention for children with hearing impairment.

From these findings, the inevitable conclusion is that identification of hearing loss by 6 months of age, followed by appropriate intervention, is the most effective strategy for the normal development of language in infants and toddlers with hearing loss. Identification of hearing loss by 6 months can only be accomplished through universal newborn hearing screening. Some questions that arise as a result of these studies include: What can one conclude from the finding that the language skills of children with mild hearing losses are no better than those with greater losses? If the finding holds up, it indicates a great need for investigations into biobehavior theories of language acquisition and into the part played by the prenatal 4 months of hearing. And it also shows a need for answering the question, When does a hearing loss begin?, because it certainly seems that all hearing losses are similar in their outcomes. Can the findings from these studies be used to benefit normally hearing children who are at risk for language delays as a result of limited language environments? Such children suffer from auditory deprivation just as surely as those with hearing losses. If the language skills of the latter children can be brought to normal range by early intervention, the same strategy may help high-risk populations. The efficacy of early intervention is just as valid for these children as it is for the children with hearing impairment. Now that the benefits of early identification of children with congenital hearing loss have been demonstrated, these benefits should be extended to all children who are at risk for language delays, with appropriate interventions applied immediately.

Maternal sensitivity predicts language gain in preschool children who are deaf and hard of hearing.

The link between maternal sensitivity and child language gain was assessed in a prospective study of hearing mothers and their deaf and hard-of-hearing (D/HH) children. Maternal sensitivity in dyadic interaction was assessed when children were approximately 2 years old, and expressive language gain was assessed at 2 to 3 years using the Minnesota Child Development Inventory. Sensitivity made significant, positive, and unique predictions of expressive language gain when the effects of maternal education, degree of child hearing loss, dyadic mode of communication, and time between assessments were controlled. Findings indicate the value of affective measures of interaction in predicting language gain.

Language of early- and later-identified children with hearing loss.

OBJECTIVE: To compare the language abilities of earlier- and later-identified deaf and hard-of-hearing children. METHOD: We compared the receptive and expressive language abilities of 72 deaf or hard-of-hearing children whose hearing losses were identified by 6 months of age with 78 children whose hearing losses were identified after the age of 6 months. All of the children received early intervention services within an average of 2 months after identification. The participants' receptive and expressive language abilities were measured using the Minnesota Child Development Inventory. RESULTS: Children whose hearing losses were identified by 6 months of age demonstrated significantly better language scores than children identified after 6 months of age. For children with normal cognitive abilities, this language advantage was found across all test ages, communication modes, degrees of hearing loss, and socioeconomic strata. It also was independent of gender, minority status, and the presence or absence of additional disabilities. CONCLUSIONS: Significantly better language development was associated with early identification of hearing loss and early intervention. There was no significant difference between the earlier- and later-identified groups on several variables frequently associated with language ability in deaf and hard-of-hearing children. Thus, the variable on which the two groups differed (age of identification and intervention) must be considered a potential explanation for the language advantage documented in the earlier-identified group.

Identification of hearing loss after age 18 months is not early enough.

The general development of 40 deaf and hard of hearing infants was analyzed. The infants were placed into one of two groups according to age at which hearing loss was identified: (a) before age 6 months and (b) after age 18 months. The mean age at testing was 40 months. Developmental quotients (DQs) were used to compare results regardless of the infants' age at time of testing. Infants were evaluated on the basis of their DQ scores on the Minnesota Child Development Inventory (MCDI; Ireton & Thwing, 1972). MCDI subtests include general development, gross motor, fine-motor, expressive language, comprehension-conceptual, situation-comprehension, self-help, and personal-social. Infants whose hearing loss was identified before age 6 months scored significantly higher than those whose hearing loss was identified after age 18 months in the expressive language and comprehension-conceptual subtests. The performance of the earlier-identified group supports the earliest identification of hearing loss and encourages implementation of universal hearing screening.

The development of deaf and hard of hearing children identified early through the high-risk registry.

The high-risk registry was used as a screening device for identifying hearing loss for many decades in Colorado. It reportedly missed approximately 50% of all infants with congenital sensorineural hearing loss (Mehl & Thomson, 1998; Parving, 1993; Watkins, Baldwin, & McEnery, 1991). Little is known about the developmental characteristics of this population. This article describes children identified through the high-risk registry. These children have been divided into two groups according to their age of identification: (a) deaf and hard of hearing children identified before age 6 months, and (b) deaf and hard of hearing children identified between ages 7 and 18 months. The children identified before age 6 months and receiving intervention at an average of 2 to 3 months after identification of hearing loss had significantly higher levels of receptive and expressive language, personal-social development, expressive and receptive vocabulary, general development, situation comprehension, and vowel production. The high-risk registry used for newborn hearing screening has been replaced by universal newborn physiological hearing screening in the state of Colorado.