Moderators and Outcomes in Children With Mild to Severe Hearing Impairment

ABSTRACT While previous studies have shown that children with mild-to-severe hearing loss are at risk for poorer
language, academic, social and psychological outcomes, these studies were conducted prior to the
implementation of universal newborn hearing screening and recent technological advances in amplification.
Early identification of hearing loss, improved amplification technologies, and access to quality early intervention
programs have the potential to improve the performance of this group of children. The requisite clinical studies
needed to provide optimal intervention to this subgroup of children with hearing loss have not been conducted.
The proposed research will address this gap. Specifically, there is a critical need to examine outcomes in a
large group of children who have benefited from these advances. Thus, the overall goal of the proposed
studies is to examine a range of longitudinal outcomes of this subgroup of children with hearing loss. Multi-
center, multi-disciplinary evaluations will be conducted in order to gain a comprehensive understanding of the
impact of mild to severe hearing loss on these children and their families. It is critical to determine the
constellation of factors that support the early development of speech, language, cognitive, and psychosocial
skills as well as quality of life issues within the family. A comprehensive set of child outcomes (e.g., speech
production and perception, language, academic, psychosocial, cognitive) and family outcomes (e.g., parenting,
quality of life, and satisfaction with services) will be examined and compared to results from normal-hearing
children with similar backgrounds. One of the largest known contributors to outcomes in children with hearing
loss is reduced auditory/linguistic experience. Therefore, the focus of the proposed work will be on variations
in receipt and effectiveness of early interventions (e.g., hearing aid use, educational programs) that are
intended to enhance auditory/linguistic experiences. In so doing we believe that it is also important to identify
barriers to service access and other factors that influence intervention compliance. Educational service
provision for children with mild to severe hearing loss may vary in critical ways (e.g., accessibility, intensity and
provider specialization). Further, it is likely that family (community of residence, parenting, income) and child
(temperament, communication skills, degree of hearing loss) factors will interact with intervention features to
influence outcomes. The planned recruitment of a large, representative sample will support the use of
multivariate procedures, including Structural Equation Modeling, to examine the ways in which child,
home/community and intervention characteristics combine to affect outcomes. Moderators and Functional Outcomes in Children with Mild to Severe Hearing Loss Narrative
This project will obtain critical information regarding the extent to which mild to severe hearing loss in early
childhood threatens the well-being of children. The project also will provide important insight into the
effectiveness of interventions concerned with mitigating the hearing loss and its negative consequences.
These data will, therefore, form the foundation for evidenced based practice and policy for the clinical
management of children with hearing loss.