TY - JOUR
T1 - Using propensity score matching to address clinical questions
T2 - The impact of remote microphone systems on language outcomes in children who are hard of hearing
AU - Curran, Maura
AU - Walker, Elizabeth A.
AU - Roush, Patricia
AU - Spratford, Meredith
N1 - Funding Information:
This work was supported by National Institute on Deafness and Other Communication Disorders Grants 5R01DC009560 (co–principal investigators, J. Bruce Tomblin, University of Iowa, and Mary Pat Moeller, Boys Town National Research Hospital) and 5R01DC013591 (principal investigator, Ryan W. McCreery, Boys Town National Research Hospital). The content of this project is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Deafness and Other Communication Disorders or the National Institutes of Health. The following people provided support, assistance, and feedback at various points in the project: Dawna Lewis, Mary Pat Moeller, J. Bruce Tomblin, Ryan McCreery, Jacob Oleson, Wendy Fick, and Marlea O’Brien. Special thanks go to the families and children who participated in the research and to the examiners at the University of Iowa, Boys Town National Research Hospital, and the University of North Carolina at Chapel Hill.
Publisher Copyright:
© 2019 American Speech-Language-Hearing Association.
PY - 2019/3
Y1 - 2019/3
N2 - Purpose: Children who are hard of hearing (CHH) have restricted access to acoustic and linguistic information. Increased audibility provided by hearing aids influences language outcomes, but the benefits of hearing aids are often limited by acoustic factors and distance. Remote microphone (RM) systems further increase auditory access by reducing the negative consequences of these factors. The purpose of this article was to identify factors that influence likelihood of RM system receipt and to investigate the effects of RM systems in home settings on later language outcomes. We used propensity score matching to compare language outcomes between children with and without access to personal RM systems in home settings. This article provides a description of how and why to perform propensity score–matching analyses with clinical populations. Method: Participants were 132 CHH. Through parent report, we identified children who received RM systems for home use by 4 years of age. Logistic regression was used to determine factors that predict likelihood of RM system receipt in home settings. Propensity score matching was conducted on a subgroup of 104 participants. Performance on language measures at age 5 years was compared across propensity-matched children who did and did not receive RMs for personal use. Results: Likelihood of RM receipt was associated with degree of hearing loss, maternal education, and location (recruitment site). Comparisons between matched pairs of children with and without RM systems in early childhood indicated significantly better discourse skills for children whose families owned RM systems, but no significant differences for vocabulary or morphosyntax. Conclusion: Results provide preliminary evidence that the provision of personal RM systems for preschool-age CHH enhances higher-level language skills. The propensity score–matching technique enabled us to use an observational, longitudinal data set to examine a question of clinical interest.
AB - Purpose: Children who are hard of hearing (CHH) have restricted access to acoustic and linguistic information. Increased audibility provided by hearing aids influences language outcomes, but the benefits of hearing aids are often limited by acoustic factors and distance. Remote microphone (RM) systems further increase auditory access by reducing the negative consequences of these factors. The purpose of this article was to identify factors that influence likelihood of RM system receipt and to investigate the effects of RM systems in home settings on later language outcomes. We used propensity score matching to compare language outcomes between children with and without access to personal RM systems in home settings. This article provides a description of how and why to perform propensity score–matching analyses with clinical populations. Method: Participants were 132 CHH. Through parent report, we identified children who received RM systems for home use by 4 years of age. Logistic regression was used to determine factors that predict likelihood of RM system receipt in home settings. Propensity score matching was conducted on a subgroup of 104 participants. Performance on language measures at age 5 years was compared across propensity-matched children who did and did not receive RMs for personal use. Results: Likelihood of RM receipt was associated with degree of hearing loss, maternal education, and location (recruitment site). Comparisons between matched pairs of children with and without RM systems in early childhood indicated significantly better discourse skills for children whose families owned RM systems, but no significant differences for vocabulary or morphosyntax. Conclusion: Results provide preliminary evidence that the provision of personal RM systems for preschool-age CHH enhances higher-level language skills. The propensity score–matching technique enabled us to use an observational, longitudinal data set to examine a question of clinical interest.
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U2 - 10.1044/2018_JSLHR-L-ASTM-18-0238
DO - 10.1044/2018_JSLHR-L-ASTM-18-0238
M3 - Article
C2 - 30950736
AN - SCOPUS:85064317147
SN - 1092-4388
VL - 62
SP - 564
EP - 576
JO - Journal of Speech, Language, and Hearing Research
JF - Journal of Speech, Language, and Hearing Research
IS - 3
ER -