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 For the study, researchers examined data on language abilities at
age 5 for children born with permanent hearing loss who received
similar interventions at different points in childhood.
Kids who received hearing aids at age 2 had worse language outcomes
than kids who got the devices fitted when they were just 3 months
old, the study found. Children who got cochlear implants at age 2
also had worse language outcomes than kids who got these devices
when they were 6 months old.
“Access to auditory cues in speech and language paves the way for
language learning,” said lead study author Teresa Ching of the
National Acoustic Laboratories Australian Hearing and the HEARing
Cooperative Research Center in Australia.
“The shorter the period of deprived access to sounds, which would be
non-existent in the case with normal hearing, the higher likelihood
for the child with hearing loss to develop language that is on par
with his/her normal-hearing peers,” Ching said by email.
Universal newborn hearing screenings have become standard in
Australia and much of the developed world, with the goal of catching
and treating hearing loss earlier when there’s the greatest
potential benefit, the researchers write in Pediatrics.
But in practice, there’s still wide variation in how soon children
with permanent hearing loss may receive hearing aids to amplify
sounds or cochlear implants to transmit sound signals to the brain
in kids with damage in the inner ear.
For the current study, researchers examined language outcomes at age
5 for 350 children with permanent hearing loss as well as for a
control group of 120 kids with normal hearing.
The kids with hearing loss were compared to children with similar
types of impairment who got the same intervention - hearing aids or
cochlear implants - at a different time. Children were also similar
in the degree of hearing loss, birth weight, IQ, additional
disabilities and mode of communication.
The impact of earlier intervention was more pronounced for children
with more severe hearing impairment than for kids with milder
hearing loss, the study found.
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Universal newborn hearing tests, however, didn’t appear to influence
language outcomes. This might be because not all kids who got tested
as newborns received hearing interventions as infants, and some
children who missed out on newborn tests still received hearing aids
or implants as babies, the authors note.
One limitation of the study is that almost half of the eligible
children invited to join the study didn’t enroll or didn’t remain in
the study until they were 5 years old, the researchers point out.
Some parents declined to participate, while in other cases kids
turned out not to have permanent hearing loss or didn’t receive aids
or implants until after their third birthday.
The low inclusion rate might explain why researchers didn’t detect
an impact from universal newborn hearing tests, the authors
conclude.
Screening to promptly detect and treat hearing loss results in the
best listening and speaking outcomes, said Dimity Dornan, founder
and executive director of Hear and Say, an nonprofit advocacy group
in Brisbane, Australia.
“When a child with hearing loss receives appropriate hearing aids,
the pathway to the brain is unlocked, allowing sound to reach the
listening part of the brain,” Dornan, who wasn’t involved in the
study, said by email.
“This opens the possibility for the rudimentary brain circuitry for
listening that the baby is born with to change from little rutted
country lanes into six-lane freeways, and sound messages can quickly
reach the brain and be interpreted,” Dornan added. “If a child does
not receive hearing aids until later, the listening brain is not
optimally developed and the listening, understanding and
acting/speaking cycle is laborious and slow.”
SOURCE: http://bit.ly/2u5ixi9 Pediatrics, online August 3, 2017.
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