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'1-3-6' guidelines improve vocabulary outcomes in children with hearing loss
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Children with hearing loss that meet all three Early Hearing Detection and Intervention guidelines — hearing screening by 1 month, diagnosis of hearing loss by 3 months and intervention by 6 months — have a higher vocabulary quotient despite possessing factors that may inhibit expressive language, such as cognitive, motor or visual disabilities.
“Universal newborn hearing screening and programs based on the Early Hearing Detection and Intervention (EHDI) guidelines were established in the United States to expedite diagnosis and treatment of hearing loss and with the hope of mitigating these delays,” Christine Yoshinaha-Itano, PhD, from the Institute of Cognitive Science at the University of Colorado, Boulder, and colleagues wrote. “To date, no studies have reported vocabulary or other language outcomes of children meeting all three components of the EHDI guidelines.
To assess the current EHDI 1-3-6 policy’s outcome on expressive speech in children and corroborate the effects of other demographic variables that can impact language outcomes, the researchers conducted a cross-sectional analysis that included 448 children who were diagnosed with bilateral hearing loss. All diagnoses were given between 8 and 39 months, and the children, all of whom participated in the National Early Childhood Assessment Program, were located within 12 states.
Of the children included, 18% had an additional disability that may impact speech and language development, which was assessed by their parents or an early interventionist, or both. Languages used for written communication in the home included English (88%) and Spanish (12%).
For the 448 children who participated in the study, the average vocabulary quotient was 74.4 (SD = 20.3), and the quotient for those without disabilities was 77.6 (n = 367; SD = 19.7). Children who did demonstrate additional disability demonstrated a vocabulary quotient of 59.8 (SD = 15.6). Language used in the home and the sex of the child had no significance on this data.
Additionally, children were more likely to have higher vocabulary quotients when they did not have additional disabilities, had a higher level of maternal education, less hearing loss, and had a parent who is deaf or hard of hearing in the household. Meeting the EHDI 1-3-6 guidelines could significantly predict this outcome even when the previous factors were controlled.
“Despite the benefits for children who met the EHDI guidelines, the mean quotient of children without additional disabilities who met the EHDI guidelines was 82, considerably less than the expected mean of 100,” Yoshinaha-Itano and colleagues wrote. “Particularly concerning is that 37% of this subgroup had quotients less than 75. Although this percentage is substantially better than for those who did not meet EHDI guidelines, it points to the importance of identifying additional factors that may lead to improved vocabulary outcomes.” — by Katherine Bortz
Disclosure: The researcher provides no relevant financial disclosures.
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