Language and Behavioral Outcomes of Children with Congenital Hearing Loss

January 31, 2006

The goal of this project is to prospectively examine the language, communication, behavior, and adaptive skills of early identified children with minimal (unilateral or bilateral < 40dB) hearing loss (Min HL) and children with moderate-to-profound bilateral (≥ 40dB) hearing loss (Mod HL) compared to typically hearing children at 24, 36, and 48 months, and to identify the child, family, and interventions characteristics which contribute to optimized outcomes. This is a continuation of comprehensive evaluations of this cohort at 6, 12, and 18 months of age.

There is increasing evidence that unilateral and mild/minimal hearing loss < 40dB impact negatively on academic and language outcomes at school age. The school age outcome data on mild and unilateral HL is important on two counts. First, current screening protocols based on a target threshold of 40dB may not identify these infants, and second, in some states even if identified, these infants are not eligible for intervention services. There is no data available on the outcomes of early identifies infants with Min HL. We have been evaluating prospectively a cohort of children with Min HL, Mod HL and typically hearing controls at 6, 12, and 18 months of age. In this continuation we will complete comprehensive evaluation at 24, 36, and 48 months.

The specific aims are:

  1. To assess the longitudinal development of receptive and expressive language, behavior and adaptive skills.
  2. To evaluate effects of the onset and frequency/quality of participation of early intervention (EI) on child language, behavior, and adaptive skills.
  3. To evaluate the communicative effectiveness of mother-child dyads and assess its relationship with child receptive and expressive language, behavior and adaptive skills.
  4. To evaluate the effects of maternal environmental factors and child factors (degree of HL, entry to Early Intervention, co-morbidities) on child outcomes.

The three primary hypotheses are:

  1. Children with bilateral moderate-to-profound HL (Mod HL) will have lower language and adaptive scores than children with unilateral or mild bilateral HL (Min HL) and children with typical hearing
  2. Language and behavior scores of children with Min HL will diverge from those of typically hearing children with increasing age
  3. Children with both Min and Mod HL enrolled in EI ≤ 3 months, and whose parents have frequent and positive experiences in EI will have better language, behavior, and adaptive skill development than those enrolled after 3 months of age.