title: Language ability in children with permanent hearing impairment: the influence of early management and family participation.
abstract: OBJECTIVE
  The goal was to examine the relationships between management after confirmation, family participation, and speech and language outcomes in the same group of children with permanent childhood hearing impairment.
  
  
  METHODS
  Speech, oral language, and nonverbal abilities, expressed as z scores and adjusted in a regression model, and Family Participation Rating Scale scores were assessed at a mean age of 7.9 years for 120 children with bilateral permanent childhood hearing impairment from a 1992-1997 United Kingdom birth cohort. Ages at institution of management and hearing aid fitting were obtained retrospectively from case notes.
  
  
  RESULTS
  Compared with children managed later (> 9 months), those managed early (< or = 9 months) had higher adjusted mean z scores for both receptive and expressive language, relative to nonverbal ability, but not for speech. Compared with children aided later, a smaller group of more-impaired children aided early did not have significantly higher scores for these outcomes. Family Participation Rating Scale scores showed significant positive correlations with language and speech intelligibility scores only for those with confirmation after 9 months and were highest for those with late confirmed, severe/profound, permanent childhood hearing impairment.
  
  
  CONCLUSIONS
  Early management of permanent childhood hearing impairment results in improved language. Family participation is also an important factor in cases that are confirmed late, especially for children with severe or profound permanent childhood hearing impairment.
authors.affiliation: Audiology Department, Whipps Cross University Hospital NHS Trust, Whipps Cross Road, Leytonstone, London E11 1NR, England. peter.watkin@whippsx.nhs.uk
authors.forename: Peter
authors.initials: P
authors.lastname: Watkin
authors.forename: Donna
authors.initials: D
authors.lastname: McCann
authors.forename: Catherine
authors.initials: C
authors.lastname: Law
authors.forename: Mark
authors.initials: M
authors.lastname: Mullee
authors.forename: Stavros
authors.initials: S
authors.lastname: Petrou
authors.forename: Jim
authors.initials: J
authors.lastname: Stevenson
authors.forename: Sarah
authors.initials: S
authors.lastname: Worsfold
authors.forename: Ho Ming
authors.initials: HM
authors.lastname: Yuen
authors.forename: Colin
authors.initials: C
authors.lastname: Kennedy
mesh_terms: D002648:Child; D003638:Deafness / Q000151:congenital / Q000503:physiopathology* / Q000628:therapy; D005190:Family; D005260:Female; D006310:Hearing Aids; D006801:Humans; D007804:Language Development; D008297:Male; D012720:Severity of Illness Index; D012944:Social Support; D013065:Speech Intelligibility / Q000502:physiology; D013068:Speech Production Measurement; D013997:Time Factors