Listen up: children with early identified hearing loss achieve age-appropriate speech/language outcomes by 3 years-of-age.
OBJECTIVE
Age-appropriate speech/language outcomes for children with early identified hearing loss are a possibility but not a certainty. Identification of children most likely to achieve optimal outcomes is complicated by the heterogeneity of the children involved in outcome research, who present with a range of malleable (e.g. age of identification and cochlear implantation, type of intervention, communication mode) and non-malleable (e.g. degree of hearing loss) factors. This study considered whether a homogenous cohort of early identified children (≤ 12 months), with all severities of hearing loss and no other concomitant diagnoses could not only significantly outperform a similarly homogenous cohort of children who were later identified (>12 months to <5 years), but also achieve and maintain age-appropriate speech/language outcomes by 3, 4 and 5 years of age.


METHODS
A mixed prospective/retrospective comparative study of a homogenous cohort of 45 early identified (≤ 12 months) and 49 late identified (> 12 months to < 5 years) children with hearing loss was conducted. The children all attended the same oral auditory-verbal early intervention programme. Speech/language assessments standardized on typically developing hearing children were conducted at 3, 4 and 5 years of age.


RESULTS
The early identified children significantly outperformed the late identified at all ages and for all severities of HL. By 3 years of age, 93% of all early identified participants scored within normal limits (WNL) for speech; 90% were WNL for understanding vocabulary; and 95% were WNL for receptive and expressive language. Progress was maintained and improved so that by 5 years of age, 96% were WNL for speech, with 100% WNL for language.


CONCLUSIONS
This study found that most children with all severities of hearing loss and no other concomitant diagnosed condition, who were early diagnosed; received amplification by 3 months; enrolled into AV intervention by 6 months and received a cochlear implant by 18 months if required, were able to "keep up with" rather than "catch up to" their typically hearing peers by 3 years of age on measures of speech and language, including children with profound hearing loss. By 5 years, all children achieved typical language development and 96% typical speech.
The Shepherd Centre, Sydney, Australia. anne.fulcher@sydney.edu.au
Anne
A
Fulcher
Alison A
AA
Purcell
Elise
E
Baker
Natalie
N
Munro
D000367:Age Factors; D001315:Australia; D002663:Child Language; D002675:Child, Preschool; D003054:Cochlear Implants; D015331:Cohort Studies; D012048:Correction of Hearing Impairment / Q000379:methods; D042241:Early Diagnosis; D018479:Early Intervention, Educational; D005260:Female; D006310:Hearing Aids; D034381:Hearing Loss / Q000175:diagnosis / Q000534:rehabilitation* / Q000601:surgery; D006801:Humans; D007805:Language Development Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D013064:Speech Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D013065:Speech Intelligibility; D016896:Treatment Outcome; D014705:Verbal Behavior; D014825:Vocabulary