Language and speech outcomes of children with hearing loss and additional disabilities: identifying the variables that influence performance at five years of age

Abstract

Objective: This study examined language and speech outcomes in young children with hearing loss and additional disabilities. Design: Receptive and expressive language skills and speech output accuracy were evaluated using direct assessment and caregiver report. Results were analysed first for the entire participant cohort, and then to compare results for children with hearing aids (HAs) versus cochlear implants (CIs). Study sample: A population-based cohort of 146 five-year-old children with hearing loss and additional disabilities took part. Results: Across all participants, multiple regressions showed that better language outcomes were associated with milder hearing loss, use of oral communication, higher levels of cognitive ability and maternal education, and earlier device fitting. Speech output accuracy was associated with use of oral communication only. Average outcomes were similar for children with HAs versus CIs, but their associations with demographic variables differed. For HA users, results resembled those for the whole cohort. For CI users, only use of oral communication and higher cognitive ability levels were significantly associated with better language outcomes. Conclusions: The results underscore the importance of early device fitting for children with additional disabilities. Strong conclusions cannot be drawn for CI users given the small number of participants with complete data.

Key Words:

• Hearing aid
• cochlear implant
• hearing loss
• language outcomes
• children
• additional disabilities

Acknowledgements

We gratefully thank all the children, their families and their teachers for participation in this study. We are also indebted to the many persons who served as clinicians for the study participants or assisted in other clinical or administrative capacities at Australian Hearing, Hear and Say Centre, the Royal Institute for Deaf and Blind Children, the Shepherd Centre, and the Sydney Cochlear Implant Centre.

Declaration of interest

This work was partly supported by the National Institute on Deafness and Other Communication Disorders (Award Number R01DC008080). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Deafness and Other Communication Disorders or the National Institutes of Health. We acknowledge the financial support of the Australian Government Department of Health, and the HEARing CRC, established and supported under the Cooperative Research Centres Program – an initiative of the Australian Government. We also acknowledge the support provided by New South Wales Department of Health, Australia; Phonak Ltd.; and the Oticon Foundation.