Cognitive Performance of School Children with Unilateral Sensorineural Hearing Loss (original) (raw)
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Pilot study of cognition in children with unilateral hearing loss
International Journal of Pediatric Otorhinolaryngology, 2013
Objective: The objective of this study was to obtain preliminary data on the cognitive function of children with unilateral hearing loss in order to identify, quantify, and interpret differences in cognitive and language functions between children with unilateral hearing loss and with normal hearing.
Longitudinal study of children with unilateral hearing loss
The Laryngoscope, 2012
Objective-Children with unilateral hearing loss (UHL) have been found to have lower language scores, and increased rate of speech therapy, grade failures, or needing Individualized Education Plans (IEPs). The objective of this study was to determine whether language skills and educational performance improved or worsened over time in a cohort of children with UHL. Study Design-Prospective longitudinal cohort study Methods-Forty-six children with permanent UHL, ages 6 to 12 years, were studied using standardized cognitive, achievement, and language testing at yearly intervals for three years. Using standardized test scores allowed implicit comparison to norms established by national cross-sectional samples. Secondary outcomes included behavioral issues, IEPs, receipt of speech therapy, or teacher report of problems at school. Analysis utilized repeated measures ANOVA and multilevel random regression modeling. Results-Several cognitive and language mean standardized scores increased over time. Possible predictors of increase with time included higher baseline cognitive levels and receipt of interventions through an IEP. However, standardized achievement scores and indicators of school performance did not show concomitant improvements. Rates of IEPs remained > 50% throughout, and rates of speech therapy were consistently about 20%. Conclusions-Children with UHL demonstrated improvement in oral language and verbal IQ scores over time, but not improvements in school performance. Parents and teachers reported persistent behavioral problems and academic weaknesses or areas of concern in about 25%. The provision of IEPs for children with UHL, and acknowledging UHL as a hearing disability, may be an effective intervention to improve language skills over time.
Effects of Unilateral Hearing Loss Upon Educational Achievement
Child: Care, Health and Development, 1980
Recent evidence suggests that children with relatively minor hearing impairments may be at a developmental disadvantage. A survey of over 42 000 students was conducted and children with unilateral hearing losses were identified on the basis of audiometric testing. A comparison of the standardized achievement test scores obtained by the unilateral hearers, using class and national norms with a sibling control group, yielded no significant differences although the hearing-impaired group scored lower on all subscales. There were sex differences observed, however, with male unilateral hearers performing significantly better than females on several subscales. Although the results indicate little educational disadvantage accompanying unilateral losses in this sample of children, in the absence of more definitive evidence, it would be prudent to consider a unilateral loss as a 'risk factor' for the production of developmental problems. There is an abundant literature describing the cognitive deficits associated with hearing impairment (e.g. Meadows 1968, Myklebust 1960). The hearing-impaired have consistently been shown to be retarded in educational achievement (Goetzinger 1972, Goetzinger & Proud 1975, Meadows 1968). As a general rule, scholastic achievement declines as hearing loss increases. It has generally been accepted that substantial and sustained auditory deprivation is necessary for the production of linguistic and educational deficits and, consequently, the effects of temporary and slight-moderate hearing losses have received little attention from researchers
Permanent Unilateral Hearing Loss (UHL) and Childhood Development
Current otorhinolaryngology reports, 2018
The aim of this study is to summarize the consequences of permanent unilateral hearing loss (UHL) on the development of children as documented in the recent literature. Congenital and early-identified UHL places young children at risk for delays in speech-language development. School-aged children with UHL score lower on standardized tests of language and cognition and need increased assistance in school for educational and behavioral issues than siblings with normal hearing, and report lower hearing-related quality of life, similar to children with bilateral hearing loss (HL). Early intervention, including use of hearing amplification devices, might ameliorate some of those affects. For a child with mild to severe UHL at presentation, the risk of progression of HL in the worse-hearing ear may be as high as 40%, and the risk of progression to bilateral HL approaches 20%. Although UHL can adversely affect the development of children, how to mitigate those effects requires investigation.
International Journal of Pediatric Otorhinolaryngology, 2017
In children who are deaf or hard of hearing (DHH), it is helpful to have meaningful early measures of development in order to provide effective interventions and offer benchmarks that help recognize varied developmental trajectories. The main objective of this study was to compare results of an early developmental assessment prior to 3 years of age to later nonverbal IQ assessed between 3 and 6 years of age in children who are DHH. Methods: This study included children 3-6 years of age with bilateral permanent hearing who were enrolled in a prospective cohort study on developmental outcomes. As part of the study, children received the Leiter International Performance Scale-Revised, which provided a nonverbal Brief IQ, as well as standardized language assessment and behavioral checklists. Children were included in this analysis if they had received an early developmental assessment with the Gesell Developmental Schedules-Revised as part of a clinical visit with a developmental pediatrician. Correlation coefficients and multiple regression analysis were used to associate the scores on the Gesell (using a developmental quotient) with scores on the Leiter-R Brief IQ. Results: Forty-five participants who enrolled in the observational study had available evaluation results from the Gesell and complete Brief IQ results from the Leiter-R. The adaptive domain of the Gesell had good correlation (r=0.61, p<.0001) with the Brief IQ on the Leiter-R. Children who had stable developmental or intelligence classifications based on scores (<70, 70 to <85, 85 to <100, >100) over time were older (>24 months) at the early Gesell assessment. Degree of hearing loss or maternal education did not appear to confound the relationship between the Gesell and the Leiter-R. Conclusions: The adaptive domain of the Gesell Developmental Schedules-Revised administered in early childhood (under 3 years of age) has good correlation with the nonverbal Brief IQ on the Leiter International Performance Scale-R. Because children who are DHH have a higher likelihood of having a developmental disability compared to the general population, early developmental assessments are often important. Although early developmental assessments have their limitations, our results indicate that they are fairly robust indicators of later development. Such early indicators can be extremely useful in the clinical and educational management of children who are DHH
Minor neurological dysfunction and IQ in 9-year-old children born at term
Developmental Medicine & Child Neurology, 2011
ABBREVIATIONS cMND Complex minor neurological dysfunction FSIQ Full-scale IQ LCPUFA Long-chain polyunsaturated fatty acids MND Minor neurological dysfunction PIQ Performance IQ sMND Simple minor neurological dysfunction VIQ Verbal IQ WASI Wechsler Abbreviated Scale of Intelligence.
Pediatrics & Neonatology, 2008
Background: The majority of children born with very low birth weight (VLBW; < 1500 g) enter mainstream schools. They experience significant neurodevelopmental disabilities during childhood. The specific aims of our study were to evaluate the neonatal outcomes of VLBW infants and whether they would influence intelligence quotient (IQ), cognitive function and learning disabilities at the age of 6 or 8 years. Methods: We enrolled VLBW neonates who weighed less than 1500 g and who were delivered at Shin-Kong Wu Ho-Su Memorial Hospital in 1996 and 1999. The psychological assessments were applied with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) for age 6 and Wechsler Intelligence Scale for Children-Third Edition (WISC-III) for age 8. We recorded their demographic data, ventilation duration by days, length of stay, use of surfactant, respiratory distress syndrome (RDS), and other complications. Results: According to whether the full scale intelligence quotient (FSIQ) was above or below the average score (FSIQ = 90), we divided VLBW children into two groups (< 90, n = 17; ≥ 90, n = 21). The children with lower gestational age had lower FSIQ (p = 0.013). The higher FSIQ group (≥ 90) showed more prenatal steroid use (5/17, 29.4% vs. 14/21, 66.7%; p = 0.049). There were more boys in the lower FSIQ group (< 90, 13/17, 76.5% vs. ≥ 90, 7/21, 33.3%; p = 0.011). The average IQ scores were 78.11 ± 9.05 and 102.57 ± 8.89 in the FSIQ < 90 and FSIQ ≥ 90 groups, respectively. The groups were similar in ventilation duration by days, use of surfactant, frequency of sepsis, RDS, bronchopulmonary dysplasia, patent ductus arteriosus, intraventricular hemorrhage and retinopathy of prematurity. Conclusion: In our study, the children with lower gestational age had lower FSIQ. There was no significant association between small for gestational age and IQ performance. The neonatal outcomes of VLBW infants did have less impact on IQ performance later in life.
Neurocognitive risk in children with cochlear implants
JAMA Otolaryngology - Head & Neck Surgery, 2014
IMPORTANCE Children who receive a cochlear implant (CI) for early severe to profound sensorineural hearing loss may achieve age-appropriate spoken language skills not possible before implantation. Despite these advances, reduced access to auditory experience may have downstream effects on fundamental neurocognitive processes for some children with CIs. OBJECTIVE To determine the relative risk (RR) of clinically significant executive functioning deficits in children with CIs compared with children with normal hearing (NH).
PEDIATRICS, 2003
Objective. To examine the effects of bronchopulmonary dysplasia (BPD) and very low birth weight (VLBW) on the cognitive and academic achievement of a large sample of 8-year-old children. Methods. Infants who were VLBW and had BPD (n ؍ 98) or did not have BPD (n ؍ 75) and term infants (n ؍ 99) were followed prospectively to age 8. Groups were compared on measures assessing 4 broad areas of functioning: intelligence, achievement, gross motor, and attentional skills. Measures included the Wechsler Intelligence Scale for Children III, the Woodcock Johnson Test of Achievement-Revised, the Bruininks-Oseretsky Test of Motor Proficiency, the Tactual Performance Test (spatial memory), and the Continuous Performance Test (attention). School outcomes were assessed by parent and teacher report, as well as from school records. Groups were comparable on socioeconomic status, sex, and race. The total sample of BPD, VLBW, and term children was compared on all outcome measures. In addition, neurologic risk was assessed in the present sample and included the following: intraventricular hemorrhage, echodense lesions, porencephaly, hydrocephalus, ventriculoperitoneal shunt, meningitis, and periventricular leukomalacia. Individual difference analyses were conducted for neurologically intact children in all 3 groups. Finally, treatment effects were examined by comparing BPD children who had received steroids as part of their treatment with BPD children who had not. Results. The BPD group demonstrated deficits compared with VLBW and term children in intelligence; reading, mathematics, and gross motor skills; and special education services. VLBW children differed from term children in all of the above areas, except reading recognition, comprehension, and occupational therapy. Attentional differences were obtained between BPD and term children only. The BPD group (54%) was more likely to be enrolled in special education classes than VLBW (37%) or term children (25%). In addition, more BPD children (20%) achieved full-scale IQ scores <70, in the mental retardation range, compared with either VLBW (11%) or term (3%) children, with all VLBW children significantly more likely than term children to achieve IQs in the subaverage category. After controlling for birth weight and neurologic problems, BPD and/or duration on oxygen predicted lower performance IQ, perceptual organization, full-scale IQ, motor and attentional skills, and special education placement. The qualitative classification of BPD (present or absent) was a significant predictor for lower scores on measures of applied problems; motor skills; and incidence of speech-language, occupational, and physical therapies. Individual difference analyses were performed to ascertain whether differences between the risk groups were primarily attributable to neurologic complications. Even with the neurologically intact sample of BPD and VLBW children, differences between the term comparison group and both the BPD and VLBW groups were found for many outcome measures. When birth weight and neurologic complications were controlled, BPD and severity of BPD were associated with lower performance and full-scale IQ, poorer perceptual organization, attention, and motor skills, as well as lower school achievement and greater participation in special education, including occupational, physical, and speech-language therapies. Treatment protocol may in part be responsible for differences observed in our BPD sample. Steroid and nonsteroid groups of BPD children differed significantly in performance IQ (72.8 vs 84.8) and full-scale IQ (77.0 vs 85.2); perceptual organization (74.0 vs 85.2); Bruininks-Oseretsky Test of Motor Proficiency score (36.6 vs 44.7); and participation in special education (78% vs 48%), occupational therapy (71% vs 44%), and physical therapy (71% vs 41%). In every instance, BPD children who received steroids fared more poorly than BPD children who did not receive steroids. Conclusions. BPD and duration on oxygen have longterm adverse effects on cognitive and academic achievement above and beyond the effects of VLBW. The problems that have been identified at 8 years of age highlight the need for continued monitoring of the learning, behavior, and development of BPD children to intervene with children who are at risk for school problems. Pediatrics 2003;112:e359-e366. URL: http://www.pediatrics. org/cgi/content/full/112/5/e359; very low birth weight, intelligence, school performance.