Parenting and infant sleep.

Background: Children with bilateral permanent hearing impairment often have impaired language and speech abilities. However, the effects of universal newborn screening for permanent bilateral childhood hearing impairment and the effects of confirmation of hearing impairment by nine months of age on subsequent verbal abilities are uncertain.Methods: We studied 120 children with bilateral permanent hearing impairment identified from a large birth cohort in southern England, at a mean of 7.9 years of age. Of the 120 children, 61 were born during periods with universal newborn screening and 57 had hearing impairment that was confirmed by nine months of age. The primary outcomes were language as compared with nonverbal ability and speech expressed as z scores (the number of standard deviations by which the score differed from the mean score among 63 age-matched children with normal hearing), adjusted for the severity of the hearing impairment and for maternal education.Results: Confirmation of hearing impairment by nine months of age was associated with higher adjusted mean z scores for language as compared with nonverbal ability (adjusted mean difference for receptive language, 0.82; 95 percent confidence interval, 0.31 to 1.33; and adjusted mean difference for expressive language, 0.70; 95 percent confidence interval, 0.13 to 1.26). Birth during periods with universal newborn screening was also associated with higher adjusted z scores for receptive language as compared with nonverbal ability (adjusted mean difference, 0.60; 95 percent confidence interval, 0.07 to 1.13), although the z scores for expressive language as compared with nonverbal ability were not significantly higher. Speech scores did not differ significantly between those who were exposed to newborn screening or early confirmation and those who were not.Conclusions: Early detection of childhood hearing impairment was associated with higher scores for language but not for speech in midchildhood.

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Language ability after early detection of permanent childhood hearing impairment.

Context Hearing loss is common and, in young persons, can compromise social development, communication skills, and educational achievement. Objective To examine the current prevalence of hearing loss in US adolescents and determine whether it has changed over time. Design Cross-sectional analyses of US representative demographic and audiometric data from the 1988 through 1994 and 2005 through 2006 time periods. Setting The Third National Health and Nutrition Examination Survey (NHANES III), 1988-1994, and NHANES 2005-2006. Participants NHANES III examined 2928 participants and NHANES 2005-2006 examined 1771 participants, aged 12 to 19 years. Main Outcome Measures We calculated the prevalence of hearing loss in participants aged 12 to 19 years after accounting for the complex survey design. Audiometrically determined hearing loss was categorized as either unilateral or bilateral for low frequency (0.5, 1, and 2 kHz) or high frequency (3, 4, 6, and 8 kHz), and as slight loss (>15 to Results The prevalence of any hearing loss increased significantly from 14.9% (95% CI, 13.0%-16.9%) in 1988-1994 to 19.5% (95% CI, 15.2%-23.8%) in 2005-2006 (P = .02). In 2005-2006, hearing loss was more commonly unilateral (prevalence, 14.0%; 95% CI, 10.4%-17.6%, vs 11.1%; 95% CI, 9.5%-12.8% in 1988-1994; P = .005) and involved the high frequencies (prevalence, 16.4%; 95% CI, 13.2%-19.7%, vs 12.8%; 95% CI, 11.1%-14.5% in 1988-1994; P = .02). Individuals from families below the federal poverty threshold (prevalence, 23.6%; 95% CI, 18.5%-28.7%) had significantly higher odds of hearing loss (multivariate adjusted OR, 1.60; 95% CI, 1.10-2.32) than those above the threshold (prevalence, 18.4%; 95% CI, 13.6%-23.2%). Conclusion The prevalence of hearing loss among a sample of US adolescents aged 12 to 19 years was greater in 2005-2006 compared with 1988-1994.

/pdf/change-in-prevalence-of-hearing-loss-in-us-adolescents-6yop8wz0k8.pdf

Change in Prevalence of Hearing Loss in US Adolescents

Background This review was commissioned because of the increasing doubt about the ability of existing screening programmes (mainly the health visitor distraction test (HVDT) at 7-8 months) to identify children with congenital hearing impairment, and technological advances which have made neonatal hearing screening an alternative option. Objectives To review the available literature on the screening of permanent childhood hearing impairment. To provide commissioners and providers of health care with information about how to deliver a more uniform service, better outcomes, and more cost-effective screening. To identify areas for further research and service development. How the research was conducted The research involved a review of the available published and unpublished literature, and a comprehensive survey of current pre-school hearing screening provision in the UK coupled with a health economics study of hearing screening costs. The research also included a number of focus groups and visits to key centres in the UK and North America. Research findings EPIDEMIOLOGY OF PERMANENT CHILDHOOD HEARING IMPAIRMENT: There are approximately 840 children a year born in the UK with significant permanent hearing impairment likely to affect their own and their family's quality of life. Present services will miss about 400 of these children by 1 1/2 years of age, and about 200 of these children by 3 1/2 years of age. Such late identification of hearing impairment greatly reduces the responsiveness of the services for individual children. Evidence for improved outcomes with earlier identification Hearing-impaired children identified late are at risk of substantial delay in their acquisition of language and communication skills, with consequent longer-term risk to education achievement, mental health and quality of life. Theoretical arguments on neural development support the limited evidence here for the increased benefit for child and family associated with very early identification. In general, parents and professionals want very early identification, which, if implemented properly, does not cause undue anxiety. Current uk practice The survey of current practice indicated a major problem with poor information systems. This problem was further highlighted as a major concern by the multi-disciplinary focus groups. Practice varies. There are two District-wide programmes in which all newborn babies are neonatally screened, a large number of ad hoc programmes for neonatal screening of 'at-risk' babies, a variety of early surveillance programmes, and widespread use of the HVDT. Intervention and habilitation for the majority of those screened neonatally is routinely undertaken within 6 months of birth. For those screened only by the health visitor, identification was on average at about 26 months of age with intervention at about 32 months on average. (ABSTRACT TRUNCATED)

https://njl-admin.nihr.ac.uk/document/download/2004155

A critical review of the role of neonatal hearing screening in the detection of congenital hearing impairment

• providing opportunities for light, moderate, and vigorous physical activity for at least 15 minutes per hour while children are in care; • providing daily outdoor time for physical activity when possible; • providing a combination of developmentally appropriate structured and unstructured physical activity experiences; • joining children in physical activity; • integrating physical activity into activities designed to promote children’s cognitive and social development; • providing an outdoor environment with a variety of portable play equipment, a secure perimeter, some shade, natural elements, an open grassy area, varying surfaces and terrain, and adequate space per child; • providing an indoor environment with a variety of portable play equipment and adequate space per child; • providing opportunities for children with disabilities to be physically active, including equipment that meets the current standards for accessible design under the Americans with Disabilities Act; • avoiding punishing children for being physically active; and RECOMMENDATIONS JUNE 2011

Early Childhood Obesity Prevention Policies

OBJECTIVE. To report the prevalence and stability of cry-fuss problems during the first 4 months of life and sleep problems from 2 to 24 months and relationships between the persistence of cry-fuss and sleep problems and outcomes at 24 months. METHODS. The study was a prospective cohort study in maternal and child health centers in 3 local government areas in Melbourne, Australia. A total of 483 first-born infants were monitored prospectively from 2 weeks through 2, 4, 8, 12, 18, and 24 months. Child behavior, maternal depression, parenting stress, and marital quality were assessed. Predictor variables were parent reports of moderate or greater cry-fuss problems (2 and 4 months) and sleep problems (8, 12, 18, and 24 months) and parent-reported, 24-hour, sleep/cry-fuss diaries (2, 4, and 12 months). RESULTS. The response rate was 68% (483 of 710 infants); the attrition rate was CONCLUSIONS. Most cry-fuss and sleep problems in the first 2 years of life are transient. Persistent, rather than transient, problems contribute to maternal depression, parenting stress, and subsequent child behavior problems.

Prevalence, stability, and outcomes of cry-fuss and sleep problems in the first 2 years of life: prospective community-based study.

ObjectivesImproved long-term outcomes of hearing loss at a population level is the underlying reason for interventions such as newborn hearing screening programs. Therefore, high-quality population surveys are needed for older children across the spectrum of hearing losses that might be detected by

Outcomes of children with mild-profound congenital hearing loss at 7 to 8 years: A population study

Background: Better language outcomes are reported for preschool children with hearing impairment (HI) diagnosed very early, irrespective of severity. However, population studies of older children are required to substantiate longer term benefits of early detection. 

Aims: To study impact of age of diagnosis and severity of HI in a population cohort of 7–8 year old children. 

Methods: Eighty eight 7–8 year old children born in Victoria, who were (a) fitted with hearing aids for congenital HI by 4.5 years and (b) did not have intellectual or major physical disability were studied. Main outcome measures were Clinical Evaluation of Language Fundamentals (CELF) and Peabody Picture Vocabulary Test (PPVT). Predictors were pure tone average (0.5, 1, 2 kHz) in better ear at diagnosis and age at diagnosis. Marginal (adjusted) means were estimated with general linear models. 

Results: Response rate was 67% (n = 89; 53 boys). Mean age at diagnosis was 21.6 months (SD 14.4); 21% had mild, 34% moderate, 21% severe, and 24% profound HI; mean non-verbal IQ was 104.6 (SD 16.7). Mean total CELF score was 76.7 (SD 21.4) and mean PPVT score 78.1 (SD 18.1). Age of diagnosis, adjusted for severity and IQ, did not contribute to language scores. In contrast, adjusted mean CELF and PPVT language scores fell sequentially with increasing severity of HI. 

Conclusions: More severe HI, but not later diagnosis, was strongly related to poorer language outcomes at 7–8 years. Further systematic study is needed to understand why children with hearing impairment have good or poor outcomes.

https://adc.bmj.com/content/archdischild/90/3/238.full.pdf

Hearing impairment: a population study of age at diagnosis, severity, and language outcomes at 7–8 years

OBJECTIVE: The goal was to determine the prevalence and effects of slight/mild bilateral sensorineural hearing loss among children in elementary school. METHODS: A cross-sectional, cluster-sample survey of 6581 children (response: 85%; grade 1: n = 3367; grade 5: n = 3214) in 89 schools in Melbourne, Australia, was performed. Slight/mild bilateral sensorineural hearing loss was defined as a low-frequency pure-tone average across 0.5, 1, and 2 kHz and/or a high-frequency pure-tone average across 3, 4, and 6 kHz of 16 to 40 dB hearing level in the better ear, with air/bone-conduction gaps of < 10 dB. Parents reported children's health-related quality of life and behavior. Each child with slight/mild bilateral sensorineural hearing loss, matched to 2 normally hearing children (low-frequency pure-tone average and high-frequency pure-tone average of < or = 15 dB hearing level in both ears), completed standardized assessments. Whole-sample comparisons were adjusted for type of school, grade level, and gender, and matched-sample comparisons were adjusted for nonverbal IQ scores. RESULTS: Fifty-five children (0.88%) had slight/mild bilateral sensorineural hearing loss. Children with and without sensorineural hearing loss scored similarly in language (mean: 97.2 vs 99.7), reading (101.1 vs 102.8), behavior (8.4 vs 7.0), and parent- and child-reported child health-related quality of life (77.6 vs 80.0 and 76.1 vs 77.0, respectively), but phonologic short-term memory was poorer (91.0 vs 102.8) in the sensorineural hearing loss group. CONCLUSIONS: The prevalence of slight/mild bilateral sensorineural hearing loss was lower than reported in previous studies. There was no strong evidence that slight/mild bilateral sensorineural hearing loss affects adversely language, reading, behavior, or health-related quality of life in children who are otherwise healthy and of normal intelligence.

Slight/Mild Sensorineural Hearing Loss in Children

https://www.academicpedsjnl.net/article/S1530-1567(05)60334-6/pdf

Zeffie Poulakis

Papers

Prevalence, stability, and outcomes of cry-fuss and sleep problems in the first 2 years of life: prospective community-based study.

Outcomes of children with mild-profound congenital hearing loss at 7 to 8 years: A population study

Hearing impairment: a population study of age at diagnosis, severity, and language outcomes at 7–8 years

Slight/Mild Sensorineural Hearing Loss in Children

Parent-reported health-related quality of life in children with congenital hearing loss: a population study.