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

Objectives: Improved 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 such programs, against which to assess future secular improvements. Measured outcomes should cover a broad range of parameters, including health-related quality of life. Design: Population-based cohort study (CHIVOS, the Children with Hearing Impairment in Victoria Outcome Study). Setting: State of Victoria, Australia. Participants: Eighty-six 7- to 8-yr-old children born in Victoria, who were (a) fitted with hearing aids for congenital hearing loss by 4.5 yr and (b) had no intellectual or major physical disability. Measures: Standardized measures of language (CELF and PPVT), articulation (Goldman-Fristoe Test of Articulation), cognition (WISC), reading, adaptive functioning, health-related quality of life, parent developmental concerns, parent- and teacher-reported intelligibility and behavior, and teacher-reported school functioning. Results: Response rate was 67% (N = 89). Of the 86 able to be included in analyses, 53 were boys; 22% had mild, 31% moderate, 17% severe, and 29% profound hearing loss; the mean nonverbal IQ was 104.6 (SD 16.7). The sample scored far below (1.3 to 1.7 SDs) the normative populations on the PPVT and on the Receptive, Expressive and Total CELF scores. On average, children's reading age was delayed nearly 10 mo. For every outcome measure except physical health, these children scored significantly worse than the relevant normative population. Language and vocabulary scores worsened with increasing severity of hearing loss, but adaptive functioning, health-related quality of life, academic skills and behavior did not. Conclusions: Comprehensive data such as these highlight the continuing plight experienced by hearing-impaired children, and will help evaluate over time whether outcomes for children with hearing loss are improving at a population level.