The real cost of hearing loss on infants and childrenExpanded from the print edition
By Dale Tylor, MD, MPH, Washington Hospital, Fremont, CA, Media and Public Relations Committee May is Better Hearing and Speech Month, a time to raise public awareness about hearing and speech issues as well as available treatment options. This year we are focusing on the impact of hearing loss as related to age, from infants and children to working-age adults to the elderly. Otolaryngologists treat hearing loss in patients of all ages, helping to mitigate the impact hearing loss can have on one’s quality of life. You can learn more about Better Hearing and Speech Month online at www.entnet.org/BetterHearingSpeechMonth. In the United States, two to three of every 1,000 children born have a detectable hearing loss in at least one ear. Further, more than 1 million children ages 1 to 19 years have bilateral mild-to-severe hearing loss, and around 3 million children have unilateral mild-to-severe hearing loss.1 Hearing loss in children can cause significant language impairments. Because educational success is substantially impacted by a child’s language and communications skills, those with hearing loss face significant academic challenges. The behavioral effects of hearing loss can mimic attention deficit disorders, cognitive or learning issues, or language processing problems. The lifetime educational cost per child of moderate or worse hearing loss in the absence of other disabilities is $115,600.2 Even children with unilateral hearing losses face significant language deficits, and have been found to have lower scores of language comprehension and oral expression than their normal hearing siblings.3 Those with unilateral loss or mild bilateral hearing loss also face educational impacts, with up to 35 percent failing a grade and up to 41 percent receiving educational assistance.4 School-aged children with hearing loss report significantly more fatigue than their normal hearing peers, which also can have negative academic and psychosocial effects.5 Parents of children with hearing impairment also are affected, and have been found to have impairment in almost all domains of health-related quality of life.6 Health disparities have been noted for children with hearing loss, with hearing services more limited for children from racial and socioeconomic minorities. Those in areas of lower median income and those of non-white or non-Asian minorities are less likely to receive cochlear implants, for example, and even when implanted can demonstrate worse speech and language outcomes. It should be noted that universal neonatal hearing screening and school-related screening programs have significantly improved detection of pediatric hearing loss, allowing for earlier treatment. Rehabilitation of hearing loss, such as with hearing aid(s), cochlear implant(s), speech therapy, or with individualized education plans, can help to positively impact the quality of life of these children. References NIH/NIDCD. Statistical Report: Prevalence of Hearing Loss in U.S. Children, 2005. Available at: http://www.nidcd.nih.gov/funding/programs/hb/outcomes/Pages/report.aspx Grosse SD. Education cost savings from early detection of hearing loss: new findings. Volta Voices. 2007;14:38-40. Lieu JEC, et al. Unilateral Hearing Loss Is Associated With Worse Speech-Language Scores in Children. 2010 Jun; 125(6):e1348-1355. Tharpe AM. Unilateral and Mild Bilateral Hearing Loss in Children: Past and Current Perspectives. Trends Amplif. 2008 Mar; 12(1):7-15. Hornsby BW, et al. Subjective fatigue in children with hearing loss: some preliminary findings. Am J Audiol. 2014 Mar; 23(1):129-134. Aras I, et al. Health related quality of life in parents of children with speech and hearing impairment. Int J Pediatr Otorhinolaryngol. 2014 Feb;78(20):323-329.
By Dale Tylor, MD, MPH, Washington Hospital, Fremont, CA, Media and Public Relations Committee
In the United States, two to three of every 1,000 children born have a detectable hearing loss in at least one ear. Further, more than 1 million children ages 1 to 19 years have bilateral mild-to-severe hearing loss, and around 3 million children have unilateral mild-to-severe hearing loss.1
Hearing loss in children can cause significant language impairments. Because educational success is substantially impacted by a child’s language and communications skills, those with hearing loss face significant academic challenges. The behavioral effects of hearing loss can mimic attention deficit disorders, cognitive or learning issues, or language processing problems. The lifetime educational cost per child of moderate or worse hearing loss in the absence of other disabilities is $115,600.2
Even children with unilateral hearing losses face significant language deficits, and have been found to have lower scores of language comprehension and oral expression than their normal hearing siblings.3 Those with unilateral loss or mild bilateral hearing loss also face educational impacts, with up to 35 percent failing a grade and up to 41 percent receiving educational assistance.4
School-aged children with hearing loss report significantly more fatigue than their normal hearing peers, which also can have negative academic and psychosocial effects.5 Parents of children with hearing impairment also are affected, and have been found to have impairment in almost all domains of health-related quality of life.6
Health disparities have been noted for children with hearing loss, with hearing services more limited for children from racial and socioeconomic minorities. Those in areas of lower median income and those of non-white or non-Asian minorities are less likely to receive cochlear implants, for example, and even when implanted can demonstrate worse speech and language outcomes.
It should be noted that universal neonatal hearing screening and school-related screening programs have significantly improved detection of pediatric hearing loss, allowing for earlier treatment. Rehabilitation of hearing loss, such as with hearing aid(s), cochlear implant(s), speech therapy, or with individualized education plans, can help to positively impact the quality of life of these children.
References
- NIH/NIDCD. Statistical Report: Prevalence of Hearing Loss in U.S. Children, 2005. Available at: http://www.nidcd.nih.gov/funding/programs/hb/outcomes/Pages/report.aspx
- Grosse SD. Education cost savings from early detection of hearing loss: new findings. Volta Voices. 2007;14:38-40.
- Lieu JEC, et al. Unilateral Hearing Loss Is Associated With Worse Speech-Language Scores in Children. 2010 Jun; 125(6):e1348-1355.
- Tharpe AM. Unilateral and Mild Bilateral Hearing Loss in Children: Past and Current Perspectives. Trends Amplif. 2008 Mar; 12(1):7-15.
- Hornsby BW, et al. Subjective fatigue in children with hearing loss: some preliminary findings. Am J Audiol. 2014 Mar; 23(1):129-134.
- Aras I, et al. Health related quality of life in parents of children with speech and hearing impairment. Int J Pediatr Otorhinolaryngol. 2014 Feb;78(20):323-329.