Auditory and language skills of children using hearing aids

To describe the linguistic profile and the hearing skills of children using hearing aids, to characterize the rehabilitation process and to analyze its association with the children's degree of hearing loss.

METHODS:

Cross-sectional study with a non-probabilistic sample of 110 children using hearing aids (6-10 years of age) for mild to profound hearing loss. Tests of language, speech perception, phonemic discrimination, and school performance were performed. The associations were verified by the following tests: chi-squared for linear trend and Kruskal-Wallis.

RESULTS:

About 65% of the children had altered vocabulary, whereas 89% and 94% had altered phonology and inferior school performance, respectively. The degree of hearing loss was associated with differences in the median age of diagnosis; the age at which the hearing aids were adapted and at which speech therapy was started; and the performance on auditory tests and the type of communication used.

CONCLUSION:

The diagnosis of hearing loss and the clinical interventions occurred late, contributing to impairments in auditory and language development.

Hearing loss; Child language; Hearing aids; Auditory perception; Correction of hearing impairment

Characteristic	n	%
Child's gender
Female	42	38.2
Male	68	61.8

Child's age
Mean ± SD: 8.5 ± 1.5 years	24	21.8
Median: 8.5 years	19	17.2
6 years–7 years	22	20.0
7 years–8 years	18	16.3
8 years–9 years	27	24.5
9 years–10 years
10 years–11 years

Type of school
Regular school	92	83.6
Special-needs school	18	16.4

Age at school enrollment
Up to 6 years	100	90.9
After 6 years	6	5.4
No data	4	3.7

Appropriate age for the school year
Yes	41	37.3
No	69	62.7

TDE result
Inferior	103	93.6
Medium	5	4.5
Superior	2	1.9

Maternal years of schooling
Mean ± SD: 7.8 ± 3.4 years/median 8 years	1	0.9
Illiterate	28	25.4
1–4 years of schooling	30	27.2
5–8 years of schooling	45	41.1
9–11 years of schooling	3	2.7
More than 11 years of schooling
No information

Per capita income
Up to 1 minimum wage	95	86.3
>1 minimum wage	12	10.9
No information	3	2.8

Presence of risk indicator for hearing loss
Yes	44	40
No	66	60

Degree of hearing loss
Profound bilateral	25	22.7
Moderately severe/severe	48	43.7
Mild/moderate	37	33.6

Type of hearing loss in the right ear
Sensorineural	104	94.5
Mixed	2	1.8
Conductive	3	2.8
Normal hearing	1	0.9

Type of hearing loss in the left ear
Sensorineural	104	94.5
Mixed	2	1.8
Conductive	3	2.8
Normal hearing	1	0.9

Time of use of ISAD/day
Up to 4 h/day	14	12.7
From 5 to 8 h/day	37	33.7
More than 8 h/day	59	53.6

Degree of hearing loss
Speech therapy/audiology intervention	Profound bilateral (n = 25)	Moderately severe/severe (n = 48)	Mild/moderate (n = 37)	p-Value
Age at diagnosis
Amplitude (years)	0.5–6.5	0.98–8.3	0.7–9.0	<0.001^a
Median (years)	3.3	5.0	5.6	0.009^a

Age at ISAD adaptation
Amplitude (years)	2.6–7.6	2.0–9.1	2.0–9.3
Median (years)	4.9	5.5	6.8

Time between diagnosis and ISAD adaptation
Amplitude (years)	0.1–4.2	0.1–3.5	0–7.5	0.04^a
Median (years)	1.4	0.7	0.5

Weekly individual speech therapy sessions
Amplitude (years)	1–8	1–8	2–9	0.09^b
Median (years)	3	4.5	5

Speech therapy follow-up
Yes	21	43	32	0.49^b
No	4	5	5

Institution where speech therapy was carried out ^c
Public	13	33	23	2.33^b
Private/others	8	10	9

Speech therapy process ^c
Continuous	13	24	15	0.42^b
Discontinuous	8	19	17

Frequency of speech therapy ^c
≥2 times/week	20	41	28	0.26^b
<2 times/week	1	2	4

Degree of hearing loss
Communicative profile	Profound bilateral (n = 25)		Moderately severe/severe (n = 48)		Mild/moderate (n = 37)		Total
	n	%	n	%	n	%	n	%
Communication
Oral	3.0	12.0	31.0	64.6	34.0	91.9	68.0	61.8
Oral + LIBRAS	1.0	4.0	9.0	16.7	3.0	8.1	12.0	10.9
Non-oral	21.0	84.0	8.0	18.8	0.0	0.0	30.0	27.3

Vocabulary alteration ^a
General	3.0	100.0	31.0	77.5	18.0	48.6	52.0	65.0
Clothing	3.0	100.0	31.0	77.5	22.0	59.5	56.0	70.0
Animals	1.0	33.3	12.0	30.0	5.0	13.5	18.0	22.5
Food	3.0	100.0	40.0	100.0	29.0	78.4	72.0	90.0
Transportation	2.0	66.6	17.0	42.5	9.0	24.3	28.0	35.0
Furniture and utensils	2.0	66.6	18.0	45.0	8.0	21.6	28.0	35.0
Professions	3.0	100.0	32.0	80.0	15.0	40.5	50.0	62.5
Places	3.0	100.0	39.0	97.5	31.0	83.8	73.0	91.2
Shapes and colors	2.0	66.6	26.0	65.0	16.0	43.2	44.0	55.0
Toys ^b	2.0	66.6	27.0	67.5	19.0	51.4	48.0	60.0

Alteration of phonology ^a
Presence of alteration	3.0	100.0	38.0	42.6	31.0	83.8	72.0	88.8
Presence of omission	2.0	66.6	20.0	48.7	14.0	37.8	36.0	44.4
Presence of substitution	3.0	100.0	34.0	82.9	24.0	64.8	61.0	75.3
Presence of distortion	2.0	66.6	16.0	39.0	9.0	24.3	27.0	33.3
Presence of cultural pattern	3.0	100.0	32.0	78.0	25.0	67.5	60.0	74.0

Performance at SPT
General
Inferior	25.0	100.0	47.0	97.9	31.0	83.8	103.0	93.6
Medium	0.0	0.0	1.0	2.1	4.0	10.8	5.0	4.5
Superior	0.0	0.0	0.0	0.0	2.0	5.4	2.0	1.8
Reading
Inferior	25.0	100.0	44.0	91.7	24.0	64.9	93.0	84.5
Medium	0.0	0.0	4.0	8.4	11.0	29.7	15.0	13.7
Superior	0.0	0.0	0.0	0.0	2.0	5.4	2.0	1.8
Writing
Inferior	25.0	100.0	47.0	97.9	29.0	78.4	101.0	91.8
Medium	0.0	0.0	1.0	2.1	7.0	18.9	8.0	7.3
Superior	0.0	0.0	0.0	0.0	1.0	2.7	1.0	0.9
Arithmetic
Inferior	25.0	100.0	46.0	95.9	27.0	73.0	98.0	89.1
Medium	0.0	0.0	2.0	4.2	8.0	21.6	10.0	9.0
Superior	0.0	0.0	0.0	0.0	2.0	5.4	2.0	1.8

Communication used^a
Degree of hearing loss	Oral	Others	OR	95% CI
Mild/moderate	34	3	1
Moderately severe/severe	31	17	6.2	1.50–29.70
Profound bilateral	3	22	83.1	12.67–731.15

Degree of hearing loss
Hearing diagnosis	Profound bilateral (n = 25)	Moderately severe/severe (n = 48)	Mild/moderate (n = 37)	p-Value (Kruskal–Wallis test)
GASP/detection
First quartile (%)	0–0	36–83	70–100	p < 0.001
Second quartile (%)	0–43	83–98	100–100
Median (%)	43	98	100
Third quartile (%)	43–86	98–100	100–100
Fourth quartile (%)	86–100	100–100	100–100

GASP/discrimination
First quartile (%)	0–0	0–100	93–100	p < 0.001
Second quartile (%)	0–13	100–100	100–100
Median (%)	13	100	100
Third quartile (%)	13–80	100–100	100–100
Fourth quartile (%)	80–100	100–100	100–100

GASP/extension
First quartile (%)	0–0	0–100	0–100	p < 0.001
Second quartile (%)	0–0	100–100	10–100
Median (%)	0	100	100
Third quartile (%)	0–10	100–100	100–100
Fourth quartile (%)	10–100	100–100	100–100

GASP/recognition
First quartile (%)	0–0	0–75	91–100	p < 0.001
Second quartile (%)	0–0	75–100	100–100
Median (%)	0	100	100
Third quartile (%)	0–0	100–100	100–100
Fourth quartile (%)	0–100	100–100	100–100

GASP/comprehension
First quartile (%)	0–0	0–35	0–90	p < 0.001
Second quartile (%)	0–0	35–90	90–100
Median (%)	0	0	100
Third quartile (%)	0–0	90–100	100–100
Forth quartile (%)	0–70	100–100	100–100

GASP/general
First quartile (%)	0–0	9.2–80.1	66.8–96.6	p < 0.001
Second quartile (%)	0–11.2	80.1–94.3	96.6–100
Median (%)	11.2	94.3	100
Third quartile (%)	11.2–32.4	94.3–100	100–100
Fourth quartile (%)	32.4–86	100–100	100–100

TFDF/general
First quartile (points)	0–0	0–2.5	0–19	p < 0.001
Second quartile (points)	0–0	2.5–16.5	19–29
Median (points)	0	16.5	29
Third quartile (points)	0–0	16.5–28.5	29–35
Fourth quartile (points)	0–27	28.5–36	35–38

Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Sede da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico Facial, Av. Indianópolia, 1287, 04063-002 São Paulo/SP Brasil, Tel.: (0xx11) 5053-7500, Fax: (0xx11) 5053-7512 - São Paulo - SP - Brazil
E-mail: revista@aborlccf.org.br

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[1] * Corresponding author. E-mail: leticiapenna@hotmail.com (L.M. Penna).

Brasil

Brasil

Auditory and language skills of children using hearing aids ☆ ☆ Please cite this article as: Penna LM, Lemos SM, Alves CR. Auditory and language skills of children using hearing aids. Braz J Otorhinolaryngol. 2015;81:148-57.

INTRODUCTION:

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSION:

Auditory and language skills of children using hearing aids ^☆ ☆ Please cite this article as: Penna LM, Lemos SM, Alves CR. Auditory and language skills of children using hearing aids. Braz J Otorhinolaryngol. 2015;81:148-57.