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Language outcomes in deaf or hard of hearing teenagers who are spoken language users: effects of universal newborn hearing screening and early confirmation

Language outcomes in deaf or hard of hearing teenagers who are spoken language users: effects of universal newborn hearing screening and early confirmation
Language outcomes in deaf or hard of hearing teenagers who are spoken language users: effects of universal newborn hearing screening and early confirmation
Objectives—This study aimed to examine whether a) exposure to universal newborn hearing screening (UNHS) and b) early confirmation of hearing loss were associated with benefits to expressive and receptive language outcomes in the teenage years for a cohort of spoken language users. It also aimed to determine whether either of these two variables were associated with benefits to relative language gain from middle childhood to adolescence within this cohort.

Design—The participants were drawn from a prospective cohort study of a population sample of children with bilateral permanent childhood hearing loss, who varied in their exposure to universal newborn hearing screening, and who had previously had their language skills assessed at 6-10 years. Sixty deaf or hard of hearing (D/HH) teenagers who were spoken language users and a comparison group of 38 teenagers with normal hearing completed standardised measures of their receptive and expressive language ability at 13-19 years.

Results—Teenagers exposed to UNHS did not show significantly better expressive (adjusted mean difference = 0.40, 95% CI = -0.26 to 1.05, d = 0.32) or receptive (adjusted mean difference = 0.68, 95% CI = -0.56 to 1.93, d = 0.28) language skills than those who were not. Those who had their hearing loss confirmed by 9 months of age did not show significantly better expressive (adjusted mean difference = 0.43, 95% CI = -0.20 to 1.05, d = 0.35) or receptive (adjusted mean difference = 0.95, 95% CI = -0.22 to 2.11, d = 0.42) language skills than those who had it confirmed later. In all cases effect sizes were of small size and in favour of those exposed to UNHS or confirmed by 9 months. Subgroup analysis indicated larger beneficial effects of early confirmation for those D/HH teenagers without CIs (N = 48; 80% of the sample), and these benefits were significant in the case of receptive language outcomes (adjusted mean difference = 1.55, 95% CI = 0.38 to 2.71, d = 0.78). Exposure to UNHS did not account for significant unique variance in any of the three language scores at 13-19 years beyond that accounted for by existing language scores at 6-10 years. Early confirmation accounted for significant unique variance in the expressive language information score at 13-19 years after adjusting for the corresponding score at 6-10 years (R2 change = 0.08, p=0.03).

Conclusions—This study found that while adolescent language scores were higher for D/HH teenagers exposed to UNHS and those who had their hearing loss confirmed by 9 months, these group differences were not significant within the whole sample. There was some evidence of a beneficial effect of early confirmation of hearing loss on relative expressive language gain from childhood to adolescence. Further examination of the impact of these variables on adolescent language outcomes in other cohorts would be valuable.
0196-0202
598-610
Pimperton, Hannah
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Kreppner, Jana
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Mahon, Merle
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Stevenson, James
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Terlektsi, Emmanouela
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Worsfold, Sarah
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Yuen, Ho
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Kennedy, Colin
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Pimperton, Hannah
705a9281-403e-4b1a-8de3-d46bf8f0a30a
Kreppner, Jana
6a5f447e-1cfe-4654-95b4-e6f89b0275d6
Mahon, Merle
5166ade4-5a04-4fb8-b907-1b83cf7c3a61
Stevenson, James
0c85d29b-d294-43cb-ab8d-75e4737478e1
Terlektsi, Emmanouela
afe028bf-071f-46ca-bb8c-9a79f0018871
Worsfold, Sarah
9e3f6aa2-8c17-4965-adf4-b3bc1d04ab54
Yuen, Ho
b1df4c57-0c2a-44ac-ab40-22b88e8effe8
Kennedy, Colin
7c3aff62-0a86-4b44-b7d7-4bc01f23ec93

Pimperton, Hannah, Kreppner, Jana, Mahon, Merle, Stevenson, James, Terlektsi, Emmanouela, Worsfold, Sarah, Yuen, Ho and Kennedy, Colin (2017) Language outcomes in deaf or hard of hearing teenagers who are spoken language users: effects of universal newborn hearing screening and early confirmation. Ear and Hearing, 38 (5), 598-610. (doi:10.1097/AUD.0000000000000434).

Record type: Article

Abstract

Objectives—This study aimed to examine whether a) exposure to universal newborn hearing screening (UNHS) and b) early confirmation of hearing loss were associated with benefits to expressive and receptive language outcomes in the teenage years for a cohort of spoken language users. It also aimed to determine whether either of these two variables were associated with benefits to relative language gain from middle childhood to adolescence within this cohort.

Design—The participants were drawn from a prospective cohort study of a population sample of children with bilateral permanent childhood hearing loss, who varied in their exposure to universal newborn hearing screening, and who had previously had their language skills assessed at 6-10 years. Sixty deaf or hard of hearing (D/HH) teenagers who were spoken language users and a comparison group of 38 teenagers with normal hearing completed standardised measures of their receptive and expressive language ability at 13-19 years.

Results—Teenagers exposed to UNHS did not show significantly better expressive (adjusted mean difference = 0.40, 95% CI = -0.26 to 1.05, d = 0.32) or receptive (adjusted mean difference = 0.68, 95% CI = -0.56 to 1.93, d = 0.28) language skills than those who were not. Those who had their hearing loss confirmed by 9 months of age did not show significantly better expressive (adjusted mean difference = 0.43, 95% CI = -0.20 to 1.05, d = 0.35) or receptive (adjusted mean difference = 0.95, 95% CI = -0.22 to 2.11, d = 0.42) language skills than those who had it confirmed later. In all cases effect sizes were of small size and in favour of those exposed to UNHS or confirmed by 9 months. Subgroup analysis indicated larger beneficial effects of early confirmation for those D/HH teenagers without CIs (N = 48; 80% of the sample), and these benefits were significant in the case of receptive language outcomes (adjusted mean difference = 1.55, 95% CI = 0.38 to 2.71, d = 0.78). Exposure to UNHS did not account for significant unique variance in any of the three language scores at 13-19 years beyond that accounted for by existing language scores at 6-10 years. Early confirmation accounted for significant unique variance in the expressive language information score at 13-19 years after adjusting for the corresponding score at 6-10 years (R2 change = 0.08, p=0.03).

Conclusions—This study found that while adolescent language scores were higher for D/HH teenagers exposed to UNHS and those who had their hearing loss confirmed by 9 months, these group differences were not significant within the whole sample. There was some evidence of a beneficial effect of early confirmation of hearing loss on relative expressive language gain from childhood to adolescence. Further examination of the impact of these variables on adolescent language outcomes in other cohorts would be valuable.

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Accepted/In Press date: 6 February 2017
e-pub ahead of print date: 1 September 2017
Published date: September 2017
Organisations: Auditory Implant Service, Primary Care & Population Sciences, Psychology, Clinical Neuroscience, Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 406230
URI: https://eprints.soton.ac.uk/id/eprint/406230
ISSN: 0196-0202
PURE UUID: 7aea25b1-cc31-4ef3-8f92-22b2884d7bcd
ORCID for Jana Kreppner: ORCID iD orcid.org/0000-0003-3527-9083

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Date deposited: 10 Mar 2017 10:43
Last modified: 10 Dec 2019 06:10

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Contributors

Author: Hannah Pimperton
Author: Jana Kreppner ORCID iD
Author: Merle Mahon
Author: James Stevenson
Author: Emmanouela Terlektsi
Author: Sarah Worsfold
Author: Ho Yuen
Author: Colin Kennedy

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