Postponement of the Newborn Hearing Screening during the COVID-19 Pandemic; Parental Experiences and Worries.

Early identification of hearing loss through newborn hearing screening followed by an early start of intervention has proven to be effective in promoting speech and language development in children with hearing loss. During the COVID-19 pandemic, newborn hearing screening was postponed for a group of newborns in the Netherlands. Therefore, meeting the guidelines for early identification was at risk. In this study, we examine parental attitudes, beliefs, and experiences concerning the hearing screening during the COVID-19 pandemic. Our results indicated that parents (n = 1053) were very positive about newborn hearing screening and their experiences with the screening, even during the COVID-19 pandemic. Parents' beliefs on the information provision around newborn hearing screening were more inconsistent. The results showed that parents with a postponed hearing screening felt less informed about the hearing screening than parents without a postponed screening. Furthermore, child and family characteristics affected how parents experienced newborn hearing screening. Parents with a premature child were more worried about the hearing abilities of their child before the screening took place. The results also indicate that deafness in the family might lead to parental worries around newborn hearing screening.

Parent-implemented early language intervention programme for late talkers: parental communicative behaviour change and child language outcomes at 3 and 4 years of age.

BACKGROUND: Late language emergence is a risk indicator for developmental language disorder. Parent-implemented early language intervention programmes (parent programmes) have been shown to have positive effects on children's receptive and expressive language skills. However, long-term effectiveness has rarely been studied. Additionally, little is known about which strategies parents learn to use after participating in parent programmes and whether this affects their child's language development. AIMS: To evaluate medium- and long-term effectiveness (1 and 2 years after inclusion) of a low-dosage parent programme in a sample of late talkers (LTs) with an expressive language delay. Specifically, we investigated which strategies the parents learned to use in interaction with their child and which strategies were associated with child language growth over time. METHODS & PROCEDURES: This quasi-experimental study with a longitudinal design included 24-month-old LTs. After the pre-test, parents of children in the intervention group received a parent programme (n = 30), while parents of children in the comparison group received care as usual (n = 30). Children's language development was assessed using standardized language tests at pre-test and two follow-up tests at 36 and 48 months of age. Change in parental communicative behaviour was measured by a parent-child interaction observation measure, at pre-test and follow-up at 36 months of age. OUTCOMES & RESULTS: At 36 months old, children in the parent programme group showed a significantly higher growth in expressive vocabulary than children in the comparison group. However, differences between the groups were not seen in the long-term, at the 48-month follow-up. In contrast to parents in the comparison group, parents in the parent programme group changed their communicative behaviour positively in two domains: Interaction and Pressure on the child. However, no changes in the domains of Language Stimulation and Responsiveness were observed. Children's growth in expressive vocabulary and expressive syntax was associated with a decrease in the domain of Pressure. CONCLUSIONS & IMPLICATIONS: At 4 years of age, the majority of children in both groups achieved expressive vocabulary scores within the normal range. However, the mean score for expressive syntax in both groups remained below that of their peers, and 29% of the children still had expressive language scores below the mean range. Ongoing monitoring of LTs' language development is necessary in order to make decisions regarding the timing and nature of intervention.

Accuracy of a Screening Tool for Early Identification of Language Impairment.

Purpose: A screening tool called the VTO Language Screening Instrument (VTO-LSI) was developed to enable more uniform and earlier detection of language impairment. This report, consisting of 2 retrospective studies, focuses on the effects of using the VTO-LSI compared to regular detection procedures. Method: Study 1 retrospectively compared VTO-LSI with regular detection procedures. Outcome measure was the detection rate of language impairment among 24-month-old children. Data were retrieved from medical records of children attending a youth health care center. Study 2 retrospectively compared the effects of VTO-LSI and regular detection procedures on the age at referral for diagnostic investigations and the influence of sex. Data were retrieved from medical records from the speech and hearing center and analyzed with multivariate analysis of variance. Results: With the VTO-LSI, significantly more cases with language impairment were identified compared with the regular detection procedure (2.4% vs. 0.4%). In regions where the VTO-LSI was used, girls were almost 2 years younger, and boys were 1 year younger when referred to diagnostic investigations than in regions with regular detection procedures. Conclusion: The VTO-LSI was more effective than regular detection procedures.

From Neonatal Hearing Screening to Intervention: Results of the Dutch Program for Neonatal Hearing Screening in Well Babies.

In the Netherlands, Youth Health Care services (YHC) have been carrying out neonatal hearing screening (NHS) in newborns since 2006. The aim of the NHS is to identify children with permanent hearing loss, so that intervention can be started before the age of 4 months. Early detection of hearing loss is important, as children who start intervention early have been shown to develop better. This article describes the structure and performance of the NHS carried out by the YHC, the quality of the program, and the timeliness of the start of intervention. Since its implementation, the NHS has been audited annually in order to monitor the program's quality. Monitoring reports and data from the Dutch Foundation for the Deaf and Hard of Hearing Child were used in this study. For many years, results have shown the NHS to be a stable screening program of high quality. The participation rate is high, refer percentage low, and the timeliness of the program is continually improving. Although the timeliness of post screening diagnostics and intervention need most improvement as they do not always meet the target times, this has improved over recent years.

Parental stress among parents of toddlers with moderate hearing loss.

BACKGROUND: The purpose of this study was to examine parental stress in parents of toddlers with moderate hearing loss compared to hearing controls. Furthermore, the associations between parental stress and child- and parent-related factors such as language, social-emotional functioning and social support were examined. DESIGN: The study sample consisted of 30 toddlers with moderate hearing loss and 30 hearing children (mean age 27.4 months). The two groups were compared using the Nijmegen Parenting Stress Index (NPSI) and parent-reports to rate the amount of social support and the children's social-emotional functioning. Receptive and expressive language tests were administered to the children to examine their language ability. RESULTS: Parents of toddlers with moderate hearing loss reported comparable levels of parental stress to parents of hearing children. Individual differences in parental stress were related to child- and parent-related factors. Poorer social-emotional functioning and language ability of the child were related to higher stress levels in parents. Parents who experienced less social support reported higher stress levels. CONCLUSIONS: Parents of toddlers with moderate hearing loss experience no more parental stress than parents of hearing children on average. Given parental stress was found to be related to poorer child functioning, early interventionists should be aware of signs of elevated stress levels in parents.

Family counseling in the Netherlands for Turkish-origin parents of deaf children with a cochlear implant.

Cultural elements such as language, beliefs about health, and family context play important roles in the uptake of rehabilitation and treatment of deafness. Because of cultural issues, minority groups often do not receive optimal care. Focusing on the Netherlands, the researchers explored how the rehabilitation and counseling of deaf children of Turkish-origin parents can be improved. The most important findings were that (a) most parents initially did not believe their child was deaf and regretted later that they did not start hearing rehabilitation earlier; (b) parents had little confidence in the Dutch health care system and sought a second opinion from a medical doctor of their own national origin; (c) parents did not know how to be actively involved in the care of their deaf child. Implications for practice aimed at improving rehabilitation and counseling for these children are described.

An implementation study of neonatal hearing screening in the Netherlands.

The objective of this study was to investigate whether universal neonatal hearing screening could be integrated in the youth health care program. The screening was performed by nurses of the well baby clinics. A three stage transient evoked otoacoustic emission screening was performed in three different screening settings in order to study the most effective set up regarding participation, refer rates, and costs. In one setting parents visited the well baby clinic, and in two settings babies were screened at home (either in combination with the screening for metabolic diseases or during an intake visit). Screening was performed on 3114 healthy newborns. The setting where universal neonatal hearing screening is integrated with the screening for metabolic diseases, proved to be most efficient and effective. The participation rate of 88.9% was highest in this setting and the overall refer rate (1.4%) was the lowest. The implementation of universal neonatal hearing screening by the well baby clinic nurses was judged to be possible. The results of this study formed the basis for nationwide implementation.