Explaining neurological factors of hearing loss through digital technologies.

The study investigated how inclusion of the considerable amount of knowledge generated through basic research in multisensory experiences can be brought into clinical paediatric audiology with a specific focus to enhance understanding of the neurological implications of childhood hearing loss. OBJECTIVES: The overall aim of the project was to investigate how to use emerging technologies to enhance the understanding of the neurological impact of paediatric hearing loss. The specific objectives were to develop an app and to evaluate its ease of use and the understanding of neurology by all types of stakeholders and end-users. METHODS: A collaborative participatory and human centred research design was used. This methodological approach brought stakeholders into the design process at an early point of time and workshops mapped the content and interaction of the iterative development of the app. Nine clinicians from Copenhagen Hearing and Balance Centre and 4 media technologists from Multisensory Experience Lab participated in the development of the app-prototype. Evaluations were made by use of questionnaires completed by stakeholders and end-users and focus group interviews. Eight parents with children with hearing loss, 13 internal stakeholders and 14 external stakeholders participated in the evaluation of the app. RESULTS: The app was overall positively evaluated. End users/parents with children with hearing loss were slightly more positive than stakeholders/professionals in audiology. CONCLUSIONS: Apps are a future media for providing health care information and it proved both relevant and applicable to start using apps also to provide complex information such as neurological implications of childhood hearing loss.

History re-written for children with hearing impairment.

A new generation of children with hearing impairment (HI) has emerged due to introduction of universal neonatal hearing screening, medical-surgical/technical and educational advances in the field of paediatric audiology. AIM: The primary aim of the study was to investigate long-term development of language fundamentals of children with HI at school level and analyse associations to several background variables. METHOD AND MATERIAL: The project design is prospective, longitudinal and comparative and was conducted over a three-year period with annual testing of core language, expressive language, working memory and pragmatics. Language scores were compared to type of hearing technology, gender, additional disability, diagnosis of HI, level of social well-being and start age of use of hearing technology. A total of 56 children participated (Children with HI N = 47; Children with normal hearing (NH) N = 9). Intervention included early start and full time use of hearing technology and 3 years of Auditory Verbal (AV) guidance at school level. RESULTS: Children with HI scored within the norm on all language fundamentals and showed high scores on parental assessments of level of social well-being. No significant association was found between any of the language fundamentals and social well-being. Children with HI and a diagnosed additional disability showed positive progression in terms of language development over the three years. CONCLUSION: The new generation of children with HI showed potentials of developing language fundamentals within normal range and thrived in terms of social well-being. Opportunities exist for children to be fully included in their respective local hearing community, if qualitative technical and educational intervention is provided.

Language Development for the New Generation of Children with Hearing Impairment.

A new generation of children with hearing impairment (HI) has emerged due to the introduction of universal neonatal hearing screening, medical-surgical/technical and educational advances. AIM: Investigation of long-term development of vocabulary and social well-being of children with HI, including children with HI and additional disability. METHOD AND MATERIAL: The project design was prospective, longitudinal, and comparative. Level of receptive vocabulary was compared to children with normal hearing, type of hearing technology, gender, additional disability, diagnosis of HI, level of social well-being, and start age for use of hearing technology. A total of 231 children participated. Intervention included early start of hearing technology and three years of auditory-verbal therapy (AVT) at the preschool level, followed by 3 years of AV guidance at the school level. RESULTS: Children with HI scored within the norm for receptive vocabulary but were outperformed by the control group. Children with HI and a diagnosed additional disability scored lower than children without additional disability, in terms of parental assessments of social well-being. Children with additional disabilities showed positive progression in terms of receptive vocabulary development. CONCLUSIONS: New generations with HI possess the potential to succeed academically in accordance with individual abilities and become active participants in the working market.

Evaluation of a sentence test in noise in children with hearing impairment.

INTRODUCTION: School-aged children with hearing impairment (HI) listen and learn in noisy environments. On-going monitoring of speech understanding in noise is essential to adjust clinical interventions accordingly. METHODS: The aim of this study was to assess Dantale II in a paediatric population. The secondary aims were identification of differences and similarities between groups of children with HI and normal hearing and between different hearing technologies; investigation of possible associations between Dantale II and verbal working memory. This was a longitudinal, prospective study comparing groups of children (n = 70) using the Dantale II with five-word sentences and verbal working memory with the Clinical Evaluation of Language Functioning-4. RESULTS: Dantale II seems clinically feasible from the age of six years. Children with NH outperformed children with HI both on completion of the tests and dB signal-to-noise ratio (SNR) scores. Children with hearing aids outperformed children with cochlear implants on dB SNR scores. A significant and moderately strong association between speech understanding in noise and verbal working memory was identified. CONCLUSIONS: Our study produced knowledge about a new generation of children with HI, who showed potentials not previously described. Future research on cognitive development of paediatric populations with HI is essential, as knowledge from adult populations cannot be transferred directly to paediatric populations. FUNDING: The project received funding from the Innovation Foundation, the Oticon Foundation, Decibel and The Capital Region of Denmark. TRIAL REGISTRATION: not relevant.