Earlier interventions for hearing loss can benefit language outcomes

The earlier newborns identified with hearing loss receive interventions such as hearing aids or cochlear implants, the better chance those infants have at matching the language skills of their peers later in childhood, according to a recent report.

The Australian study, published in Pediatrics, found that children who received hearing aids or cochlear implants in the first few months of life went on to develop better language skills than children who didn't receive intervention until age 2 years.

Teresa Ching, PhD, from the National Acoustic Laboratories and the HEARing Cooperative Research Centre in Melbourne, Australia, and lead author of the report, says the findings highlight the need for pediatricians to work toward getting their hearing-impaired patients early intervention.

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"Despite universal newborn hearing screening for early detection of hearing loss, there is wide variation in how soon children receive treatment for hearing loss," Ching says. "The population-based study has shown that the earlier a child receives amplification or cochlear implantation, the higher the likelihood for the child to develop language that is on par with his or her normal hearing peers. The impact of earlier intervention was more pronounced for children with more severe hearing loss than those with milder hearing loss."

Similar to programs in the United States and across the globe, Australia has implemented universal newborn hearing screenings, but a wide range of ages still exists at which children who have been identified with permanent hearing loss receive interventions.

The study evaluated the efficacy of some top interventions, and by what age those interventions should be implemented to have the best outcomes.

Ching says current protocols are to provide amplification to children with hearing loss by age 6 months, with no specific guidelines on timing for cochlear implantation. Time is a huge factor for these children, however, says Ching, noting that the less time the child is deprived of sound, the better equipped they will be to develop language skills that match their peers.

“The younger a child received intervention, the better the language outcomes. In addition, more substantial benefits of earlier access to useful hearing via both hearing amplification and cochlear implants were obtained by those with worse hearing. Earlier intervention, rather than access to [hearing screenings], improved outcomes,” the report notes. “It is vital to implement a seamless clinical pathway from screening to diagnosis to intervention so that the opportunity offered by [hearing screenings] to improve language development can be captured.”

The study shows that fitting hearing aids before age 3 months and cochlear implantation by age 6 months resulted in much better language achievement by age 5 years, compared with those who received the same treatment at a later age.

Bilateral permanent hearing loss affects up to 2 of every 1000 newborns, according to the report, and can have a hugely negative impact on a child’s development. The study examined language development in 350 children aged up to 5 years who had received either hearing aids or cochlear implants at different ages.

Results were most significant in children with more severe hearing impairment than for children with milder impairment, the study noted.

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Universal hearing tests had no significant impact on language development, according to the report. Researchers suggest that this may be attributed to the fact that not all children whose hearing was tested at birth received interventions as infants, and not all children were tested as newborns but still received intervention for hearing loss at some point.

Ching says she hopes the research will lead to improved clinical pathways that will help newborns identified to have hearing loss at birth get earlier access to interventions.