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Objective To determine whether elementary school-aged children with unilateral hearing loss (UHL) demonstrate significantly worse language skills than their sibling controls with normal hearing, and whether they are more likely to receive extra assistance or resources at school. Patients and Methods Case-control study of age 6-12 year old children with UHL compared with sibling controls (74 matched pairs, total n=148), all with normal cognition by parental report. Scores on the oral portion of the Oral and Written Language Scales (OWLS) were the primary outcome measure. Potential confounders were evaluated for their effect on the OWLS scores. Multivariable analysis was used to determine whether UHL independently predicted OWLS scores. Results Children with UHL had significantly worse language comprehension (91 vs. 98, P = 0.003), oral expression (94 vs. 101, P = 0.007), and oral composite (90 vs. 99, P <0.001) scores than their siblings with normal hearing. Multivariable regression models demonstrated that UHL was an independent predictor of these OWLS scores, with moderate effect sizes of 0.3 to 0.7. Family income and maternal education level were also independent predictors of oral expression and oral composite scores. No differences were found between children with right or left UHL, nor with varying severity of hearing loss. Children with UHL were more likely to have an Individualized Education Plan (OR 4.4, 95% CI 2.0-9.5) and to have received speech-language therapy (OR 2.6, 95% CI 1.3-5.4). Conclusions School-aged children with UHL demonstrated worse oral language scores compared with siblings with normal hearing. These findings suggest that the common practice of withholding hearing-related accommodations from children with UHL should be reconsidered and studied, and that parents, pediatricians, and educators be informed about the deleterious effects of UHL on oral language skills.

The results demonstrate the initial measurement properties of the PedsQL™ Infant Scales in healthy and ill infants. The findings suggest that the PedsQL™ Infant Scales may be utilized in the evaluation of generic HRQOL in infants ages 1-24 months.

earing loss in children is common (Box 1); by age 18 years, it affects nearly 1 of every 5 children in the United States. Without hearing rehabilitation, hearing loss can cause detrimental effects on speech, language, developmental, educational, and cognitive outcomes in children. Hearing rehabilitation can mitigate those detrimental effects for many children, particularly when identified soon after birth or onset.The diagnosis and management of pediatric hearing loss have undergone significant changes in the past 30 years. In 1993, the National Institutes of Health recommended newborn hearing screening within the first 3 months of life. 1 The Joint Committee on Infant Hearing, consisting of representatives from many national organizations dedicated to ensuring early identification, intervention, and follow-up care of infants and young children with hearing loss, published statements in 1994, 2000, 2007, and 2019 to establish guidelines for newborn hearing screening and for early hearing detection and intervention programs, benchmarks for quality, tracking of outcomes, and initial management of infants with hearing loss. 2 Through the Individuals with Disabilities Act (2004), Part C provides free intervention services from birth to age 3 years for any child in the United States identified with hearing loss, and Part B provides educational assistance for children aged 3 through 21 years through individualized educational plans and programs for hearing disability.The multichannel cochlear implant was initially approved in the United States in 1990 for children 2 years or older; the age was lowered to 18 months in 1998, 12 months in 2000, and then 9 months in March 2020. 3 The combination of newborn hearing screening programs (Box 2), advances in cochlear implant and hearing aid technology, and legislative policy changes have allowed more than 75% of children with hearing loss to attend public schools mainstreamed with normal-hearing students. 4 The ability of screenings to detect hearing loss in infancy, the efficacy of hearing aids and cochlear implants to mitigate consequences of hearing loss, the proliferation of genetic studies expanding the understanding of genes involved with hearing, and the knowledge about the interaction between hearing and cognition have fundamentally altered the understanding about children with hearing loss. This review will summarize what is known about the current diagnosis and management of pediatric hearing loss, with a focus on some of the current controversies in management. MethodsPubMed was searched with the Medical Subject Heading term hearing loss with filters for English language, child (birth-18 years), and humans from 1993 through July 31, 2020. The search was IMPORTANCE Hearing loss in children is common and by age 18 years, affects nearly 1 of every 5 children. Without hearing rehabilitation, hearing loss can cause detrimental effects on speech, language, developmental, educational, and cognitive outcomes in children.OBSERVATIONS Consequences of hearing loss in children...

Objective Children with unilateral hearing loss (UHL) have been found to have lower language scores, and increased rate of speech therapy, grade failures, or needing Individualized Education Plans (IEPs). The objective of this study was to determine whether language skills and educational performance improved or worsened over time in a cohort of children with UHL. Study Design Prospective longitudinal cohort study Methods Forty-six children with permanent UHL, ages 6 to 12 years, were studied using standardized cognitive, achievement, and language testing at yearly intervals for three years. Using standardized test scores allowed implicit comparison to norms established by national cross-sectional samples. Secondary outcomes included behavioral issues, IEPs, receipt of speech therapy, or teacher report of problems at school. Analysis utilized repeated measures ANOVA and multilevel random regression modeling. Results Several cognitive and language mean standardized scores increased over time. Possible predictors of increase with time included higher baseline cognitive levels and receipt of interventions through an IEP. However, standardized achievement scores and indicators of school performance did not show concomitant improvements. Rates of IEPs remained > 50% throughout, and rates of speech therapy were consistently about 20%. Conclusions Children with UHL demonstrated improvement in oral language and verbal IQ scores over time, but not improvements in school performance. Parents and teachers reported persistent behavioral problems and academic weaknesses or areas of concern in about 25%. The provision of IEPs for children with UHL, and acknowledging UHL as a hearing disability, may be an effective intervention to improve language skills over time.