Service Provision for Children Who Are Hard of Hearing at Preschool and Elementary School Ages

Abstract

Purpose To characterize preschool and school services for children who are hard of hearing (CHH), we described service setting, amount, and configuration and analyzed the relationship between service receipt and student hearing levels and language scores. Characteristics of professionals providing services were described and then used to predict level of comfort with skills supporting listening and spoken language. The amount of provider communication with children's audiologists was also investigated. Method Participants included parents of CHH (preschool n = 174; school n = 155) and professionals (preschool n = 133; school n = 104) who completed interviews and questionnaires as part of a longitudinal study. Children's hearing, speech, and language data were collected from annual testing and analyzed in relation to service data. Results A majority (81%) of preschool-age CHH received services. Children were more likely to be in a preschool for children who are deaf or hard of hearing (CDHH) or exceptional children than a general education preschool. By elementary school, 70% received services, nearly all in general education settings. Sessions averaged twice a week for a total of approximately 90 min. Children who no longer received services performed significantly better on speech/language measures than those who received services, regardless of service setting. Professionals were primarily speech-language pathologists (SLPs) and teachers of CDHH. SLPs reported significantly less comfort with skills involving auditory development and hearing technologies and less frequent communication with the child's audiologists than teachers of CDHH. Overall communication with audiologists was more frequent in the preschool years. Conclusions As preschool-age CHH transition into school, the majority continue to qualify for services. Congruent with national trends, school-age CHH in the Outcomes of Children with Hearing Loss study were most often in general education settings. Without specialized preprofessional or postgraduate training, SLPs and teachers of CDHH did not report comfort with all the skills critical to developing listening and spoken language. This finding supports the need for increased implementation of interprofessional practice among SLPs and teachers of CDHH, as well as audiologists, to best meet the needs unique to this population.

Time-Gated Word Recognition in Children: Effects of Auditory Access, Age, and Semantic Context

“…Recent findings suggest that this population is at risk for communication delays, even when HL is "only" in the mild range (Tomblin et al, 2015;Tomblin, Oleson, Ambrose, Walker, & Moeller, 2018;Walker et al, 2015). Nevertheless, the intervention needs of CHH are sometimes overlooked in the educational setting (Antia, Jones, Reed, & Kreimeyer, 2009), and speech-language pathologists may lack preprofessional or professional preparation for working with school-age CHH (Page et al, 2018). Therefore, evidencebased research on factors that support listening and learning for CHH is critically important for developing effective clinical interventions.…”

Longitudinal Speech Recognition in Noise in Children: Effects of Hearing Status and Vocabulary

“…With the advent of newborn hearing screening, they are now being identified and fitted with hearing aids (HAs) during infancy (Holte et al, 2012). Early access to technology and services is posited to have a positive, long-term impact on functional outcomes, which results in the vast majority of CHH being educated in regular education settings (Page et al, 2018). As most CHH rely entirely on spoken language to communicate, they face significant challenges as they enter classrooms that are likely to have poor acoustics (Knecht et al, 2002).…”

“…For example, it is unclear whether higher HA dosage levels averaged across time is sufficient to support the development of speech recognition in noise, or whether fluctuations in auditory access (either due to inconsistency with wearing HAs or changes in hearing levels or aided audibility) could have a negative impact on listening in noise. The need to demonstrate the effects of aided auditory access is particularly relevant for school age children, some of whom receive less academic support in later grades (Page et al, 2018; Klein et al, 2019) and are at risk for inconsistent HA use in the classroom as they enter adolescence (Gustafson et al, 2015). Greater knowledge of the effects of HA dosage on speech recognition in noise can guide implementation of effective interventions for children with hearing loss and has the potential to motivate parents, teachers, and service providers to encourage increased HA usage.…”

Effects of Grade and School Services on Children's Responsibility for Hearing Aid Care

“…Question 3 was addressed quantitatively using an analysis of covariance (ANCOVA) model, which measured the effect of grade and IEP or 504 plan receipt on responsibility score while controlling for the covariates BEPTA and maternal education. BEPTA was included as a covariate because children with more hearing loss are more likely to receive special services in school than children with milder hearing loss (Page et al, 2018). Maternal education was included as a covariate because it was expected that higher maternal education would be associated with higher child hearing aid responsibility, possibly due to increased self-advocacy support from the caregiver.…”

“…Averaged across grades, the proportion of caregivers reporting a task was usually completed by an adult versus not regularly completed was .26 versus .49 for testing batteries, .07 versus .14 for putting hearing aids in the case, and .22 versus .24 for using the dri-aid kit, respectively. The apparently low involvement of school personnel in completing hearing aid maintenance may be in part because many SLPs who serve children with hearing loss are not comfortable managing hearing aids and other hearing assistive technology, and many SLPs do not have access to educational audiologists (Page et al, 2018;Richburg & Knickelbein, 2011). Ultimately, it is the responsibility of school personnel to be knowledgeable of which maintenance tasks should be completed and ensure that these tasks are done regularly.…”