22 results on '"Teresa Y. C. Ching"'
Search Results
2. Speech, language, functional communication, psychosocial outcomes and QOL in school-age children with congenital unilateral hearing loss
- Author
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Linda Cupples, Teresa Y. C. Ching, and Sanna Hou
- Subjects
unilateral hearing loss ,congenital hearing loss ,children ,speech perception ,language ability ,school-age children ,Pediatrics ,RJ1-570 - Abstract
IntroductionChildren with early-identified unilateral hearing loss (UHL) might be at risk for delays in early speech and language, functional communication, psychosocial skills, and quality of life (QOL). However, a paucity of relevant research prohibits strong conclusions. This study aimed to provide new evidence relevant to this issue.MethodsParticipants were 34 children, ages 9;0 to 12;7 (years;months), who were identified with UHL via newborn hearing screening. Nineteen children had been fitted with hearing devices, whereas 15 had not. Assessments included measures of speech perception and intelligibility; language and cognition; functional communication; psychosocial abilities; and QOL.Results and discussionAs a group, the children scored significantly below the normative mean and more than one standard deviation below the typical range on speech perception in spatially separated noise, and significantly below the normative mean on written passage comprehension. Outcomes in other aspects appear typical. There was however considerable within participant variation in the children's degree of hearing loss over time, raising the possibility that this pattern of results might change as children get older. The current study also revealed that participants with higher levels of nonverbal ability demonstrated better general language skills and better ability to comprehend written passages. By contrast, neither perception of speech in collocated noise nor fitting with a hearing device accounted for unique variance in outcome measures. Future research should, however, evaluate the fitting of hearing devices using random assignment of participants to groups in order to avoid any confounding influence of degree of hearing loss or children's past/current level of progress. more...
- Published
- 2024
- Full Text
- View/download PDF
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3. Audiological characteristics of children with congenital unilateral hearing loss: insights into Age of reliable behavioural audiogram acquisition and change of hearing loss
- Author
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Vicky W. Zhang, Sanna Hou, Angela Wong, Christopher Flynn, Jane Oliver, Michelle Weiss, Stacey Milner, and Teresa Y. C. Ching
- Subjects
unilateral hearing loss ,children ,audiological characteristics ,behavioural audiogram ,progressive hearing loss ,etiology ,Pediatrics ,RJ1-570 - Abstract
ObjectivesThe aims of this study were to report the audiological characteristics of children with congenital unilateral hearing loss (UHL), examine the age at which the first reliable behavioural audiograms can be obtained, and investigate hearing changes from diagnosis at birth to the first reliable behavioural audiogram.MethodThis study included a sample of 91 children who were diagnosed with UHL via newborn hearing screening and had reliable behavioural audiograms before 7 years of age. Information about diagnosis, audiological characteristics and etiology were extracted from clinical reports. Regression analysis was used to explore the potential reasons influencing the age at which first reliable behavioural audiograms were obtained. Correlation and ANOVA analyses were conducted to examine changes in hearing at octave frequencies between 0.5 and 4 kHz. The proportions of hearing loss change, as well as the clinical characteristics of children with and without progressive hearing loss, were described according to two adopted definitions: Definition 1: criterion (1): a decrease in 10 dB or greater at two or more adjacent frequencies between 0.5 and 4 kHz, or criterion (2): a decrease in 15 dB or greater at one octave frequency in the same frequency range. Definition 2: a change of ≥20 dB in the average of pure-tone thresholds at 0.5, 1, and 2 kHz.ResultsThe study revealed that 48 children (52.7% of the sample of 91 children) had their first reliable behavioural audiogram by 3 years of age. The mean age at the first reliable behavioural audiogram was 3.0 years (SD 1.4; IQR: 1.8, 4.1). We found a significant association between children's behaviour and the presence or absence of ongoing middle ear issues in relation to the delay in obtaining a reliable behavioural audiogram. When comparing the hearing thresholds at diagnosis with the first reliable behavioural audiogram across different frequencies, it was observed that the majority of children experienced deterioration rather than improvement in the initial impaired ear at each frequency. Notably, there were more instances of hearing changes (either deterioration or improvement), in the 500 Hz and 1,000 Hz frequency ranges compared to the 2,000 Hz and 4,000 Hz ranges. Seventy-eight percent (n = 71) of children had hearing deterioration between the diagnosis and the first behavioural audiogram at one or more frequencies between 0.5 and 4 kHz, with a high proportion of them (52 out of the 71, 73.2%) developing severe to profound hearing loss. When using the averaged three frequency thresholds (i.e., definition 2), only 26.4% of children (n = 24) in the sample were identified as having hearing deterioration. Applying definition 2 therefore underestimates the proportion of children that experienced hearing changes. The study also reported diverse characteristics of children with or without hearing deterioration.ConclusionThe finding that 78% of children diagnosed with UHL at birth had a decrease in hearing loss between the hearing levels at first diagnosis and their first behavioural audiogram highlights the importance of monitoring hearing threshold levels after diagnosis, so that appropriate intervention can be implemented in a timely manner. For clinical management, deterioration of 15 dB at one or more frequencies that does not recover warrants action. more...
- Published
- 2023
- Full Text
- View/download PDF
4. Mild matters: trial learnings and importance of community engagement in research for early identified bilateral mild hearing loss
- Author
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Valerie Sung, Teresa Y. C. Ching, Libby Smith, Vivienne Marnane, Michelle Saetre-Turner, Alison King, Rachael Beswick, Claire E. Iseli, and Peter Carew
- Subjects
pediatric mild bilateral hearing loss ,hearing amplification ,newborn hearing screening ,randomized controlled clinical trial (RCT) ,acceptability and feasibility ,Pediatrics ,RJ1-570 - Abstract
IntroductionEarly identification of mild hearing loss has resulted in early hearing amplification without adequate evidence of effectiveness. This paper describes learnings from a pilot trial, combined with a qualitative study, to highlight the importance of community engagement in designing research studies to determine whether early amplification benefits young children with bilateral mild hearing loss.MethodsPART 1 of the study is a proof-of-concept non-blinded multi-centre randomised controlled trial (RCT) of hearing device fitting vs. no fitting aimed to gather preliminary data and determine its acceptability/feasibility in children more...
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- 2023
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- View/download PDF
5. Relationship between objective measures of hearing discrimination elicited by non-linguistic stimuli and speech perception in adults
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Hugo Sohier, Fabrice Bardy, and Teresa Y. C. Ching
- Subjects
Medicine ,Science - Abstract
Abstract Some people using hearing aids have difficulty discriminating between sounds even though the sounds are audible. As such, cochlear implants may provide greater benefits for speech perception. One method to identify people with auditory discrimination deficits is to measure discrimination thresholds using spectral ripple noise (SRN). Previous studies have shown that behavioral discrimination of SRN was associated with speech perception, and behavioral discrimination was also related to cortical responses to acoustic change or ACCs. We hypothesized that cortical ACCs could be directly related to speech perception. In this study, we investigated the relationship between subjective speech perception and objective ACC responses measured using SRNs. We tested 13 normal-hearing and 10 hearing-impaired adults using hearing aids. Our results showed that behavioral SRN discrimination was correlated with speech perception in quiet and in noise. Furthermore, cortical ACC responses to phase changes in the SRN were significantly correlated with speech perception. Audibility was a major predictor of discrimination and speech perception, but direct measures of auditory discrimination could contribute information about a listener’s sensitivity to acoustic cues that underpin speech perception. The findings lend support for potential application of measuring ACC responses to SRNs for identifying people who may benefit from cochlear implants. more...
- Published
- 2021
- Full Text
- View/download PDF
6. Early Cognitive Predictors of 9-Year-Old Spoken Language in Children With Mild to Severe Hearing Loss Using Hearing Aids
- Author
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Teresa Y. C. Ching, Linda Cupples, and Vivienne Marnane
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short-term memory ,language ,cognitive predictors ,hearing aids ,children with hearing loss ,Psychology ,BF1-990 - Abstract
This study examined the extent to which cognitive ability at 5 years of age predicted language development from 5 to 9 years of age in a population-based sample of children with hearing loss who participated in the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study. The developmental outcomes of 81 children with hearing loss were evaluated at 5 and 9 years of age. Hearing loss ranged from mild to severe degrees, and all participants used hearing aids. They all used spoken language as the primary mode of communication and education. Nine-year-old language was assessed using the Clinical Evaluation of Language Fundamentals – 4th edition (CELF-4), the Peabody Picture Vocabulary Test – 4th edition (PPVT-4), and the Expressive Vocabulary Test – 2nd edition (EVT-2). Multiple regression analyses were conducted to examine the extent to which children’s scores on these standardized assessments were predicted by their cognitive ability (non-verbal IQ and verbal working memory) measured at 5 years of age. The influence of early language scores at 5 years and a range of demographic characteristics on language scores at 9 years of age was evaluated. We found that 5-year-old digit span score was a significant predictor of receptive and expressive language, but not receptive or expressive vocabulary, at 9 years of age. Also, 5-year-old non-word repetition test score was a significant predictor of only expressive language and vocabulary, but not receptive language or vocabulary at 9 years of age. After allowing for the effects of non-verbal IQ and 5-year-old receptive vocabulary, early digit span score (but not non-word repetition score) was a significant predictor of expressive and receptive language scores at 9 years of age. The findings shed light on the unique role of early verbal working memory in predicting the development of receptive and expressive language skills and vocabulary skills in children who use hearing aids. more...
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- 2019
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7. Psychosocial Development in 5-Year-Old Children With Hearing Loss Using Hearing Aids or Cochlear Implants
- Author
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Cara L. Wong, Teresa Y. C. Ching, Linda Cupples, Laura Button, Greg Leigh, Vivienne Marnane, Jessica Whitfield, Miriam Gunnourie, and Louise Martin
- Subjects
Otorhinolaryngology ,RF1-547 - Abstract
This article reports on the psychosocial development and factors influencing outcomes of 5-year-old children with cochlear implants (CIs) or hearing aids (HAs). It further examines differences between children with CIs and HAs with similar levels of hearing loss. Data were collected as part of the Longitudinal Outcomes of Children with Hearing Impairment study—a prospective, population-based study. Parents/caregivers of children completed the Strengths and Difficulties Questionnaire ( n = 333), the Social Skills subscale from the Child Development Inventory ( n = 317), and questionnaires on functional auditory behavior (Parents’ Evaluation of Aural/oral performance of Children), and demographics. Children completed assessments of nonverbal cognitive ability (Wechsler Non-verbal Scale of Ability) and language (Preschool Language Scale - fourth edition). On average, parent-rated Strengths and Difficulties Questionnaire scores on emotional or behavioral difficulties were within 1 SD of the normative mean; however, Child Development Inventory scores on social skills were more than 1 SD below the norm. Children with severe-to-profound hearing losses using HAs had significantly more behavioral problems than children with CIs. Regression analyses showed that non-verbal cognitive ability, language, and functional auditory behavior were significantly associated with psychosocial outcomes for children with HAs, whereas outcomes for children with CIs were associated with functional auditory behavior and the presence of additional disabilities. Age at hearing intervention, severity of hearing loss, and communication mode were not associated with outcomes. The results suggest that even children who develop good language ability with the help of a HA or CI may have psychosocial problems if they exhibit difficulties with listening and communicating in everyday environments. The findings have implications for developing interventions for young children with hearing loss. more...
- Published
- 2017
- Full Text
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8. An economic evaluation of Australia’s newborn hearing screening program: A Within-study cost-effectiveness analysis
- Author
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Jing Wang, Rajan Sharma, Vivienne Marnane, Melissa Wake, Bonny Parkinson, Lisa Gold, Yuanyuan Gu, Kompal Sinha, and Teresa Y. C. Ching
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medicine.medical_specialty ,Hearing loss ,Cost-Benefit Analysis ,Context (language use) ,Deafness ,Article ,Speech and Hearing ,Willingness to pay ,Hearing ,Peabody Picture Vocabulary Test ,medicine ,Humans ,Child ,Hearing Loss ,health care economics and organizations ,1103 Clinical Sciences, 1109 Neurosciences ,business.industry ,Hearing Tests ,Australia ,Infant, Newborn ,Wechsler Adult Intelligence Scale ,Infant ,Cost-effectiveness analysis ,Otorhinolaryngology ,Family medicine ,Economic evaluation ,Quality-Adjusted Life Years ,medicine.symptom ,business ,Health Utilities Index - Abstract
OBJECTIVES: Hearing loss is one of the most prevalent congenital disorders among children. Many countries have implemented Universal Newborn Hearing Screening (UNHS) for early diagnosis and treatment of hearing loss. Despite widespread implementation, the value for money of UNHS is unclear due to lack of cost and outcomes data from rigorous study designs. The objective of this research is to conduct a within-study cost-effectiveness analysis of UNHS compared with targeted screening (targeting children with risk factors of hearing loss) from the Australian healthcare system perspective. This evaluation is the first economic evaluation to assess the cost-effectiveness of UNHS compared to targeted screening using real-world data from a natural experiment. DESIGN: The evaluation assumed the Australian healthcare system perspective and considered a time horizon of five years. Utilities were estimated using responses to the Health Utilities Index Mark III. Screening costs were estimated based on the Victorian Infant Hearing Screening Program. Ongoing costs were estimated based on administrative data, while external data sources were used to estimate costs related to hearing services. Missing data were handled using the multiple imputation method. Outcome measures included Quality-adjusted Life Years (QALYs) and four language and communication-related outcomes: Peabody Picture Vocabulary Test, Wechsler Nonverbal scale of ability, Progressive Achievement Test, and comprehensive, expressive, and total language scores based on the Preschool Language Scale. RESULTS: On average, the UNHS cost an extra Australian dollar (A$)22,000 per diagnosed child and was associated with 0.45 more QALYs per diagnosed child compared with targeted screening to 5 years, resulting in an Incremental Cost-Effectiveness Ratio (ICER) of A$48,000 per QALY gained. Higher screening costs in the UNHS arm were the main drivers of the results. The ICERs for language outcomes lay between A$3,900 (for expressive language score) and A$83,500 per one-point improvement in language score (i.e., for Wechsler Nonverbal scale of ability). UNHS had a 69% probability of being more cost-effective compared to targeted screening at a willingness to pay threshold of A$60,000 per QALY gained. ICERs were most sensitive to the screening costs. CONCLUSIONS: The evaluation demonstrated the usefulness of a within-study economic evaluation to understand the value for money of the UNHS program in the Australian context. Findings from this evaluation suggested that screening costs were the key driver of cost-effectiveness results. Most outcomes were not significantly different between UNHS and targeted screening groups. The ICER may be overestimated due to the short follow-up period. Further research is warranted to include long-term resource use and outcome data, late diagnosis, transition and remission between severity levels, and timing of diagnosis and treatment. more...
- Published
- 2022
9. Relationship between objective measures of hearing discrimination elicited by non-linguistic stimuli and speech perception in adults
- Author
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Fabrice Bardy, Hugo Sohier, and Teresa Y C Ching
- Subjects
Adult ,medicine.medical_specialty ,Speech perception ,genetic structures ,Science ,Audiology ,Signal-To-Noise Ratio ,Predictive markers ,behavioral disciplines and activities ,Article ,Discrimination Learning ,Hearing Aids ,Hearing ,medicine ,otorhinolaryngologic diseases ,Pathology ,Humans ,Hearing Loss ,Multidisciplinary ,Diagnostic marker ,Diagnostic markers ,Auditory Threshold ,Cochlear Implantation ,Noise ,QUIET ,Auditory Perception ,Speech Perception ,Medicine ,sense organs ,Psychology ,psychological phenomena and processes - Abstract
Some people using hearing aids have difficulty discriminating between sounds even though the sounds are audible. As such, cochlear implants may provide greater benefits for speech perception. One method to identify people with auditory discrimination deficits is to measure discrimination thresholds using spectral ripple noise (SRN). Previous studies have shown that behavioral discrimination of SRN was associated with speech perception, and behavioral discrimination was also related to cortical responses to acoustic change or ACCs. We hypothesized that cortical ACCs could be directly related to speech perception. In this study, we investigated the relationship between subjective speech perception and objective ACC responses measured using SRNs. We tested 13 normal-hearing and 10 hearing-impaired adults using hearing aids. Our results showed that behavioral SRN discrimination was correlated with speech perception in quiet and in noise. Furthermore, cortical ACC responses to phase changes in the SRN were significantly correlated with speech perception. Audibility was a major predictor of discrimination and speech perception, but direct measures of auditory discrimination could contribute information about a listener’s sensitivity to acoustic cues that underpin speech perception. The findings lend support for potential application of measuring ACC responses to SRNs for identifying people who may benefit from cochlear implants. more...
- Published
- 2021
10. Factors influencing parents’ decisions about communication choices during early education of their child with hearing loss: a qualitative study
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Laura Button, Teresa Y. C. Ching, Jessica Whitfield, Nerina Scarinci, Vivienne Marnane, and Jessica Sjahalam-King
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Hearing loss ,Applied psychology ,Qualitative descriptive ,MEDLINE ,Sign language ,Article ,Education ,030507 speech-language pathology & audiology ,03 medical and health sciences ,Speech and Hearing ,Access to information ,0302 clinical medicine ,Assistive technology ,otorhinolaryngologic diseases ,medicine ,medicine.symptom ,030223 otorhinolaryngology ,0305 other medical science ,Psychology ,Neuroscience of multilingualism ,Qualitative research - Abstract
OBJECTIVE: To explore the factors influencing parents’ choice of communication mode during early education of their child with hearing loss. DESIGN: Qualitative descriptive analysis of semi-structured interviews of parents of children with hearing loss. STUDY SAMPLE: Fourteen parents of children who participated in the Longitudinal Outcomes of Children with Hearing Impairment study. RESULTS: Four themes emerged from thematic analysis of the interview data: (1) parents draw on a variety of experiences and information to make decisions; (2) parents’ preferred outcomes for their children drive their choices; (3) child’s preference and proficiency drive parental choice; and (4) parents’ fears and worries influence decisions. Parents required unbiased, descriptive information as well as evaluative information from professionals, so that they could consider all options in making a decision that met their needs. They required continual support for implementation of their choices as they adjusted to their children’s changing needs. CONCLUSIONS: Decisions around communication mode are rarely made in isolation, but occur within a larger decision-making matrix that include device choices, early intervention agency choices and “future-proofing” the child’s future communication options. more...
- Published
- 2018
11. Age at Intervention for Permanent Hearing Loss and 5-Year Language Outcomes
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Teresa Y. C. Ching, Harvey Dillon, Laura Button, Greg Leigh, Linda Cupples, Vivienne Marnane, Patricia Van Buynder, and Mark Seeto
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Male ,medicine.medical_specialty ,Time Factors ,Hearing loss ,Birth weight ,MEDLINE ,Audiology ,Language Development ,Article ,03 medical and health sciences ,Nonverbal communication ,0302 clinical medicine ,030225 pediatrics ,Intervention (counseling) ,medicine ,otorhinolaryngologic diseases ,Early Intervention, Educational ,Humans ,Mass Screening ,Prospective Studies ,030223 otorhinolaryngology ,Prospective cohort study ,Child ,Hearing Loss ,Language ,business.industry ,Hearing Tests ,Cochlear Implantation ,Confidence interval ,Language development ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Regression Analysis ,Female ,medicine.symptom ,business ,Child Language - Abstract
OBJECTIVES: Universal newborn hearing screening has been implemented to detect permanent childhood hearing loss (PCHL) early, with the ultimate goal of improving outcomes through early treatment. However, there is disagreement between studies on the size of this benefit and in some cases whether it is significantly different from 0. There have been no studies of sufficient size in which researchers have determined reliably whether the effect varies with degree of PCHL. We aimed to explore how intervention timing influences 5-year language in children with PCHL. METHODS: Via a prospective study of 350 children, we used standard multiple regression analyses to investigate the effect of age at intervention or hearing screening on language outcomes after allowing for the effects of nonverbal IQ, degree of PCHL, sex, birth weight, maternal education, additional disabilities, and communication mode. RESULTS: The benefit of early intervention for language development increased as hearing loss increased. Children whose amplification started at age 24 months had poorer language than those whose amplification started at 3 months. The difference was larger for 70-dB HL (−11.8 score points; 95% confidence interval [95% CI]: −18.7 to −4.8) than for 50-dB HL (−6.8; 95% CI: −10.8 to −2.8). Children who received cochlear implants at 24 months had poorer language than those implanted at 6 months (−21.4; 95% CI: −33.8 to −9.0). There was no significant effect of screening on outcomes. CONCLUSIONS: Early intervention improves language outcomes, thereby lending support to streamlining clinical pathways to ensure early amplification and cochlear implantation after diagnosis. more...
- Published
- 2017
12. Psychosocial Development in 5-Year-Old Children With Hearing Loss Using Hearing Aids or Cochlear Implants
- Author
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Teresa Y. C. Ching, Miriam Gunnourie, Greg Leigh, Louise Martin, Vivienne Marnane, Linda Cupples, Cara L. Wong, Jessica Whitfield, and Laura Button
- Subjects
Male ,psychosocial ,medicine.medical_treatment ,Emotions ,Strengths and Difficulties Questionnaire ,Child Behavior ,functional communication skills ,Audiology ,Special Issue: Australian Hearing Hub ,Hearing Aids ,0302 clinical medicine ,Hearing ,Surveys and Questionnaires ,Cochlear implant ,Parents’ Evaluation of Aural/oral performance of Children ,Longitudinal Studies ,Prospective Studies ,Child Development Inventory ,030223 otorhinolaryngology ,10. No inequality ,Communication ,Age Factors ,Erikson's stages of psychosocial development ,lcsh:Otorhinolaryngology ,Cochlear Implantation ,lcsh:RF1-547 ,Disabled Children ,Child, Preschool ,Auditory Perception ,Female ,medicine.symptom ,0305 other medical science ,Psychosocial ,medicine.medical_specialty ,deaf or hard of hearing ,Hearing loss ,Language Development ,030507 speech-language pathology & audiology ,03 medical and health sciences ,Speech and Hearing ,Social skills ,Acquired immunodeficiency syndrome (AIDS) ,social skills ,otorhinolaryngologic diseases ,medicine ,Humans ,Interpersonal Relations ,Hearing Loss ,Social Behavior ,language ,business.industry ,Australia ,cochlear implant ,medicine.disease ,Cochlear Implants ,Persons With Hearing Impairments ,pediatric ,Otorhinolaryngology ,business - Abstract
This article reports on the psychosocial development and factors influencing outcomes of 5-year-old children with cochlear implants (CIs) or hearing aids (HAs). It further examines differences between children with CIs and HAs with similar levels of hearing loss. Data were collected as part of the Longitudinal Outcomes of Children with Hearing Impairment study—a prospective, population-based study. Parents/caregivers of children completed the Strengths and Difficulties Questionnaire ( n = 333), the Social Skills subscale from the Child Development Inventory ( n = 317), and questionnaires on functional auditory behavior (Parents’ Evaluation of Aural/oral performance of Children), and demographics. Children completed assessments of nonverbal cognitive ability (Wechsler Non-verbal Scale of Ability) and language (Preschool Language Scale - fourth edition). On average, parent-rated Strengths and Difficulties Questionnaire scores on emotional or behavioral difficulties were within 1 SD of the normative mean; however, Child Development Inventory scores on social skills were more than 1 SD below the norm. Children with severe-to-profound hearing losses using HAs had significantly more behavioral problems than children with CIs. Regression analyses showed that non-verbal cognitive ability, language, and functional auditory behavior were significantly associated with psychosocial outcomes for children with HAs, whereas outcomes for children with CIs were associated with functional auditory behavior and the presence of additional disabilities. Age at hearing intervention, severity of hearing loss, and communication mode were not associated with outcomes. The results suggest that even children who develop good language ability with the help of a HA or CI may have psychosocial problems if they exhibit difficulties with listening and communicating in everyday environments. The findings have implications for developing interventions for young children with hearing loss. more...
- Published
- 2017
13. Detection Rates of Cortical Auditory Evoked Potentials at Different Sensation Levels in Infants with Sensory/Neural Hearing Loss and Auditory Neuropathy Spectrum Disorder
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Sanna Hou, Kirsty Gardner-Berry, Hsiu-Wen Chang, and Teresa Y. C. Ching
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Hearing aid ,medicine.medical_specialty ,Absolute threshold of hearing ,Hearing loss ,medicine.medical_treatment ,Sensory system ,Audiogram ,Audiology ,medicine.disease ,Article ,03 medical and health sciences ,Speech and Hearing ,0302 clinical medicine ,Auditory brainstem response ,Auditory neuropathy spectrum disorder ,Sensation ,medicine ,otorhinolaryngologic diseases ,medicine.symptom ,030223 otorhinolaryngology ,Psychology ,030217 neurology & neurosurgery - Abstract
With the introduction of newborn hearing screening, infants are being diagnosed with hearing loss during the first few months of life. For infants with a sensory/neural hearing loss (SNHL), the audiogram can be estimated objectively using auditory brainstem response (ABR) testing and hearing aids prescribed accordingly. However, for infants with auditory neuropathy spectrum disorder (ANSD) due to the abnormal/absent ABR waveforms, alternative measures of auditory function are needed to assess the need for amplification and evaluate whether aided benefit has been achieved. Cortical auditory evoked potentials (CAEPs) are used to assess aided benefit in infants with hearing loss; however, there is insufficient information regarding the relationship between stimulus audibility and CAEP detection rates. It is also not clear whether CAEP detection rates differ between infants with SNHL and infants with ANSD. This study involved retrospective collection of CAEP, hearing threshold, and hearing aid gain data to investigate the relationship between stimulus audibility and CAEP detection rates. The results demonstrate that increases in stimulus audibility result in an increase in detection rate. For the same range of sensation levels, there was no difference in the detection rates between infants with SNHL and ANSD. more...
- Published
- 2016
14. Is Early Intervention Effective in Improving Spoken Language Outcomes of Children With Congenital Hearing Loss?
- Author
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Teresa Y. C. Ching
- Subjects
Male ,medicine.medical_specialty ,MEDLINE ,Audiology ,Congenital hearing loss ,Language Development ,Speech and Hearing ,Hearing Aids ,Intervention (counseling) ,Early Medical Intervention ,medicine ,Humans ,Speech ,Narrative ,Longitudinal Studies ,Cochlear implantation ,Hearing Loss ,Early language ,business.industry ,Research Forum: Intervention and Outcomes of Children With Hearing Loss ,Australia ,Cochlear Implantation ,Language development ,Treatment Outcome ,Child, Preschool ,Female ,business ,Spoken language - Abstract
Purpose The purpose of this research forum article was to present research findings on the effectiveness of early intervention for improving outcomes of children with congenital hearing loss. Method The method involved a narrative overview of recent findings from the Longitudinal Outcomes of Children with Hearing Impairment study. Results Early intervention, either in the form of amplification or cochlear implantation, was associated with higher language scores. Maternal education and communication mode used during early intervention were also significant contributors to child outcomes. Early performance predicted later language development. Conclusion Early intervention is effective in improving early language outcomes, at a population level. more...
- Published
- 2015
15. Major findings of the LOCHI study on children at 3 years of age and implications for audiological management
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Teresa Y. C. Ching and Harvey Dillon
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Hearing aid ,Male ,Linguistics and Language ,medicine.medical_specialty ,Hearing loss ,medicine.medical_treatment ,Auditory neuropathy ,Population ,Audiology ,Language Development ,Language and Linguistics ,Article ,law.invention ,Speech and Hearing ,Hearing Aids ,Auditory neuropathy spectrum disorder ,Randomized controlled trial ,law ,Early Medical Intervention ,otorhinolaryngologic diseases ,Medicine ,Humans ,Longitudinal Studies ,Medical prescription ,Prospective cohort study ,education ,Hearing Loss ,education.field_of_study ,business.industry ,Infant ,medicine.disease ,Early Diagnosis ,Prescriptions ,Treatment Outcome ,Child, Preschool ,Female ,medicine.symptom ,business - Abstract
This article describes the major findings of the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study.A population-based prospective cohort study; with randomized controlled trials of hearing aid prescription and non-linear frequency compression.451 children in New South Wales, Victoria and Southern Queensland.Significant predictors of language outcomes at 3 years of age included severity of hearing loss, gender, presence of additional disabilities, maternal education, and age at cochlear implantation. Although prescription did not have a significant effect on outcomes, its influence on loudness and hearing aid safety has implications for management. After controlling for a range of predictor variables, nonlinear frequency compression did not have a significant effect on outcomes. For the same hearing sensitivity, the presence of auditory neuropathy did not have a significant effect on outcomes.These findings form the basis for evidence-based guidelines for management of children with hearing loss. more...
- Published
- 2013
16. Introduction to the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study: background, design, sample characteristics
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Teresa Y. C. Ching, Harvey Dillon, and Greg Leigh
- Subjects
Research design ,Male ,Linguistics and Language ,medicine.medical_specialty ,Hearing loss ,Population ,MEDLINE ,Audiology ,Language and Linguistics ,Article ,Speech and Hearing ,Hearing Aids ,Neonatal Screening ,Intervention (counseling) ,Health care ,Outcome Assessment, Health Care ,medicine ,otorhinolaryngologic diseases ,Humans ,Longitudinal Studies ,Prospective Studies ,Prospective cohort study ,education ,Hearing Loss ,Randomized Controlled Trials as Topic ,education.field_of_study ,business.industry ,Infant, Newborn ,Infant ,Early Diagnosis ,Research Design ,Cohort ,Female ,Queensland ,medicine.symptom ,New South Wales ,business - Abstract
Objective: This article describes the background and the design of the longitudinal outcomes of children with hearing impairment (LOCHI) study, and the characteristics of the study cohort. Design: Children born between 2002 and 2007 who were identified with hearing loss and received audiological intervention by 3 years of age in Australia enrolled in the study. Their demographic characteristics are described. Study sample: Four hundred and fifty-one children in New South Wales, Victoria, and Southern Queensland. Results: Data on age at first hearing-aid fitting for different degrees of hearing loss are reported together with demographic characteristics of the cohort. Conclusion: A unique environment in Australia where all children with varied access to universal newborn hearing screening received the same consistent hearing services from a national hearing service provider makes it possible to investigate the effects of access to early auditory intervention on children's outcomes at a population l... more...
- Published
- 2013
17. Multilingual children with hearing loss: Factors contributing to language use at home and in early education
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Sharynne McLeod, Teresa Y. C. Ching, Kathryn Crowe, and David H. McKinnon
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Linguistics and Language ,Linguistic diversity ,Hearing loss ,Exploratory analysis ,Education environment ,Sign language ,CHAID ,Language and Linguistics ,Article ,Education ,Developmental psychology ,Speech and Hearing ,Clinical Psychology ,Mode (music) ,Developmental and Educational Psychology ,medicine ,Multilingualism ,medicine.symptom ,Psychology - Abstract
Understanding the relationship between children’s cultural and linguistic diversity and child, caregiver, and environmental characteristics is important to ensure appropriate educational expectations and provisions. As part of the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study, children’s caregivers and educators completed questionnaires on demographic characteristics, including the communication mode (oral, manual, or mixed) and languages used in home and early educational environments. This article reports an exploratory analysis to examine factors associated with language use and communication mode of children at 3 years of age. A Chi Square Automatic Interaction Detector (CHAID) analysis was performed on data from 406 children to examine factors influencing communication mode and oral language use. The factor that most influenced children’s communication mode at home was the communication mode used by their female caregiver. Children’s communication mode in their early education environment was most related to the communication mode they used at home, and then related to the presence of additional needs in the children, female caregivers’ level of education and the male caregivers’ use of languages other than English (LOTEs). A second exploratory CHAID analysis of data for children from multilingual families ( n = 106) indicated that female caregivers’ use of English at home significantly influenced whether children used a LOTE at home. Finally, the use of a LOTE at home was associated with the use of a LOTE in the early education environment. These findings serve as an initial description of the factors that were associated with the communication mode and language use of children with hearing loss. more...
- Published
- 2013
18. The Cultural and Linguistic Diversity of 3-Year-Old Children with Hearing Loss
- Author
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Sharynne McLeod, Kathryn Crowe, and Teresa Y. C. Ching
- Subjects
Early childhood education ,Male ,Hearing loss ,Population ,education.educational_degree ,Empirical Manuscript ,Sign language ,Habilitation ,Education ,Developmental psychology ,Speech and Hearing ,Sign Language ,Heritage language ,Cultural diversity ,medicine ,Humans ,Family ,Prospective Studies ,education ,Hearing Loss ,Language ,School Health Services ,education.field_of_study ,Cultural Characteristics ,Communication ,Australia ,Caregivers ,Child, Preschool ,Female ,medicine.symptom ,Psychology ,Spoken language - Abstract
Understanding the cultural and linguistic diversity of young children with hearing loss informs the provision of assessment, habilitation, and education services to both children and their families. Data describing communication mode, oral language use, and demographic characteristics were collected for 406 children with hearing loss and their caregivers when children were 3 years old. The data were from the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study, a prospective, population-based study of children with hearing loss in Australia. The majority of the 406 children used spoken English at home; however, 28 other languages also were spoken. Compared with their caregivers, the children in this study used fewer spoken languages and had higher rates of oral monolingualism. Few children used a spoken language other than English in their early education environment. One quarter of the children used sign to communicate at home and/or in their early education environment. No associations between caregiver hearing status and children’s communication mode were identified. This exploratory investigation of the communication modes and languages used by young children with hearing loss and their caregivers provides an initial examination of the cultural and linguistic diversity and heritage language attrition of this population. The findings of this study have implications for the development of resources and the provision of early education services to the families of children with hearing loss, especially where the caregivers use a language that is not the lingua franca of their country of residence. more...
- Published
- 2012
19. The NAL-NL2 Prescription Procedure
- Author
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Gitte Keidser, Scott Brewer, Teresa Y. C. Ching, Matthew Flax, and Harvey Dillon
- Subjects
Hearing aid ,Empirical data ,Computer science ,Process (engineering) ,medicine.medical_treatment ,Speech recognition ,media_common.quotation_subject ,lcsh:Otorhinolaryngology ,lcsh:RF1-547 ,Article ,hearing aids ,Loudness ,Naturalness ,Otorhinolaryngology ,Component (UML) ,prescription procedures ,medicine ,Quality (business) ,Medical prescription ,media_common - Abstract
NAL-NL2 is the second generation of prescription procedures from The National Acoustic Laboratories (NAL) for fitting wide dynamic range compression (WDRC) instruments. Like its predecessor NALNL1 (Dillon, 1999), NAL-NL2 aims at making speech intelligible and overall loudness comfortable. This aim is mainly driven by a belief that these factors are most important for hearing aid users, but is also driven by the fact that less information is available about how to adjust gain to optimise other parameters that affect prescription such as localisation, tonal quality, detection of environmental sounds, and naturalness. In both formulas, the objective is achieved by combining a speech intelligibility model and a loudness model in an adaptive computer- controlled optimisation process. Adjustments have further been made to the theoretical component of NAL-NL2 that are directed by empirical data collected during the past decade with NAL-NL1. In this paper, the data underlying NAL-NL2 and the derivation procedure are presented, and the main differences from NAL-NL1 are outlined. more...
- Published
- 2011
- Full Text
- View/download PDF
20. Binaural-Bimodal Fitting or Bilateral Implantation for Managing Severe to Profound Deafness: A Review
- Author
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Teresa Y. C. Ching, Harvey Dillon, and E. van Wanrooy
- Subjects
Sound localization ,Hearing aid ,medicine.medical_specialty ,Speech perception ,Hearing loss ,medicine.medical_treatment ,Audiology ,Severity of Illness Index ,Article ,Hearing Loss, Bilateral ,030507 speech-language pathology & audiology ,03 medical and health sciences ,Speech and Hearing ,0302 clinical medicine ,Cochlear implant ,medicine ,otorhinolaryngologic diseases ,Humans ,030223 otorhinolaryngology ,business.industry ,Cochlear Implantation ,Cochlear Implants ,Candidacy ,Speech Perception ,Implant ,medicine.symptom ,0305 other medical science ,business ,Binaural recording - Abstract
There are now many recipients of unilateral cochlear implants who have usable residual hearing in the non-implanted ear. To avoid auditory deprivation and to provide binaural hearing, a hearing aid or a second cochlear implant can be fitted to that ear. This article addresses the question of whether better binaural hearing can be achieved with binaural/bimodal fitting (combining a cochlear implant and a hearing aid in opposite ears) or bilateral implantation. In the first part of this article, the rationale for providing binaural hearing is examined. In the second part, the literature on the relative efficacy of binaural/bimodal fitting and bilateral implantation is reviewed. Most studies on comparing either mode of bilateral stimulation with unilateral implantation reported some binaural benefits in some test conditions on average but revealed that some individuals benefited, whereas others did not. There were no controlled comparisons between binaural/bimodal fitting and bilateral implantation and no evidence to support the efficacy of one mode over the other. In the third part of the article, a crossover trial of two adults who had binaural/bimodal fitting and who subsequently received a second implant is reported. The findings at 6 and 12 months after they received their second implant indicated that binaural function developed over time, and the extent of benefit depended on which abilities were assessed for the individual. In the fourth and final parts of the article, clinical issues relating to candidacy for binaural/ bimodal fitting and strategies for bimodal fitting are discussed with implications for future research. more...
- Published
- 2007
21. Prescribing Amplification for Children: Adult-Equivalent Hearing Loss, Real-Ear Aided Gain, and NAL-NL1
- Author
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Teresa Y. C. Ching and Harvey Dillon
- Subjects
medicine.medical_specialty ,Young child ,Computer science ,Hearing loss ,business.industry ,Control engineering ,Audiology ,Article ,03 medical and health sciences ,Speech and Hearing ,0302 clinical medicine ,Software ,030220 oncology & carcinogenesis ,Tube placement ,medicine ,otorhinolaryngologic diseases ,Software system ,sense organs ,medicine.symptom ,030223 otorhinolaryngology ,business ,Insertion gain - Abstract
This paper focuses on how the acoustical differences between the ear canals of adults and children affect amplification requirements and describes efficient strategies to allow for these differences when prescribing and verifying amplification. We will first summarize the problem for hearing assessment and then describe how adult-equivalent hearing loss can be calculated to circumvent this problem. Example cases demonstrate manual calculation and automatic derivation by using the NAL-NL1 software. The advantage of using real-ear aided gain prescriptions rather than real-ear insertion gain prescriptions for young children is explained. The practical benefit of deriving coupler gain targets to achieve the required real-ear aided gain by using individually measured real-ear-to-coupler differences is emphasized, together with a discussion on the practical issues relating to calibration and probe tube placement in measuring real-ear-to-coupler differences. Finally, an illustrative case exemplifies the derivation of individualized coupler gain targets by using the NAL-NL1 software system to achieve the required real-ear aided gain for a young child. more...
- Published
- 2003
22. Etiology and audiological outcomes at 3 years for 364 children in Australia.
- Author
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Hans-Henrik M Dahl, Teresa Y C Ching, Wendy Hutchison, Sanna Hou, Mark Seeto, and Jessica Sjahalam-King
- Subjects
Medicine ,Science - Abstract
Hearing loss is an etiologically heterogeneous trait with differences in the age of onset, severity and site of lesion. It is caused by a combination of genetic and/or environmental factors. A longitudinal study to examine the efficacy of early intervention for improving child outcomes is ongoing in Australia. To determine the cause of hearing loss in these children we undertook molecular testing of perinatal "Guthrie" blood spots of children whose hearing loss was either detected via newborn hearing screening or detected later in infancy. We analyzed the GJB2 and SLC26A4 genes for the presence of mutations, screened for the mitochondrial DNA (mtDNA) A1555G mutation, and screened for congenital CMV infection in DNA isolated from dried newborn blood spots. Results were obtained from 364 children. We established etiology for 60% of children. One or two known GJB2 mutations were present in 82 children. Twenty-four children had one or two known SLC26A4 mutations. GJB2 or SLC26A4 changes with unknown consequences on hearing were found in 32 children. The A1555G mutation was found in one child, and CMV infection was detected in 28 children. Auditory neuropathy spectrum disorder was confirmed in 26 children whose DNA evaluations were negative. A secondary objective was to investigate the relationship between etiology and audiological outcomes over the first 3 years of life. Regression analysis was used to investigate the relationship between hearing levels and etiology. Data analysis does not support the existence of differential effects of etiology on degree of hearing loss or on progressiveness of hearing loss. more...
- Published
- 2013
- Full Text
- View/download PDF
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