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Children who are deaf or hard of hearing (DHH) are at higher risk of developing mental health problems. This study reports on the parent and teacher ratings of emotional and behavioural difficulties (EBD) in 5-year old DHH children. It explores the similarities and differences between informants, and the risk and protective factors associated with parent and teacher-ratings of EBD. Parents and teachers of 224 DHH children completed questionnaires on children's EBD and functional auditory behaviour. Children completed standardized assessments of non-verbal cognitive and language abilities. On average, parent- and teacher-rated EBD were 0.42 and 0.20 standard deviations higher than typically developing children. Parents reported more behavioural problems (hyperactivity and conduct), whereas teachers reported poorer prosocial behaviour. Inter-rater correlations were generally low to moderate (0.29 to 0.50). Overall, children with additional disabilities, lower non-verbal cognitive ability, and poor functional auditory behaviour were at higher risk of EBD. Language ability was only a significant predictor of teacher-rated EBD for children with hearing aids but not cochlear implants. Differences in informant-ratings emphasize the need for a multi-informant approach to get a global perspective on the psychopathology of DHH children. The findings indicate that parents may need assistance with managing behavioural problems at home, and teachers should facilitate more opportunities to practice prosocial behaviour at school. Intervention efforts should focus on facilitating good functional listening skills, as this may in turn, improve the mental health of young DHH children.

Ear infection or otitis media (OM) occurs in many Aboriginal and Torres Strait Islander children at a young age and tends to persist over a long period of time. Chronic OM is associated with conductive hearing loss that reduces a child's access to sounds. This can have a negative impact on development of listening and communication skills. Primary health and early childhood workers are best positioned to detect children with hearing and listening problems. However, they lack appropriate tools to screen and triage young children for early referral. By using a co-design approach with Aboriginal primary health workers and early childhood teachers, we have developed the Parents' Evaluation of Listening and Understanding Measure (PLUM) listening skills questionnaire. The PLUM provides a systematic framework for front-line workers to explore a parent's observations of their child's listening behaviour in everyday situations to detect hearing and listening problems in young Aboriginal children. This paper reports the development of the scale. PLUM scores for 438 children from urban, regional and remote communities in Australia were collected. The internal consistency reliability was 0.87. Normative data from 235 children with normal hearing (hearing thresholds averaged between 0.5 and 4 kHz in the better ear to be no greater than 20 dB HL) were used to define the relationship between PLUM scores and age. The functions allow performance of individual children to be related to their normal-hearing peers.

Many Aboriginal and Torres Strait Islander children are affected by chronic middle ear infection or otitis media from infancy that has a negative impact on development of listening and communication skills. Deficits in these skills are often not detected until school-age when the opportunity for early intervention is lost. Primary health and early childhood workers need screening tools to assist them with detecting the problem early, but there is a scarcity of tools. This study reports the development and validation of a screening tool for detecting communication problems in young Aboriginal and Torres Strait Islander children. The tool, called the Hearing and Talking Scale (HATS), relies on a systematic use of parent observations of communication behaviours of their children in everyday situations. Developed by using a co-design approach, the HATS is culturally and linguistically appropriate for use with parents/carers of young children by front-line workers not trained in speech-language pathology. We validated the HATS by comparing the HATS score of 68 children (46 Indigenous and 22 non-Indigenous children) with their performance in standardised assessments. The accuracy of the HATS was 80% and 81% when compared to the ASQ-TRAK and the Expressive Vocabulary Test respectively. The HATS takes 5 minutes to administer, and is easy to score and interpret. It can be used as part of a standard ear and hearing health check for young children to support early detection so that those with problems can be referred for specialist diagnosis and treatment at a young age.

To explore the factors influencing parents' choice of communication mode during early education of their child with hearing loss. Qualitative descriptive analysis of semi-structured interviews with parents of children with hearing loss. Fourteen parents of children who participated in the Longitudinal Outcomes of Children with Hearing Impairment study. 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. The results reinforced the importance of parents receiving 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. Parents also require continual support for implementation of their choices as they adjust to their children's changing communication needs. Parent 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 ongoing communication needs.

The communication journey of a child with hearing loss is often a complex, interwoven process in which the child's use of language or method of communication may change numerous times. As there has been limited research exploring the caregiver decision-making process behind making such changes, this qualitative descriptive study aimed to explore the factors which influence the caregiver decision making-process to change the communication method of their child with hearing loss. Individual semi-structured in-depth interviews were conducted with seven caregivers of children with hearing loss in Australia. Thematic analysis revealed five key themes which influenced caregiver decisions regarding changes to their child's method of communication, including: (1) family characteristics; (2) family access to information; (3) family strengths; (4) family beliefs; and (5) family-centered practice. The overall finding that the family unit is at the core of decision-making has important clinical implications regarding early intervention professionals' provision of family-centered services when working with the families of children with hearing loss.

Purpose: Telepractice administration of norm-referenced assessments of communication and cognition is relatively new, and evidence to support this practice for children with hearing loss is limited. This rapid review examines the validity, reliability, feasibility, and common features of telepractice-administered normreferenced assessments of communication and cognition for children with hearing loss to determine whether results via telepractice-administration are usable. Method: This rapid review was conducted in accordance with the Cochrane Collaboration Rapid Reviews Methods Group recommendations. Rayyan software was used for initial and full-text screening, and the Quality Assessment of Diagnostic Accuracy Studies was used to measure study quality. Results: Electronic databases searches identified two studies that met the eligibility criteria. The findings of this rapid review provide some evidence to indicate that results of norm-referenced assessments do not differ depending on test administration conditions or hearing group status. Although both studies were of sufficient quality, replicability of these studies is uncertain due to the limited description of telepractice administration procedures. Participants indicated that sound levels provided by inbuilt computer speakers were adequate for them to be able to participate in telepractice assessment. Conclusion: Telepractice administration of the norm-referenced assessments in the included studies may be valid, reliable, and feasible; however, the generalizability of these findings to other norm-referenced assessments is uncertain due to the limited amount of research. [ABSTRACT FROM AUTHOR]

Previous research has shown an association between children's development of psychosocial and motor skills. This study evaluated the development of these skills in 301 three-year-old deaf and hard of hearing children (M: 37.8 months) and considered a range of possible predictors including gender, birth weight, age at first fitting with hearing devices, hearing device used, presence of additional disabilities, severity of hearing loss, maternal education, socio-economic status (SES), language ability, and communication mode. Caregivers reported on children's development using the Child Development Inventory (CDI). On average, both psychosocial and motor development quotients were within the typical range for hearing children, with large individual differences. There was a positive correlation between language ability and both social and motor development, and also between social and motor development. Age at first fitting of hearing aids (as an indicator of age at identification of hearing loss), SES, degree of hearing loss, and maternal education were not significant predictors of social skill or motor development, whereas presence of additional disabilities and birth weight were. Girls performed better than boys on all but the Gross Motor subscale of the CDI. Children with hearing aids tended to perform better than those with cochlear implants on the Gross Motor subscale.

Universal newborn hearing screening programs have led to early identification of infants with congenital mild bilateral hearing loss (MBHL). The current lack of evidence-based protocols to guide audiological management of infants with MBHL has led to clinical equipoise about fitting of hearing aids. The purpose of this study was to increase understanding about the perspectives of paediatric audiologists on factors influencing their management of MBHLin infants and young children. A qualitative descriptive research methodology involving semi-structured interviews with audiologists. Twenty-three paediatric audiologists in diagnostic and rehabilitation settings in Victoria, Australia. Three main themes that influenced management were identified. These include: (1) evidence, or the lack of it, influences audiologists' practice; (2) audiologists recognise the need to be fluid; and (3) family characteristics and parents' perspectives. "Audiologists delivering family-centred practice" was identified as an overarching theme across these factors. Audiologists recognised the importance of adopting a family-centred approach in their management of MBHL in infants and young children. Embodied in their practice was the acknowledgement of limited evidence, the consideration of multiple child and family factors, and the incorporation of perspectives of parents and families in adopting a fluid approach to provide individualised services. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the factors influencing 5-year language, speech and everyday functioning of children with congenital hearing loss. Design: Standardised tests including PLS-4, PPVT-4 and DEAP were directly administered to children. Parent reports on language (CDI) and everyday functioning (PEACH) were collected. Regression analyses were conducted to examine the influence of a range of demographic variables on outcomes. Study sample: Participants were 339 children enrolled in the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study. Results: Children’s average receptive and expressive language scores were approximately 1 SD below the mean of typically developing children, and scores on speech production and everyday functioning were more than 1 SD below. Regression models accounted for 70-23% of variance in scores across different tests. Earlier CI switch-on and higher non-verbal ability were associated with better outcomes in most domains. Earlier HA fitting and use of oral communication were associated with better outcomes on directly administered language assessments. Severity of hearing loss and maternal education influenced outcomes of children with HAs. The presence of additional disabilities affected outcomes of children with CIs. Conclusions: The findings provide strong evidence for the benefits of early HA fitting and early CI for improving children’s outcomes. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore the perspectives of caregivers regarding the information and support they received following diagnosis of their child’s hearing loss. Design: A mixed methods explanatory sequential design was conducted. Study sample: A total of 445 caregivers of children completed a written survey, and five parents participated in qualitative in-depth interviews. Results: The most common sources of information for caregivers were discussion with an audiologist, written information, and discussion with a medical professional. Approximately 85% of caregivers reported they were satisfied with the personal/emotional support and information received from service providers. Additional comments from 91 caregivers indicated that 11% experienced a breakdown in information transfer with health professionals. Interviews conducted with five parents from three families revealed two themes which described the diagnostic period as a difficult and emotional experience for parents: (1) support and information provided during diagnosis: what happens first? and (2) accessing early intervention services following a diagnosis of hearing loss: navigating the maze. Conclusions: The findings of this study give insight into the perspectives of caregivers who have a child diagnosed with hearing loss. The importance of providing timely information and personal/emotional support to caregivers cannot be underestimated. [ABSTRACT FROM AUTHOR]

Objective: This study examined language and speech outcomes in young children with hearing loss and additional disabilities. Design: Receptive and expressive language skills and speech output accuracy were evaluated using direct assessment and caregiver report. Results were analysed first for the entire participant cohort, and then to compare results for children with hearing aids (HAs) versus cochlear implants (CIs). Study sample: A population-based cohort of 146 five-year-old children with hearing loss and additional disabilities took part. Results: Across all participants, multiple regressions showed that better language outcomes were associated with milder hearing loss, use of oral communication, higher levels of cognitive ability and maternal education, and earlier device fitting. Speech output accuracy was associated with use of oral communication only. Average outcomes were similar for children with HAs versus CIs, but their associations with demographic variables differed. For HA users, results resembled those for the whole cohort. For CI users, only use of oral communication and higher cognitive ability levels were significantly associated with better language outcomes. Conclusions: The results underscore the importance of early device fitting for children with additional disabilities. Strong conclusions cannot be drawn for CI users given the small number of participants with complete data. [ABSTRACT FROM AUTHOR]

Objective: The aims of this paper were to report on the global psychosocial functioning of 5-year-old DHH children and examine the risk and protective factors that predict outcomes. Design: A cross-sectional analysis of data collected from a prospective, population-based longitudinal study. Study sample: Parents/caregivers of 356 children completed questionnaires on psychosocial development (CDI, SDQ), functional communication (PEACH) and demographic information. Children completed standardized assessments of non-verbal cognitive ability (WNV) and language (PLS-4). Results: On average, global psychosocial functioning was within the range of typically developing children; however, variability was high and 12% of children had scores that were more than 2 SDs below the norm. Non-verbal cognitive ability, presence of additional disabilities, language and functional communication significantly predicted outcomes. In contrast, type of hearing device, severity of hearing loss and age at intervention did not. Conclusion: The global psychosocial functioning of this cohort of 5-year-old DHH children fell within the range of typically developing children. The findings suggest that spoken language ability and functional communication skills are vital for healthy psychosocial development. [ABSTRACT FROM AUTHOR]

Objective: To determine the influence of choice of prescription and other child-, family- and intervention-related factors on speech, language, and functional performance of hearing-impaired children by three years of age. Design and study sample: A randomized controlled design was implemented as part of a population-based, longitudinal study on outcomes of children with hearing impairment (LOCHI) in Australia. Two hundred and eighteen children were randomly assigned to either the NAL or the DSL prescription for first fitting of hearing aids. Their performance outcomes were evaluated. Results: Prescriptive targets were closely matched in children's hearing aids. There were no significant differences in children's language, speech production, or functional performance between prescriptions. Parents' ratings of children's device usage and loudness discomfort were not significantly different between prescription groups. Functional performance within the first year of fitting together with degree of hearing loss, presence of additional disabilities, and maternal education explained 44% of variation in language ability of children by three years of age. Conclusions: There was no significant association between choice of hearing-aid prescription and variance in children's outcomes at three years of age. In contrast, additional disability, maternal educational level, and early functional performance were significant predictive factors of children's outcomes. [ABSTRACT FROM AUTHOR]

Objectives: Carers of children with disabilities, especially primary carers, tend to have poorer labor market outcomes than carers of typically developing children. However, the extant literature has been largely silent on whether interventions for children's disabilities spill over to carers' employment outcomes, if at all. We aimed to fill this gap., Design: We analyzed data from the Longitudinal Outcomes of Children with Hearing Impairment study, which is a unique panel dataset of Australian children who are deaf or hard-of-hearing (DHH). The Longitudinal Outcomes of Children with Hearing Impairment dataset includes information about 449 DHH children. We used 3 waves covering the same children at ages 0 to 3, 5 to 7, and 8 to 10 years during 2005 and 2018. We used a panel random-effects model, the use of which was supported by the Hausman specification test to control for time-invariant individual heterogeneity., Results: We found that primary carers (typically mothers) of DHH children with cochlear implants (CI) were more likely to be employed relative to DHH children without a CI. The positive association was stronger among carers from a lower socioeconomic background., Conclusions: The association between childhood CI and carer employment may potentially be due to relaxed primary carers' time constraints to care for the child, increased self-efficacy, and reduced carer stress, enabling them to engage in other activities, including employment. Further research through large-scale, longitudinal studies is warranted to solidify the findings of this research., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)