SLPCohortEar and hearing2020

Aided Hearing Moderates the Academic Outcomes of Children With Mild to Severe Hearing Loss.

J Bruce Tomblin, Jake Oleson, Sophie E Ambrose and 3 others

PMID 32032223

WHAT IT FOUND

For children with mild to severe hearing loss, hearing aids that made more speech audible were associated with a weaker link between unaided hearing loss and oral language.

Oral language then related to school skills such as reading and writing.

Key findings

01Aided speech audibility changed the association between unaided hearing and oral language: at higher aided audibility, unaided hearing loss was no longer associated with language.

02Children with moderately-severe hearing loss had poorer oral language and reading than children with normal hearing.

03Oral language was supported as a pathway linking hearing status to reading and writing.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The study was observational, so it cannot show that hearing aids caused better oral language or academic outcomes. The sample was biased toward families with higher maternal education, so the results may not apply to children from lower socioeconomic homes. Children with developmental disabilities, children who used sign language, and children with cochlear implants were excluded, so the findings do not describe those groups. Hearing aid fitting, daily use, and other early intervention services were not separated, so the contribution of any single component cannot be isolated. The number of children assessed changed across waves, with 226 children at second grade and 198 children at fourth grade. The paper describes a boundary around an aided speech intelligibility index value of 0.70, but it says this is not an ideal clinical target. Aided hearing did not significantly moderate reading, writing, or calculation directly, so the academic pathway appears to run through oral language.

Declared interests

The article lists NIH extramural research support.

The easy way to misread this

Do not conclude that hearing aids directly caused better academic outcomes. This was an observational study, and the direct moderation of aided hearing on reading, writing, and calculation was not significant.

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The study

Participants
274 children overall; 183 children with bilateral mild to severe hearing loss and 91 children with normal hearing; 226 children assessed after second grade and 198 children assessed after fourth grade.
Certainty of evidence
Low

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Cite

J Bruce Tomblin, Jake Oleson, Sophie E Ambrose, et al. Aided Hearing Moderates the Academic Outcomes of Children With Mild to Severe Hearing Loss. Ear and hearing. 2020.

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