Rethinking the Accessibility of Hearing Assessments for Children with Developmental Disabilities.
Angela Yarnell Bonino, Deborah Mood, Mary S Dietrich
PMID 39023803WHAT IT FOUND
Children with developmental disabilities were nearly four times more likely than peers to miss gold-standard hearing assessments within three months.
This gap was widest for those with cerebral palsy or multiple diagnoses, leaving many children undiagnosed and unable to access hearing technology or early intervention.
Key findings
01Children with any developmental disability had a 24.4% rate of not accessing an audiogram or ABR within 3 months, compared to 9.3% for the comparison group (RR = 3.79).
02The risk of missing assessment was highest for children with two or more diagnoses (33.2%, RR = 13.24) and for those with cerebral palsy (37.8%, RR = 9.87).
03Among children who did eventually receive testing, those with cerebral palsy (50.6%) and Down syndrome (45.8%) had significantly higher rates of reduced hearing than the comparison group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study used retrospective electronic health records, which are prone to data entry errors and missing information. It is impossible to know if an assessment was attempted but failed to produce usable thresholds, or if it was never attempted. The definition of developmental disability was narrow (ASD, CP, DS, ID), so other children with disabilities were included in the comparison group, potentially underestimating the disparity. Results are from three large academic hospitals with specialized teams, so they may not reflect care in community settings. The study did not determine why children missed assessments, only that they did.
Declared interests
The study was funded by the National Institute on Deafness and Other Communication Disorders. No other conflicts of interest are reported in the provided text.
The easy way to misread this
Do not assume that a child with a developmental disability has had their hearing assessed. Nearly one in four children with these diagnoses did not receive a gold-standard hearing test within three months, and many remained undiagnosed for at least a year. A missing hearing evaluation is a common finding, not an exception.
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