Children with developmental disabilities – one in six children in the United States – are less likely to have access to a gold-standard hearing assessment in the first three months of hearing treatment, according to a recent article in Journal of Autism and Developmental Disorders reported.
Many developmental disorders, such as cerebral palsy, Down syndrome, autism, and intellectual disability, are associated with reduced hearing. This is because there are common causes and risk factors for both conditions, such as genetic predisposition, exposure to certain viruses during pregnancy, premature birth, or the need for treatment in the neonatal intensive care unit. According to Vanderbilt University Medical Center, timely diagnosis of reduced hearing and access to appropriate interventions is important to optimize developmental outcomes.
Further reading: Pediatrics, the LMH test and hearing care in hospice: An interview with Dr. Jane Madell
However, children with developmental disabilities may face a number of barriers to accessing quality health care. The current study quantifies the relative risk of children with developmental disabilities not receiving a gold standard hearing test in the first three months of hearing care.
Using electronic health records from the Audiological and Genetic Database, hearing tests of 131,783 children (0-18 years) at three hospitals in the United States between 2008 and 2018 were analyzed. The study found that children with developmental disabilities were almost four times more likely to not receive a gold standard hearing test than children in the comparison group.
“There are likely several possible factors contributing to the differences we observed. One factor we are particularly interested in is the misalignment between developmental abilities, the child’s health profile, and the requirements of hearing testing,” says lead author Dr. Angela Bonino, assistant professor of hearing and speech sciences at Vanderbilt University Medical Center.
According to Bonino, the general assumption in this field is that when behavioral test results are not available, hearing is measured using an ABR test instead. However, the study data do not support this assumption.
“There are a number of reasons why this can happen, but it is important to remember that children with developmental disabilities often have concurrent health problems that pose additional risks when using sedation. However, because the ABR requires a child to be quiet during the test, sedation is often required after about 6 months, when natural sleep is less likely,” she says.
“This work is important to ensure that all children, not just those who are developing typically, receive high-quality hearing care,” says Dr. Anne Marie Tharpe, chief of the Division of Hearing and Speech Sciences at Vanderbilt University Medical Center. “Approximately 30 to 40 percent of children with permanent hearing loss have additional disabilities, so developmentally appropriate methods of assessing their hearing are critical to their care and outcomes.”
The study results underline the need to introduce testing methods and guidelines for hearing assessment in children with developmental disorders in order to prevent negative effects on development.
“When children use hearing aids, they should have access to a hearing screening that accurately and quickly determines their hearing status regardless of their age, development or medical profile,” says Bonino.
Featured image: Dreamstime
