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父母关于轻度双侧或单侧听力损失儿童使用助听器情况的报告

Parent Report of Amplification Use in Children with Mild Bilateral or Unilateral Hearing Loss.

作者信息

Fitzpatrick Elizabeth M, Gaboury Isabelle, Durieux-Smith Andrée, Coyle Doug, Whittingham JoAnne, Salamatmanesh Mina, Lee Rachel, Fitzpatrick Jessica

机构信息

Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.

Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.

出版信息

J Am Acad Audiol. 2019 Feb;30(2):93-102. doi: 10.3766/jaaa.17020. Epub 2018 Jan 15.

Abstract

BACKGROUND

Amplification is considered to be one of the most important interventions for children with hearing loss. However, achieving consistent use of hearing technology in young children is an important problem, particularly when hearing loss is of mild degree. Little information is available about amplification use specifically for children with mild bilateral or unilateral hearing loss when such losses are targeted and identified early because of the availability of newborn hearing screening.

PURPOSE

We examined amplification use in a contemporary cohort of early-identified children with mild bilateral and unilateral hearing loss.

RESEARCH DESIGN

As part of the Mild and Unilateral Hearing Loss in Children Study, we collected parent reports on their child's use of amplification during the preschool years.

STUDY SAMPLE

A total of 69 children (38 unilateral and 31 bilateral mild) enrolled in the study from 2010 to 2015. Children entered the study at various ages between 12 and 36 mo of age and were followed up to age 48 mo. The median age of the children at enrollment was 16.5 mo (interquartile range [IQR] = 9.5, 26.8). Hearing loss was confirmed in these children at a median age of 3.6 mo (IQR = 2.4, 5.7).

DATA COLLECTION AND ANALYSIS

Baseline characteristics related to the child and family were collected through an intake form at study enrollment. Data on amplification fitting and use were collected via parent questionnaires at each assessment interval. Information from parent questionnaires was summarized descriptively and amplification use was grouped into categories. Through logistic regression, we examined the relationship between amplification use and laterality of hearing loss, sex, and maternal education.

RESULTS

Amplification was recommended for 59 (85.5%) children at a median age of 6.5 mo (IQR = 3.6, 21.2) and children were fitted at a median age of 10.9 mo (IQR = 6.0, 22.1). Based on parent report, hearing aid use was consistent for 39 (66.1%) of 59 children who had amplification recommended. Parent questionnaires showed very little change in use for most of the children over the study period. More children with bilateral hearing loss used their amplification consistently than those with unilateral hearing loss. After adjusting for maternal education and sex of the child, the odds for consistent use in children with mild bilateral loss was almost seven times higher (odds ratio = 6.75; 95% confidence interval = 1.84, 24.8) than for those with unilateral loss.

CONCLUSIONS

Although 85.5% of children with mild bilateral or unilateral hearing loss received amplification recommendations, only two-thirds achieved consistent use by age 3-4 yr based on parent report. Children with mild bilateral loss were more likely to use amplification during the preschool years than those with unilateral loss.

摘要

背景

放大助听被认为是对听力损失儿童最重要的干预措施之一。然而,让幼儿持续使用听力技术是一个重要问题,尤其是在听力损失为轻度的情况下。由于新生儿听力筛查的普及,对于早期发现并确诊的轻度双侧或单侧听力损失儿童,关于其放大助听使用情况的信息很少。

目的

我们研究了当代一组早期确诊的轻度双侧和单侧听力损失儿童的放大助听使用情况。

研究设计

作为儿童轻度和单侧听力损失研究的一部分,我们收集了家长关于其孩子在学龄前使用放大助听情况的报告。

研究样本

2010年至2015年共有69名儿童(38名单侧,31名双侧轻度)参与了该研究。儿童在12至36个月龄之间的不同年龄进入研究,并随访至48个月龄。入组儿童的中位年龄为16.5个月(四分位间距[IQR]=9.5,26.8)。这些儿童在中位年龄3.6个月(IQR=2.4,5.7)时被确诊为听力损失。

数据收集与分析

通过研究入组时的一份登记表收集与儿童及其家庭相关的基线特征。在每个评估间隔通过家长问卷收集关于放大助听适配和使用的数据。对家长问卷中的信息进行描述性总结,并将放大助听使用情况分类。通过逻辑回归分析,我们研究了放大助听使用与听力损失的侧别、性别和母亲教育程度之间的关系。

结果

59名(85.5%)儿童在中位年龄6.5个月(IQR=3.6,21.2)时被建议使用放大助听,儿童佩戴放大助听的中位年龄为10.9个月(IQR=6.0,22.1)。根据家长报告,在59名被建议使用放大助听的儿童中,39名(66.1%)持续使用了助听器。家长问卷显示,在研究期间,大多数儿童的使用情况变化很小。双侧听力损失的儿童比单侧听力损失的儿童更持续地使用放大助听。在调整了母亲教育程度和儿童性别后,轻度双侧听力损失儿童持续使用放大助听的几率几乎是单侧听力损失儿童的7倍(优势比=6.75;95%置信区间=1.84,24.8)。

结论

虽然85.5%的轻度双侧或单侧听力损失儿童收到了放大助听建议,但根据家长报告,到3 - 4岁时只有三分之二的儿童持续使用。学龄前,轻度双侧听力损失的儿童比单侧听力损失的儿童更有可能使用放大助听。

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