Carew Peter, Shepherd Daisy A, Smith Libby, Howell Tegan, Lin Michelle, Bavin Edith L, Reilly Sheena, Wake Melissa, Sung Valerie
Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC 3052, Australia.
Department of Audiology and Speech Pathology, The University of Melbourne, Parkville, VIC 3010, Australia.
Children (Basel). 2023 Jul 14;10(7):1223. doi: 10.3390/children10071223.
Through a cross-sectional community study of 2044 children aged 2 years, we (1) examine the impact of hearing loss on early spoken expressive vocabulary outcomes and (2) investigate how early intervention-related factors impact expressive vocabulary outcomes in children with hearing loss predominantly identified through universal newborn hearing screening. We used validated parent/caregiver-reported checklists from two longitudinal cohorts (302 children with unilateral or bilateral hearing loss, 1742 children without hearing loss) representing the same population in Victoria, Australia. The impact of hearing loss and amplification-related factors on vocabulary was estimated using g-computation and multivariable linear regression. Children with versus without hearing loss had poorer expressive vocabulary scores, with mean scores for bilateral loss 0.5 (mild loss) to 0.9 (profound loss) standard deviations lower and for unilateral loss marginally (0.1 to 0.3 standard deviations) lower. For children with hearing loss, early intervention and amplification by 3 months, rather than by 6 months or older, resulted in higher expressive vocabulary scores. Children with hearing loss demonstrated delayed spoken expressive vocabulary despite whole-state systems of early detection and intervention. Our findings align with calls to achieve a 1-2-3 month timeline for early hearing detection and intervention benchmarks for screening, identification, and intervention.
通过对2044名2岁儿童进行的横断面社区研究，我们（1）研究听力损失对早期口语表达词汇量结果的影响，以及（2）调查早期干预相关因素如何影响主要通过新生儿听力普遍筛查确定的听力损失儿童的表达词汇量结果。我们使用了来自澳大利亚维多利亚州同一人群的两个纵向队列（302名单侧或双侧听力损失儿童，1742名无听力损失儿童）中经过验证的家长/照顾者报告清单。使用g计算和多变量线性回归估计听力损失和放大相关因素对词汇量的影响。有听力损失的儿童与无听力损失的儿童相比，表达词汇量得分更低，双侧听力损失的平均得分低0.5（轻度损失）至0.9（重度损失）个标准差，单侧听力损失的平均得分略低（0.1至0.3个标准差）。对于有听力损失的儿童，在3个月而非6个月或更晚进行早期干预和听力放大，会带来更高的表达词汇量得分。尽管有全州范围的早期检测和干预系统，但有听力损失的儿童口语表达词汇仍出现延迟。我们的研究结果与呼吁实现1-2-3个月的早期听力检测和干预基准时间线（用于筛查、识别和干预）一致。
