Patti F. Martin

Health state preference scores for children with permanent childhood hearing loss: a comparative analysis of the QWB and HUI3.

PurposeThe aim of this study was to compare two preference-weighted, caregiver-reported measures of health-related quality of life for children with permanent childhood hearing loss to determine whether cost-effectiveness analysis applied to deaf and hard of hearing populations will provide similar answers based on the choice of instrument.MethodsCaregivers of 103 children in Arkansas, USA, with documented hearing loss completed the Quality of Well-Being Scale (QWB) and the Health Utilities Index Mark 3 (HUI3) to describe the health status of their children. Audiology and other clinical measures were abstracted from medical records. Mean scores were compared overall and by degree of hearing loss. Linear regression was used to correlate preference scores with a four-frequency pure-tone average, cochlear implant status, and other factors.ResultsMean preference scores for the QWB and HUI3 were similar (0.601 and 0.619, respectively) although the HUI3 demonstrated a wider range of values (−0.132 to 1.000) compared to the QWB (0.345–0.854) and was more sensitive to mild hearing loss. Both measures correlated with the pure-tone average, were negatively associated with comorbid conditions and positively associated with cochlear implant status. In the best fitting regression models, similar estimates for cochlear implant status and comorbid conditions were obtained from the two measures.ConclusionsDespite considerable differences in the HUI3 and the QWB scale, we found agreement between the two instruments at the mean, but clinically important differences across a number of measures. The two instruments are likely to yield different estimates of cost-effectiveness ratios, especially for interventions involving mild to moderate hearing loss.

Verification of Speech Spectrum Audibility for Pediatric Baha Softband Users With Craniofacial Anomalies

Objective The purpose of this study was (1) to determine benefit of the Baha Softband coupled to the Softband for infants and children with bilateral conductive hearing loss; and (2) to verify audibility of the speech spectrum for octave frequencies 500 through 4000 Hz. Design The research design for this retrospective chart study is pretest-posttest repeated measures. Setting The study was conducted in the Department of Audiology and Speech Pathology, Arkansas Childrens Hospital. Participants Twenty-five children aged 6 months to 18 years with craniofacial disorders and bilateral conductive hearing loss participated in the study. Participants were consistent, full-time unilateral Baha users with the Baha Compact bone-conduction amplifier coupled to the head via the Softband. Interventions The intervention was the Baha device coupled to the head via the Softband as a prerequisite to surgical implantation. Main Outcome Measure(s) The primary study outcome measures used aided and unaided soundfield audiometric thresholds to calculate functional gain. Audibility of the speech spectrum was verified by comparison with target aided thresholds. Results Results revealed an improvement in soundfield thresholds with Baha amplification for the four octave frequencies. Means, standard deviations, and confidence intervals for aided and unaided thresholds are reported. Percentages of thresholds meeting target levels were significant at all frequencies, exceeding the 80% criterion. Conclusions Benefit of the Baha in providing audibility of the speech spectrum for infants and children with bilateral congenital conductive hearing loss has been demonstrated, offering important and timely data supporting third-party reimbursement.

Home Visiting Programs for Families of Children who are Deaf or Hard of Hearing: A Systematic Review

Prelingual hearing loss greatly restricts a child’s language development, hindering his or her behavioral, cognitive, and social functioning. Although technology such as hearing aids and cochlear implants provide access to sound, infants and children also need habilitation to develop skills. These skills include learning to listen, or attend, to process language (whether visual or spoken), and to produce language and communicate. Home visiting is widely recognized as a cost-effective intervention service delivery model. Home visiting programs for promoting language development in children who are diagnosed as deaf or hard of hearing have been in existence for over 50 years, yet there is limited evidence of their effectiveness. This review was undertaken to assess the evidence of effectiveness of home visiting in children with prelingual hearing loss. While many studies have examined early intervention for children who are deaf or hard of hearing, few are published from specific home visiting programs meeting the criteria for inclusion in this review. Studies from specific home visiting program models designed to meet the needs of the target population are needed to examine the effectiveness of promoting language development within the context of a home visiting program for children who are deaf or hard of hearing and their families.

Universal Pediatric Hearing Screening

Educational objectives: To understand the use of OAEs in pediatric otolaryngology and to establish an OAE-based universal hearing screening program at local hospitals.