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Hearing difficulties in children with special health care needs
Shirley A Russ1, Mary K Kenney, Michael D Kogan
1*UCLA Center for Healthier Children, Families and Communities, David Geffen School of Medicine, UCLA, Los Angeles, CA; †U.S Department of Health and Human Services, Health Resources and Services, Administration, Maternal and Child Health Bureau, Washington, DC.
Insights
Children with special health care needs (CSHCN) and hearing difficulties often have sensory/developmental comorbidities. These increase the risk of social, communication, and learning challenges, requiring integrated care.
Area of Science:
- Pediatric Health
- Audiology
- Developmental Pediatrics
Background:
- Children with special health care needs (CSHCN) represent a vulnerable population with complex health profiles.
- Hearing difficulties are a significant concern within this group, impacting overall development and well-being.
Purpose of the Study:
- To characterize CSHCN with hearing difficulties.
- To examine hearing aid utilization patterns.
- To investigate the prevalence of comorbidities and their impact on social, communication, and functional outcomes.
Main Methods:
- Analysis of cross-sectional data from 40,723 children (birth to 17 years) from the 2005-2006 National Survey of Children with Special Health Care Needs.
- Inclusion of 1,982 children (5%) with parent-reported hearing difficulties.
- Bivariate and multivariable analyses to identify factors associated with hearing aid use and functional outcomes.
Main Results:
- Only 20% of CSHCN with hearing difficulties used hearing aids; use increased with age, non-English primary language, and lower income.
- Over half of aided children still experienced hearing difficulties.
- CSHCN with hearing difficulties and sensory/developmental comorbidities showed significantly higher odds of learning, communication, social-emotional, and behavioral difficulties compared to those with only one condition or neither.
Conclusions:
- Sensory/developmental comorbidities are prevalent in CSHCN with hearing difficulties.
- These comorbidities are strongly associated with poorer social, communication, and educational functioning.
- Healthcare services for CSHCN need to comprehensively address hearing impairments, comorbidities, and associated functional deficits to improve outcomes.
Objective:
To determine characteristics of children with special health care needs (CSHCN) with hearing difficulties including patterns of hearing aid use, comorbidity, and social and communication function.
Methods:
Bivariate and multivariable analysis of cross-sectional data on 40,723 children aged from birth to 17 years from the 2005-2006 National Survey of Children with Special Health Care Needs, including 1,982 (5%) with parent-reported hearing difficulties.
Results:
Among CSHCN, 383 (1%) used hearing aids, representing 20% of those with reported hearing difficulties. Odds of hearing aid use increased with age, primary language other than English, and lower income. More than half (58%) of the aided children reported hearing difficulties even with their aid. Among CSHCN with cerebral palsy, 13% had reported hearing difficulties and 3% used hearing aids. Equivalent figures for children with Down syndrome were 24% and 4%, mental retardation/developmental delay 12% and 5%, and autism spectrum disorder 9% and 2%. Overall, two-thirds of CSHCN with hearing difficulties had one or more sensory/developmental comorbidities; CSHCN with both hearing difficulties and a sensory/developmental comorbidity had highest odds of learning difficulties, speaking/communication difficulties, feeling anxious/depressed, acting out/bullying, and difficulty making friends. CSHCN with hearing difficulties alone, or sensory/developmental conditions alone had intermediate odds, after socio-demographic adjustment.
Conclusions:
Sensory/developmental comorbidities are common among CSHCN with hearing difficulties, and they are associated with higher odds of poorer social, communication, and educational function. Services for CSHCN must be equipped to address a range of hearing difficulties as well as sensory/developmental comorbidities and to improve social/emotional functioning as well as learning and communication.
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