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Functional Consequences of Poor Binaural Hearing in Development: Evidence From Children With Unilateral Hearing Loss

Claire McSweeny1, Sharon L Cushing1,2,3, Jennifer L Campos4,5

  • 1Archie's Cochlear Implant Lab, 7979Hospital for Sick Children, Toronto, Ontario, Canada.

Trends in Hearing
|October 18, 2021
PubMed

Insights

Children with poor binaural hearing, including unilateral hearing loss and bilateral cochlear implants, face significant cognitive and academic challenges. These deficits impact visuospatial memory, language, and learning, underscoring the importance of addressing hearing impairments early.

Area of Science:

  • Auditory Neuroscience
  • Developmental Psychology
  • Pediatric Audiology

Background:

  • Poor binaural hearing in children, characterized by unilateral hearing loss or bilateral cochlear implants (CIs), is hypothesized to cause cognitive and academic deficits.
  • Children with unilateral hearing loss lack binaural cues, while those with bilateral CIs may have impaired spectral and binaural processing.
  • Vestibular/balance deficits in both groups may exacerbate memory and learning challenges.

Purpose of the Study:

  • To investigate the cognitive and academic impacts of poor binaural hearing in children.
  • To compare deficits in children with unilateral hearing loss versus those with bilateral CIs.
  • To identify specific areas of cognitive and academic performance affected by impaired binaural hearing.

Main Methods:

  • Eighty-eight children (aged 9.89 ± 3.40 years) were grouped into unilateral hearing loss (n=20), bilateral CI (n=32), and typically developing (n=36).
  • Participants completed a comprehensive battery of sensory, cognitive, and academic tests.
  • Principal component analyses were used to identify patterns of deficits.

Main Results:

  • Children in both hearing loss groups demonstrated significantly poorer skills than normal-hearing peers across most tests.
  • While unilateral hearing loss showed more asymmetric speech perception, balance and language deficits were similar between the two hearing loss groups.
  • Visuospatial memory deficits were prevalent in both groups, particularly in children with unilateral hearing loss. Verbal memory remained comparable to controls.

Conclusions:

  • Poor binaural hearing in children significantly impacts cognitive development, particularly visuospatial memory, oral language, mathematics, and reading.
  • Similarities in balance and language deficits suggest a shared impact of impaired binaural processing.
  • Findings highlight the critical need for early intervention and support for children with binaural hearing impairments to mitigate developmental consequences.

Keywords:
balancebilateral cochlear implantsdeafnesslanguageshort-term memoryunilateral hearing lossverbalvestibularvisuospatialworking memory

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