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Published on: March 24, 2023
The Effect of Universal Newborn Hearing Screening on Spoken Language after Cochlear Implantation
Ida Amir1, Ben J Thomson1, Jenny Herrod1
1Department of ORL, Christchurch Public Hospital, Christchurch, New Zealand.
Insights
Universal newborn hearing screening (UNHS) enables earlier cochlear implant (CI) referrals and surgeries for children with prelingual deafness. Early identification and intervention through UNHS significantly improve language development outcomes in children receiving CIs.
Area of Science:
- Audiology
- Pediatric Medicine
- Speech-Language Pathology
Background:
- Universal Newborn Hearing Screening (UNHS) implemented in New Zealand by 2010.
- UNHS aims to improve outcomes for children with prelingual deafness.
- Previous audit showed UNHS reduced time to cochlear implant (CI) referral and surgery.
Purpose of the Study:
- Evaluate the relationship between earlier CI and language development.
- Assess time to achieve age-appropriate language post-CI.
- Determine the effect of socioeconomic status on language skills.
Main Methods:
- Retrospective cohort study comparing children before and after UNHS implementation.
- Language outcomes assessed using Preschool Language Scale and Peabody Picture Vocabulary Test (Global Language Scores - GLS).
- Socioeconomic status categorized using New Zealand Index of Deprivation (NZDep).
Main Results:
- Post-UNHS group received CI significantly earlier (7 vs. 20 months for referral, 13 vs. 24.7 months for surgery).
- Higher GLS observed in the post-UNHS group at 2, 3, and 4 years post-implantation.
- Significant linear decrease in GLS with increasing age at CI; no correlation found between NZDep and GLS.
Conclusions:
- UNHS facilitates earlier diagnosis and intervention for hearing loss.
- Children identified via UNHS achieve age-appropriate spoken language sooner after CI.
- Earlier CI implantation is linked to better language outcomes.
Background:
The universal newborn hearing screening (UNHS) was fully implemented across New Zealand by 2010 to improve outcomes for children with prelingual deafness. A previous audit undertaken by our center, the Southern Cochlear Implant Programme (SCIP), demonstrated that UNHS has significantly reduced the time to referral and surgery for cochlear implants in these children.
Aims:
This study aims to evaluate the relationship between earlier implantation and language development, the time taken to achieve age-appropriate language, and the effect of socioeconomic status on language skills.
Methods:
This is a retrospective cohort study comparing prelingual children with severe to profound bilateral hearing loss who underwent cochlear implantation in SCIP before and after the introduction of the UNHS. The language outcomes were assessed using the Preschool Language Scale and/or the Peabody Picture Vocabulary Test. For the purpose of our study, the standard scores of these tests were expressed as global language scores (GLS). GLSs between 85 and 115 are considered within normal range for age. The socioeconomic status was categorized based on the New Zealand Index of Deprivation (NZDep).
Results:
Children in the post-UNHS group (46/95 children) were referred to SCIP and received CI at a significantly earlier age (mean = 7 vs 20 mo, p = 8.95E-10, and mean = 13 vs. 24.7 mo, p = 1.43E-07). At 2 years postimplantation, the GLS was significantly higher in the post-UNHS group (mean scores = 93.3 vs. 79.1, p = 0.0213). The scores remained statistically higher in the post-UNHS group when assessed at 3 and 4 years postimplantation. At 2, 3, and 4 years postimplantation, there is a significant linear decrease in GLS with increasing age at cochlear implantation. We found no correlation between NZDep and GLS.
Conclusion:
Children identified through UNHS have the advantage of earlier diagnosis, earlier hearing intervention, and longer duration with the implants, and they can achieve age-appropriate spoken language after 2 years of implantation.
