Identifying reduced hearing in children who have developmental disabilities: Insights for inclusive research
Angela Yarnell Bonino1,2, Deborah Mood3
1Department of Speech, Language, and Hearing Sciences, University of Colorado Boulder, Boulder, CO, United States.
Insights
Identifying reduced hearing in children with developmental disabilities is challenging due to data limitations. Standardized methods are needed for accurate pediatric hearing health assessments in big data research.
Area of Science:
- Pediatric audiology
- Big data analytics in healthcare
- Developmental disabilities research
Background:
- Advancements in big data analytics and clinical data repositories offer opportunities to study pediatric hearing health.
- Accurate identification of reduced hearing is crucial for clinical management in children, especially those with developmental disabilities.
- Current methods for determining hearing status in large datasets need evaluation for this population.
Purpose of the Study:
- To compare five distinct methods for identifying reduced hearing using pure-tone thresholds.
- To assess these methods in the context of children's developmental disability status.
- To inform best practices for analyzing pediatric hearing data in large-scale electronic health records.
Main Methods:
- Retrospective analysis of 226,580 encounters from 100,960 children (0-18 years) across three clinical sites.
- Inclusion of children with diagnoses of intellectual disability, autism spectrum disorder, Down syndrome, or cerebral palsy (9% of cohort).
- Comparison of five pure-tone threshold-based methods for classifying hearing status.
Main Results:
- Encounters involving children with developmental disabilities were more likely to have insufficient data for hearing status determination.
- Methods requiring more data (e.g., multiple thresholds) yielded fewer classifiable encounters.
- Children with developmental disabilities were identified with reduced hearing at older ages compared to controls, despite more stable hearing loss patterns.
Conclusions:
- Guidance is provided for researchers on determining hearing status in children within big data applications using electronic health records.
- Significant assessment disparities highlight the need for further investigation into pediatric hearing healthcare for children with developmental disabilities.
- The study underscores the challenges and importance of reliable hearing status determination in this vulnerable population.
Introduction:
Recent advancements in big data analytics and the formation of large-scale clinical data repositories provide a unique opportunity to determine the current state of pediatric hearing health care for children who have developmental disabilities. Before answering unresolved questions about diagnostic practice, it is paramount to determine a standard and reliable method for identifying children who have reduced hearing because clinical management is affected by hearing status. The purpose of this study was to compare 5 different methods for identifying cases of reduced hearing from pure-tone thresholds based on developmental disability status.
Methods:
Using retrospective clinical data from 100,960 children (0-18 years), hearing status was determined for a total of 226,580 encounters from three clinical sites. 9% of the children had a diagnosis of intellectual disability, autism spectrum disorder, Down syndrome, or cerebral palsy.
Results:
Results revealed that encounters from children who have developmental disabilities were more likely to have insufficient data to allow hearing status to be determined. Moreover, methods with higher data demands (i.e., number of thresholds and ear-specific thresholds) resulted in fewer classifiable encounters. The average child age when hearing status was classified for the first time was older for children who have developmental disabilities than for children in the comparison group. Allowing thresholds to build up over multiple test sessions did result in more children who have developmental disabilities being classified than for single-encounter methods, but a meaningful decrease in child age at the time of classification was not seen for this strategy. Compared to the comparison group, children who have developmental disabilities were more likely to have reduced hearing that was stable over time, yet their hearing status was determined at older ages.
Discussion:
Results provide key guidance to researchers for how to determine hearing status in children for big data applications using electronic health records. Furthermore, several assessment disparities are spotlighted for children who have developmental disabilities that warrant further investigation.
