Related Experiment Video
Updated: Jul 12, 2026
Neuro-rehabilitation Approach for Sudden Sensorineural Hearing Loss
Published on: January 25, 2016
Factors associated with delayed referral and hearing rehabilitation for congenital sensorineural hearing loss
Marc Drake1, David R Friedland1, Bushra Hamad1
1Medical College of Wisconsin, Department of Otolaryngology and Communication Sciences, United States.
Insights
Social determinants like insurance and race significantly impact referral and intervention timelines for congenital hearing loss. Premature infants and publicly insured children face delays in hearing aid fitting and cochlear implant referrals.
Area of Science:
- Pediatrics
- Audiology
- Public Health
Background:
- Congenital sensorineural hearing loss (CSNHL) affects numerous children globally.
- Early identification and intervention are crucial for optimal developmental outcomes.
- Social determinants of health (SDOH) and clinical factors may influence access to timely care.
Purpose of the Study:
- To investigate the impact of SDOH and clinical status on referral and intervention for CSNHL.
- To analyze disparities in the timing of hearing rehabilitation and amplification.
- To examine factors affecting cochlear implant candidacy and outcomes.
Main Methods:
- Retrospective chart review of 216 children with CSNHL (2013-2021).
- Data collected on demographics (gestational age, race, insurance), hearing loss severity, and CMV status.
- Analysis of referral rates, evaluation timing, and amplification/implantation timelines.
Main Results:
- Delayed hearing aid referral/fitting observed in premature and publicly insured children.
- Non-white and publicly insured patients experienced delays in hearing aid fitting.
- White patients were more likely referred for cochlear implants; privately insured and CMV+ patients had faster cochlear implant pathways.
- Non-white patients faced delays in cochlear implant referral, and privately insured patients had longer intervals from evaluation to implantation.
Conclusions:
- Sociodemographic factors significantly influence hearing amplification referral and timing for CSNHL.
- Insurance type and CMV status are key factors in cochlear implant pathway progression.
- Addressing SDOH is critical to reduce disparities in hearing loss intervention.
Objectives:
To identify the impact of social determinants of health and clinical status on referral and intervention for congenital sensorineural hearing loss.
Study Design:
Retrospective chart review of children with confirmed sensorineural or mixed hearing loss between 2013 and 2021 at a single academic medical institution.
Methods:
Referral rates and timing for hearing rehabilitation, rates and timing of completed evaluation, and rate and timing of amplification were recorded. Patient demographics included gestational age, race, ethnicity, sex, hearing loss severity, and CMV status.
Results:
There were 216 children with confirmed sensorineural or mixed hearing loss, of which 77 had a unilateral hearing loss and 89 a severe or profound hearing loss. Delayed referral for hearing aid evaluation was noted in premature patients (median 375 days premature, median 147 term; p < 0.01) and publicly insured patients (median 215 days, median 123 private; p = 0.04). Delayed time to hearing aid fitting was noted for non-white patients (median 325 days, median 203 white patients; p < 0.01), publicly insured patients (median 309 days, median 212 private insurance; p < 0.02), and premature patients (median 462 days, median 224 term; p = 0.03). White patients were more likely to be referred for cochlear implant (p = 0.03).Privately insured patients and patients with a positive CMV test were more likely to be referred for cochlear implant evaluation, be seen in the cochlear implant clinic, and undergo implantation (p < 0.05). Non-white patients had a delay in cochlear implantation referral (median 928 days, median 398 days white patients; p = 0.05). Prolonged interval between evaluation in cochlear implant clinic to implantation was noted for privately insured patients (median 125 days; median 78 days publicly insured; p = 0.05).
Conclusions:
Sociodemographic factors were significantly associated with hearing amplification referral rates and time until amplification for children with identified congenital sensorineural hearing loss. For cochlear implantation, insurance type, CMV status were significantly associated with rate and timing of cochlear implant pathway.
More Related Videos
14:05Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
Published on: January 23, 2017
06:04Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
