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Updated: May 23, 2025

Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
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Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages

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Speech Delay and Hearing Rehabilitation Disparities in Children With Hearing Loss

Lacey C Magee1, Malek Bouzaher1, Mihika Thapliyal2

  • 1Department of Otolaryngology-Head and Neck Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|March 7, 2025
PubMed

Insights

Children with private insurance and white children with bilateral hearing loss (HL) received more hearing rehabilitation and had fewer speech delays. These findings highlight disparities in care for pediatric HL.

Area of Science:

  • Pediatric audiology
  • Health services research
  • Health equity

Background:

  • Bilateral hearing loss (HL) affects children's speech development.
  • Access to hearing rehabilitation varies among pediatric populations.
  • Racial and socioeconomic factors may influence healthcare access and outcomes.

Purpose of the Study:

  • To examine how race and insurance type impact speech delay rates in children with bilateral HL.
  • To investigate disparities in access to hearing rehabilitation (cochlear implants and hearing aids) based on race and insurance.

Main Methods:

  • Retrospective cross-sectional study using the Pediatric Health Information System (PHIS) database.
  • Included 18,422 pediatric patients with bilateral HL treated at 52 US tertiary care hospitals.
  • Analyzed demographics, insurance type, cochlear implant/hearing aid use, and speech delay diagnoses.

Main Results:

  • Patients with private insurance were more likely to be white, receive cochlear implants (CIs) or hearing aids (HAs), and less likely to have speech delays compared to publicly insured patients.
  • White patients were more likely to receive CIs/HAs and less likely to have speech delays than non-white patients.
  • These associations persisted after adjusting for other variables.

Conclusions:

  • Significant disparities exist in hearing rehabilitation access and speech delay rates among children with bilateral HL based on race and insurance type.
  • Population-level data reveal inequities that warrant policy interventions.
  • Addressing these disparities is crucial for ensuring equitable care for all children with pediatric HL.
Abstract

Keywords:
cochlear implanthearing aidhearing health care servicesinsurance statuspediatric hearing loss

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