Developmental Profiles of Young Deaf and Hard of Hearing Children and Their Associated Predictors

Concomitant developmental disability is common in deaf and hard of hearing (DHH) children. We describe the early developmental profiles of DHH children and explore factors that may be predictive of these profiles.

We report on data from DHH children aged 0-66 months who are participants of a longitudinal child hearing databank in Victoria, Australia. Developmental profiles were measured using the Ages and Stages Questionnaire (ASQ) across five domains (communication, gross motor, fine motor, personal social and problem solving). We reported descriptive statistics and used logistic regression to estimate odds ratios and determined which characteristics were associated with below cut-off ASQ scores.

Caregivers of 882 children aged 0-66 months completed the ASQ between 2012 and 2022. A considerable proportion of children scored below their developmental expectations for age with 35% below ASQ cut-off for communication, 24% fine motor, 23% problem solving, 21% gross motor and 20% personal social. Children with a mild degree of hearing loss scored below cut-off ranging from 16% to 26% across the domains. Predictive factors for below cut-off development included admission to neonatal intensive care, extreme prematurity, infection requiring intravenous antibiotics and having more than one comorbidity for all domains. Bilateral hearing loss, cochlear implant use, jaundice requiring treatment and seizures were associated with communication delays. Cochlear implant use was a protective factor for gross motor development.

Early developmental screening is vital for DHH children, as these children have multiple developmental needs. Degree of hearing loss does not predict overall development; however, children with a mild degree of hearing loss can have developmental impairments and benefit from developmental monitoring. Early targeted intervention to support DHH children is imperative in maximizing their functional abilities and well-being.

Deaf and hard of hearing children may have additional developmental disabilities and comorbidities, and early intervention supports their development. This paper provides insights into the specific factors that influence development in young deaf and hard of hearing children drawn from a large sample of universally early-identified children. All deaf and hard of hearing children should receive developmental monitoring, including children with mild hearing loss. Developmental monitoring should target deaf and hard of hearing children who were born premature, those who received early medical interventions at birth and those with medical comorbidities.