Association of Access Challenges and Family Support With Language Development for Children With Hearing Loss

Area of Science:

• Pediatric Audiology
• Developmental Pediatrics
• Speech-Language Pathology

Background:

• Children with hearing loss face higher risks of language delays.
• Access to specialized care can influence language development.
• The specific impact of access challenges on language disparities needs further investigation.

Purpose of the Study:

• To examine the relationship between access challenges, quantified by the Access Challenge Index (ACI), and the initial language abilities of young children with hearing loss.
• To identify specific factors contributing to access challenges that may affect language outcomes.

Main Methods:

• Analysis of baseline data from 182 children (0-27 months) with bilateral hearing loss across four children's hospitals.
• Language performance assessed using the Preschool Language Scales (PLS) and Receptive-Expressive Emergent Language Scale (REEL).
• Statistical analysis, including inverse probability weighting, to correlate Access Challenge Index (ACI) scores with language outcomes.

Main Results:

• Higher ACI scores were significantly associated with poorer total language scores on both PLS and REEL.
• The Family Support subscale of the ACI was a strong predictor of worse language outcomes for both assessment tools.
• The study included a diverse cohort, with a majority from lower-income backgrounds and a significant proportion using a language other than English at home.

Conclusions:

• Family support is a critical, modifiable factor contributing to language disparities in children with hearing loss.
• Targeted interventions aimed at bolstering family support systems show promise for enhancing language development in this population.
• Addressing access challenges, especially those related to family support, is crucial for improving language outcomes.