Medical risk factors associated with listening difficulties in children

To facilitate early detection and intervention for listening difficulties (LiD), we examined whether four objective medical risk factors found in infants and toddlers would be associated with later LiD.

Prospective, case-control study. Children (6-13 years old) with normal audiograms grouped into LiD (n = 68) and typically developing (n = 84) based on caregiver report. All were native English users. Testing included comprehensive audiometry, speech perception, and cognitive function. Caregiver reports, medical records, and testing ascertained risk of prematurity, head injury, otitis media and extended high frequency (EHF) hearing loss. Logistic regression, chi-square, correlation, and odds ratios determined associations of LiD with risk factors.

Prevalence and risk of prematurity (18%, OR 3.39 [95% CI, 1.1-10.2]), head injury (21%, 3.37 [1.2-9.3]), and EHF hearing loss (32%, 2.42 [1.1-5.5]) were significantly greater for children with LiD than typically developing children. Ventilation tubes were no more common in the LiD group. EHF loss was associated with both prematurity and tubes. Prematurity, tubes, and EHF loss were significantly related to poorer competing speech perception and dichotic listening.

Children with a history of prematurity, head injury or EHF loss are at increased risk of LiD, a neurodevelopmental disorder associated with learning and communication problems.