Unilateral Hearing Loss in Children

儿童单侧听力损失

• 批准号: 7338315
• 负责人: JUDITH Eunkyung Cho LIEU
• 金额: $ 18.03万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-01-24 至 2009-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7338315
• 关键词: Academic achievement; Achievement; Audiometry; Behavior assessment; Behavioral; Case-Control Studies; Child; Clinical; Condition; Control Groups; Data; Drops; Ear; Educational Status; Goals; Hearing; Individual; Intervention; Interview; Knowledge; Language; Lead; Measures; Medical; Newborn Infant; Noise; Outcome; Outcome Measure; Parents; Patients; Performance; Prevalence; Problem behavior; Protocols documentation; Rate; Records; Recruitment Activity; Research; Research Personnel; Risk; Risk Factors; School-Age Population; Schools; Score; Screening procedure; Siblings; Signal Transduction; Speech; Standards of Weights and Measures; Students; Subgroup; Tail; Testing; Thinking; Time; Unilateral Hearing Loss; case control; cognitive control; hearing impairment; improved; peer; performance tests; programs; skills; socioeconomics

DESCRIPTION (provided by applicant): Unilateral hearing loss (UHL) in school-aged children has an estimated prevalence of 1/1000 to over 5%. The prevalence of UHL in newborns is estimated to be 0.4/1000 to 3.4%. In the past, UHL was thought to have little consequence because speech and language presumably developed appropriately with one normally hearing ear. Unless they have medical problems that lead to an early hearing screen or audiogram, children with UHL are often undetected until they enter school and undergo hearing screenings. Earlier studies have suggested that a significantly increased proportion (22-59%) of children with UHL may have educational and/or behavioral problems, compared to their normally hearing peers. Limited data exists about the effect of UHL on acquisition of speech and language skills. Similarly, little is known about which children with UHL might benefit from intervention or amplification to avoid academic delay, or whether children who have early difficulties in school "catch up." The broad, long-term objective of this research is to increase the knowledge about UHL in children. The specific aims of this present study are: 1) Determine the rate of educational risk in children with UHL as compared to a control group of siblings with normal hearing, using a standardized achievement assessment; 2) Determine whether educational performance or behavioral problems increase or decrease in children with UHL over time; and 3) Determine whether performance on speech-in-noise tests predicts academic achievement in children with UHL. Our primary hypothesis is that children with UHL have a 30% rate of educational risk compared with an expected 16% rate of educational risk in children with normal hearing. We defined educational risk as performance on standardized achievement tests that is 1.0 standard deviation or more below the mean. Our secondary hypotheses are: 1) Children with UHL who are at educational risk do not improve their performance in school over time; and 2) Poor performance on speech-in-noise tests is a significant risk factor for poor academic achievement in children with UHL. This study proposes a case-control study comparing children who have UHL with control siblings on standardized measures of educational and behavioral risk, using a standardized achievement assessment (WIAT-II-A) as the primary outcome measure. Assuming a 10% drop out rate, a one-tailed alpha level of 0.05 and beta level of 0.20 for 80% power, 126 subjects for each group will be recruited. Secondary outcomes will include repeating one or more grades, requiring additional educational assistance, and behavioral problems. A subgroup of children with UHL will be followed over 3 years to obtain longitudinal data about changes in achievement trajectory and behavioral problems. Speech-in-noise test performance will be obtained through an audiologic protocol developed for this study. Bivariate and multivariable analyses will be used to determine which socioeconomic, clinical or patient factors are independently associated with our outcomes. The results from this study will enlighten the epidemiologic and clinical impact UHL has on a student's educational achievement.

描述（由申请人提供）：学龄儿童单侧听力损失 (UHL) 的患病率估计为 1/1000 至 5% 以上。新生儿 UHL 的患病率估计为 0.4/1000 至 3.4%。过去，UHL 被认为影响不大，因为言语和语言可能是用一只听力正常的耳朵适当发展的。除非他们有导致早期听力筛查或听力图的健康问题，否则患有 UHL 的儿童通常在进入学校并接受听力筛查之前不会被发现。早期研究表明，与听力正常的同龄人相比，患有 UHL 的儿童可能存在教育和/或行为问题的比例显着增加（22-59%）。关于 UHL 对言语和语言技能习得影响的数据有限。同样，对于哪些患有 UHL 的儿童可能会受益于干预或放大以避免学业延迟，或者早期在学校遇到困难的儿童是否能“赶上”，人们也知之甚少。这项研究的广泛、长期目标是增加儿童对 UHL 的了解。本研究的具体目的是： 1) 使用标准化成绩评估，确定 UHL 儿童与听力正常兄弟姐妹的对照组相比的教育风险率； 2) 确定 UHL 儿童的教育表现或行为问题是否随着时间的推移而增加或减少； 3) 确定噪声中言语测试的表现是否可以预测 UHL 儿童的学业成绩。我们的主要假设是，患有 UHL 的儿童的教育风险率为 30%，而听力正常的儿童的教育风险率为 16%。我们将教育风险定义为标准化成绩测试中的表现低于平均值 1.0 个标准差或更多。我们的次要假设是：1）处于教育风险中的 UHL 儿童不会随着时间的推移提高他们在学校的表现； 2) 噪声中言语测试表现不佳是 UHL 儿童学业成绩不佳的一个重要风险因素。本研究提出了一项病例对照研究，使用标准化成绩评估 (WIAT-II-A) 作为主要结局指标，对患有 UHL 的儿童与对照兄弟姐妹的教育和行为风险标准化指标进行比较。假设退出率为 10%，单尾 alpha 水平为 0.05，beta 水平为 0.20，功效为 80%，则每组将招募 126 名受试者。次要结果包括留级一个或多个年级、需要额外的教育援助以及行为问题。将对患有 UHL 的儿童进行为期 3 年的跟踪，以获得有关成就轨迹和行为问题变化的纵向数据。噪声中语音测试性能将通过为本研究开发的听力学协议获得。双变量和多变量分析将用于确定哪些社会经济、临床或患者因素与我们的结果独立相关。这项研究的结果将揭示 UHL 对学生教育成绩的流行病学和临床影响。