Longitudinal outcomes of hearing-impaired children: early vs later intervention

听力障碍儿童的纵向结果：早期干预与后期干预

• 批准号: 10645047
• 负责人: VIJAYALAKSHMI EASWAR
• 金额: $ 34.07万
• 依托单位: AUSTRALIAN HEARING SERVICES
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-08-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10645047
• 关键词: 16 year old; 5 year old; Acoustics; Address; Adoption; Affect; Age; Area; Audiology; Australia; Bilateral Hearing Loss; Child; Child Development; Clinical; Clinical Services; Cochlear implant procedure; Cohort Studies; Communication; Data; Devices; Diagnosis; Early Diagnosis; Early Intervention; Early identification; Education; Effectiveness; Enrollment; Environment; Equation; Equipoise; Family; Gender; Goals; Growth; Health Policy; Healthcare; Hearing; Hearing Aids; Intervention; Investments; Knowledge; Laboratories; Language; Live Birth; Long-Term Effects; Measures; Mediating; Mental Health; Modeling; Newborn Infant; Outcome; Outcome Measure; Policies; Population; Practice Management; Prospective Studies; Provider; Quality of life; Randomized; Regression Analysis; Research; Resources; Service provision; Services; Socioeconomic Status; Speech Perception; Testing; Time; Unilateral Hearing Loss; United States National Institutes of Health; arm; auditory neuropathy; base; childhood hearing loss; cognitive skill; cohort; cost effectiveness; cost-effectiveness ratio; disability; economic evaluation; economic value; follow-up; hearing impairment; hearing screening; improved; improved outcome; incremental cost-effectiveness; language outcome; population based; population health; prospective; psychosocial; psychosocial wellbeing; service delivery; skills; societal costs

PROJECT SUMMARY/ ABSTRACT Permanent childhood hearing loss, which occurs in 1-2/1000 live-births, has negative impacts on children's lives incurring high societal costs. Universal newborn hearing screening (UNHS) enables early detection of hearing loss and intervention, with the goal of improving long-term outcomes at a population level. Despite widespread adoption of UNHS, serious evidence gaps remain. The effectiveness of early intervention for improving long-term outcomes is uncertain, the cost-effectiveness is unproven, and the impact of device fitting on outcomes of children with unilateral hearing loss is unknown. By capitalizing on a unique environment in Australia where children receive uniform hearing services from a single provider (Australian Hearing, AH), but had differential access to UNHS during a narrow time window, the research team commenced the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study in 2005. Through NIH support, a population-based cohort of 450 children with bilateral hearing loss (53% fitted with hearing aids before age 6 months) have been enrolled, and their outcomes have been measured prospectively over 10 years. The 5-year data revealed that the earlier children received hearing-aid fitting or cochlear implantation, the better the language outcomes. Benefits were greater for those with more severe hearing loss. Would these early benefits extend to later educational attainment, psychosocial well-being, and quality of life? Is early intervention cost- effectiveness in the long term? Further, does early intervention improve outcomes of children born with unilateral hearing loss? As a non-target condition detected via UNHS, there is clinical equipoise about management because evidence is lacking. Supported by NIH, the Children with Unilateral Hearing Loss (CUHL) study enrolled 179 children, ~50% of whom were randomly assigned to fitting of devices after diagnosis. This application draws on the assembled LOCHI and CUHL cohorts. The Aims are to: (1) determine the long-term effectiveness of early intervention by measuring outcomes of the LOCHI cohort at 16 years of age; (2) determine the cost-effectiveness by performing an economic evaluation using data on outcomes and healthcare resource use to be collected from the LOCHI cohort; and (3) determine how fitting and use of hearing device influence language outcomes of children with unilateral hearing loss by evaluating the CUHL cohort at 3 and 5 years of age. All data and a range of predictors will be evaluated in multiple regression analyses and structural equation modelling. As the research arm of AH, we will minimise loss to follow-up by maintaining contact via the AH service provision network. Accomplishing the aims will a) provide the much-needed evidence to guide clinical best-practice management of children across the entire spectrum of hearing loss, including unilateral hearing loss; and b) demonstrate the cost-effectiveness of UNHS and early intervention to guide policy decisions.

项目摘要/摘要 在1-2/1000实时出生中发生的永久童年听力损失对 儿童的生活会产生高昂的社会成本。通用新生儿听力筛查（UND）可以提早 检测听力损失和干预，目的是改善人群的长期结局 等级。尽管广泛采用了联合国联合组织，但仍然存在严重的证据差距。早期的有效性 改善长期结局的干预措施不确定，成本效益未经证实，并且 设备拟合对单方面听力损失儿童结果的影响尚不清楚。 通过利用澳大利亚独特的环境，儿童获得统一的听力服务 来自单个提供商（澳大利亚听证会，啊），但在狭窄的情况下可以差异 时间窗口，研究团队开始了听力儿童的纵向结果 2005年的障碍（LOCHI）研究。通过NIH支持，这是一个基于人群的队列 双边听力损失（在6个月之前安装了53％的助听器），他们的 结果已在10年内前瞻性地衡量。 5年的数据显示 儿童接受了助听器配件或人工耳蜗的植入，语言结果越好。好处 对于听力损失更严重的人来说，更大。这些早期的好处会延长到以后 教育成就，社会心理健康和生活质量？是早期干预成本 - 从长远来看？此外，早期干预是否改善了与 单方面听力损失？作为通过UND检测到的非目标条件，有关 管理因为缺乏证据。在NIH的支持下，单方面听力损失的孩子 （CUHL）研究招募了179名儿童，其中约有50％被随机分配给设备的安装 诊断。该应用程序借鉴了组装的Lochi和Cuhl队列。目的是：（1） 通过测量LOCHI队列的结果来确定早期干预的长期有效性 16岁； （2）通过使用的经济评估来确定成本效益 有关结果和医疗资源的数据，可以从Lochi队列中收集； （3） 确定听力设备的合适和使用如何影响单方面儿童的语言结果 通过评估3岁和5岁的Cuhl队列来听力损失。所有数据和一系列预测变量 将在多个回归分析和结构方程建模中进行评估。作为研究部门 在AH中，我们将通过AH服务提供网络保持联系，从而最大程度地减少随访的损失。 实现目标将a）提供急需的证据，以指导临床最佳实践 在整个听力损失范围内管理儿童，包括单方面的听力损失；和 b）展示联合国联合组织和早期干预的成本效益以指导政策决策。

项目成果

Phonological Awareness at 5 years of age in Children who use Hearing Aids or Cochlear Implants.

使用助听器或人工耳蜗的儿童 5 岁时的语音意识。

• DOI: 10.1044/hhdc25.2.48
• 发表时间: 2015
• 期刊: Perspectives on hearing and hearing disorders in childhood
• 作者: Ching,TeresaYC;Cupples,Linda
• 通讯作者: Cupples,Linda

Learning from the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study: summary of 5-year findings and implications.

• DOI: 10.1080/14992027.2017.1385865
• 发表时间: 2018-05
• 期刊: International journal of audiology
• 影响因子: 2.7
• 作者: Ching TYC;Dillon H;Leigh G;Cupples L
• 通讯作者: Cupples L

Language and speech perception of young children with bimodal fitting or bilateral cochlear implants.

• DOI: 10.1179/1467010014z.000000000168
• 发表时间: 2014-05-01
• 期刊: Cochlear implants international
• 作者: Ching, Teresa Y C;Day, Julia;Flynn, Christopher
• 通讯作者: Flynn, Christopher

Psychosocial Development in 5-Year-Old Children With Hearing Loss Using Hearing Aids or Cochlear Implants.

• DOI: 10.1177/2331216517710373
• 发表时间: 2017-01
• 期刊: Trends in hearing
• 影响因子: 2.7
• 作者: Wong CL;Ching TYC;Cupples L;Button L;Leigh G;Marnane V;Whitfield J;Gunnourie M;Martin L
• 通讯作者: Martin L

Is Early Intervention Effective in Improving Spoken Language Outcomes of Children With Congenital Hearing Loss?

• DOI: 10.1044/2015_aja-15-0007
• 发表时间: 2015-09-01
• 期刊: AMERICAN JOURNAL OF AUDIOLOGY
• 影响因子: 1.8
• 作者: Ching, Teresa Y. C.