A study of ages of suspicion, identification, hearing aid fitting and intervention of habilitation/rehabilitation in hearing impaired children

• Main Authors: Chiu-Li Lu, 盧秋利
• Other Authors: Chuan-Jen Hsu
• Format: Others
• Language: zh-TW
• Published: 2007
• Online Access: http://ndltd.ncl.edu.tw/handle/98184514398118497700

碩士 === 國立台北護理學院 === 聽語障礙科學研究所 === 95 === The purpose of this study is to survey the ages of suspicion of hearing loss, identification of hearing loss, hearing aid fitting, and intervention of habilitation/rehabilitation in hearing impaired children in Taiwan. We also investigate the influence of severity of hearing loss, high risk factors of hearing loss, education levels of mother (main care-giver) and newborn hearing screening on various ages related with hearing loss and their intervals. The subjects are those who once undertook the hearing tests and habilitation/rehabilitation in Ya-Wen Children’s Hearing Foundation, either in Taipei or Kaohsiung. The subjects were born from 1981 to 2003 and the total numbers of studied subjects are 359. The analysis data were obtained from records of history of hearing loss and demographics, and reports of hearing tests of all subjects from Ya-Wen Children’s Hearing Foundation. Summary of Results: 1. Despite of severity of hearing loss, the average age of suspicion is 20.75 months, the average age of identification is 26.22 months, the average age of hearing aid fitting is 30.89 months and the age of intervention of habilitation/rehabilitation is 37.00 months. 2. Association between the severity of hearing loss and various ages related with hearing loss: The earliest average age of suspicion is 14.40 months in children with profound hearing loss and the latest one is 34.33 months in those with mild hearing loss. The earliest average age of identification is 18.81 months in children with profound hearing loss and the latest one is 36.76 months in those with moderate-severe hearing loss. The earliest average age of hearing aid fitting is 24.43 months in children with profound hearing loss and the latest one is 41.29 months in those with moderate hearing loss. The earliest age of intervention of rehabilitation/ rehabilitation is 33.56 months in children with profound hearing loss and the latest one is 44.18 months in those with moderate hearing loss. Furthermore, there is significant difference in the average age of identification between profound hearing loss group and groups of moderate, moderate-severe and severe hearing loss (p< .05), and between severe hearing loss group and moderate-severe hearing loss group (p< .05). Significant difference in the average age of hearing aid fitting is also shown between profound hearing loss group and groups of moderate and moderate-severe hearing loss (p< .05), and between severe hearing loss group and moderate-severe hearing loss group (p< .05). 3. There is no significant difference in various ages related with hearing loss and their intervals between groups with and without high risk hearing loss (p> .05). 4. Association of education levels of mother and ages related with hearing loss of hearing impaired children: In higher education level group (above high school), the average ages of identification, hearing aids fitting and intervention of habilitation/rehabilitation are earlier, distribution tendency is more concentrated and highly related than in the lower one (below high school). However, there is no significant difference in these average ages between two groups (p> .05). In addition, the age interval between identification and intervention of habilitation/rehabilitation, as well as that between hearing aids fitting and intervention of habilitation/rehabilitation, is significantly shorter in higher education level group. Intervals between identification, hearing aids fitting and intervention of habilitation/ rehabilitation are longer and more inconsistent in lower education level group. In other words, mothers of lower education level very likely need more time to process intervention of habilitation/rehabilitation after identification of hearing loss. 5. In Taiwan, the newborn hearing screening started in 1998. For children born before 1998, the ages of identification and hearing aids fitting are highly related (Pearson Correlation Coefficient .867) and the rest combinations are moderately related (Pearson Correlation Coefficient .552 and .438). For children born after 1998, all ages related with hearing loss are highly related. Significant differences in all ages related with hearing loss, as well as their intervals, are shown between those born before and after 1998 (p< .05). For children born after 1998, significant differences in all ages related with hearing loss are shown between those with and without hearing screening (p< .05), but not in their intervals (p> .05). Conclusions: The severer the hearing loss is, the earlier the ages of suspicion and identification of hearing loss are. For children without newborn hearing screening, the average interval between ages of identification and intervention of habilitation/rehabilitation is about 10 months, no matter who are with or without the high-risk hearing loss, and no matter how the hearing loss severity is in those without the high-risk. It is still a big gap from JCIH(2000) target, identification of hearing loss at 3 months old and intervention of habilitation/ rehabilitation before 6 months old. Therefore early suspicion of hearing loss is a way to match the target of early identification and early intervention, and newborn hearing screening would be a good tool for it. The ages related with hearing loss are all significantly earlier in children with hearing screening born after 1998 than those without hearing screening, indicating that newborn hearing screening can benefit early identification of hearing loss. However, no significant differences in the intervals of various ages related with hearing loss are shown between children with and without hearing screening. The intervals are even longer in children with hearing screening than those without hearing screening, indicating the effect of early intervention is not good enough at present. It needs more professional effort and cooperation including speech and hearing specialty, public health and public media to achieve the aim of early intervention. Furthermore, this research result also shows that interval between identification and intervention of habilitation/rehabilitation is longer for mothers (main care-givers) of lower education level. Therefore, more effort on public education for parents of lower education level is recommended to be the important part of early diagnostic and early intervention plan to shorten the interval between identification and intervention of habilitation/rehabilitation.