Hearing loss, frequent ear infections, speech-language development and therapy, and use of other services in preschool-aged children in the United States

Background: The Early Childhood Longitudinal Study–Birth Cohort (ECLS–B) is a nationally representative study of 14,000 US children born in 2001.

Methods: This report is based on 7,269 singleton births in ECLS–B followed prospectively at 9-months, 2-years, and 4-years of age. Multiple measures of child health, development, disability, and services were collected from the children, parents, and nonparental care providers. Parents reported on hearing loss, ear infection (EI) frequency and treatments, speech-language development and therapy, and use of other services. Children's gross and fine motor skills and mental development were directly assessed.

Results: Between 2–4 years of age, 41.3% were evaluated for hearing loss and 4.6% were diagnosed with hearing problems; 70.9% of children had at least one medically-diagnosed EI by 4 years. After adjusting for age, sex, race/ethnicity, and maternal education, children with many recent EIs (4+) were more likely to have had their hearing evaluated (odds ratio: 2.34, 95% confidence interval: 1.91-2.87), had hearing problems diagnosed (6.34, 4.33-9.29), received speech-language therapy (2.63, 1.77-3.93), occupational therapy (2.93, 1.87-4.59), physical therapy (3.38, 2.05-5.58), hearing services (5.82, 2.69-12.61), and treatment with ear tubes (11.27, 7.05-18.02). Hearing loss was corrected in 59.5% of diagnosed children, but remained for 40.5%. The prevalence of unresolved hearing loss (unilateral and bilateral) at age 4 was 1.86%.

Conclusion: The ECLS–B is the only recent, nationally representative study available allowing analysis of relationships between hearing, chronic or recurrent ear infections, communication impairments, speech-language therapy, and other services from infancy to kindergarten entry.