186833 Hearing loss, frequent ear infections, speech-language development and therapy, and use of other services in preschool-aged children in the United States

Wednesday, October 29, 2008: 12:45 PM

Howard J. Hoffman, MA , Epidemiology and Biostatistics, National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health (NIH), Bethesda, MD
Jennifer Park, PhD , National Center for Education Statistics, Washington, DC
Katalin Losonczy, MA , Sparks, SAS Statistical Programmer, Bethesda, MD
May S. Chiu, BS , Epidemiology and Biostatistics, National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health (NIH), Bethesda, MD
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.

Learning Objectives:
Recognize the strong association between hearing loss in preschool-aged children and chronic or recurrent ear infections Understand patterns of speech-language therapy, occupational or physical therapy, and hearing services for young, preschool-aged children with intermittent or persistent hearing loss and frequent ear infections (otitis media) Understand the importance of nationally representative and longitudinal studies for establishing prevalence rates, risk factors, and associated conditions, including use of specialized therapy and other services

Keywords: Child Health, Communication

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have directed research programs relating to the epidemiology of children's health in 2 Institutes at NIH, NICHD and NIDCD, over the past 37 years. As part of my research activities, I have published over 175 peer-reviewed papers in the scientific and biomedical literature on epidemiology, biostatistics, and public health research studies.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.