Quality of Life in Youth With Severe to Profound Sensorineural Hearing Loss
ABSTRACT Adolescence is a life stage with rapid and major developmental changes, yet little is known about how these changes influence the quality of life of young people who are deaf or hard of hearing (DHH).
To determine differences in the 3 domains of a hearing-specific quality-of-life instrument between youth who had severe to profound sensorineural hearing loss based on whether they used no technology, hearing aids, or cochlear implants.
A multi-institutional prospective cohort study.
A convenience sample of 11- to 18-year-old youths with severe to profound sensorineural hearing loss recruited between January 1 and December 31, 2008.
Youth Quality of Life-Research Instrument and Youth Quality of Life Instrument-Deaf and Hard of Hearing (YQoL-DHH) scores. The YQoL-DHH was composed of 3 domains: participation, self-acceptance/advocacy, and stigma-related quality of life.
A total of 157 individuals participated. Overall mean (SD) age was 14.1 (2.3) years, and the female-male ratio was 82:75. Forty-nine individuals (31.2%) were not using any technology, 45 (28.7%) were using hearing aids, and 63 (40.1%) were using cochlear implants. Mean age of unilateral or first cochlear implant was 62.9 months. Thirty-eight individuals (24.2%) attended schools with DHH programs, 55 (35.0%) attended schools without DHH programs, and 58 (36.9%) attended schools for the deaf. Statistically significant differences were noted in YQoL-DHH participation and perceived stigma scores between the groups when stratified by technology used and school setting.
These data suggest that the domains of quality of life as measured by our instrument differ significantly among youth based on technology used and school setting. Youth using no technology or cochlear implants tended to score higher than those using hearing aids in mainstream schools with or without DHH programs and in schools for the deaf. The YQoL-DHH instrument is able to detect differences in quality of life within a group of youth with severe to profound hearing loss.
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ABSTRACT: The study participants were 197 deaf or hard-of-hearing students with mild to profound hearing loss who attended general education classes for 2 or more hours per day. We obtained scores on standardized achievement tests of math, reading, and language/writing, and standardized teacher's ratings of academic competence annually, for 5 years, together with other demographic and communication data. Results on standardized achievement tests indicated that, over the 5-year period, 63%-79% of students scored in the average or above-average range in math, 48%-68% in reading, and 55%-76% in language/writing. The standardized test scores for the group were, on average, half an SD below hearing norms. Average student progress in each subject area was consistent with or better than that made by the norm group of hearing students, and 79%-81% of students made one or more year's progress annually. Teachers rated 69%-81% of students as average or above average in academic competence over the 5 years. The teacher's ratings also indicated that 89% of students made average or above-average progress. Students' expressive and receptive communication, classroom participation, communication mode, and parental participation in school were significantly, but moderately, related to academic outcomes.Journal of Deaf Studies and Deaf Education 02/2009; 14(3):293-311. DOI:10.1093/deafed/enp009 · 1.02 Impact Factor
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ABSTRACT: This article investigated to what extent age, use of a cochlear implant, parental hearing status, and use of sign in the home determine language of instruction for profoundly deaf children. Categorical data from 8,325 profoundly deaf students from the 2008 Annual Survey of Deaf and Hard-of-Hearing Children and Youth were analyzed using chi-square automated interaction detector, a stepwise analytic procedure that allows the assessment of higher order interactions among categorical variables. Results indicated that all characteristics were significantly related to classroom communication modality. Although younger and older students demonstrated a different distribution of communication modality, for both younger and older students, cochlear implantation had the greatest effect on differentiating students into communication modalities, yielding greater gains in the speech-only category for implanted students. For all subgroups defined by age and implantation status, the use of sign at home further segregated the sample into communication modality subgroups, reducing the likelihood of speech only and increasing the placement of students into signing classroom settings. Implications for future research in the field of deaf education are discussed.Journal of Deaf Studies and Deaf Education 08/2010; 15(4):334-47. DOI:10.1093/deafed/enq034 · 1.02 Impact Factor
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ABSTRACT: As shown by many studies, deaf children benefit considerably by cochlear implants (CI), concerning oral language and integration in mainstream schools. This had lead to the general view of a good quality of life of these children. Unfortunately so far nearly no studies on quality of life, and specially no studies on health-related quality of life (HRQoL) of children with cochlear implants, have been published. The present study with the objective for first, initial information on health-related quality of life of Austrian pupils with cochlear implants is a first step to fill this gap. Forty-four Austrian pupils, out of 65 candidates, age 8-16, with a hearing experience of at least 3 years with implants, and their parents were surveyed in the CI Center, Salzburg (cross sectional study). Basic medical and audiological data were available for all pupils. Because of reading comprehension difficulties 15 pupils were excluded. Parents and children were surveyed with the KINDLr, a generic instrument for health-related quality of life of children and adolescents. Main outcome measures were the HRQoL-total scores (mean, transformed to 100, standard deviation). In addition, 95% confidence intervals, effect sizes, t scores (one- and two-sided t-tests), rank order correlations and coefficients of determination were calculated. The HRQoL-total score of the children with CI (n=18), age 8-12 was below the standard for hearing children (P<0.001). It differed from the total score of the parent rating (P<0.0001). The difference between the parent ratings of non-excluded and of excluded children (n=12) was not significant. The total score of the adolescents (n=11), age 13-16 was within the norm, with no significant difference between adolescent and parents. The total scores correlate with parent-child agreement in the ratings, with outcomes of audiological speech tests, length of time of deafness, and age at implantation. Children with CI experience a lower health-related quality of life, compared to hearing children, with a low parent-child agreement. The findings of this study point to a normal subjective health of adolescents with CI.International Journal of Pediatric Otorhinolaryngology 08/2005; 69(8):1089-101. DOI:10.1016/j.ijporl.2005.02.018 · 1.19 Impact Factor