Karl R. White

Utah State University | USU · Department of Psychology

Enhancing parent language interactions with children beginning in infancy is important because it results in better language abilities, social skills, and academic outcomes in children. A number of researchers have suggested that parent language interactions with children could be enhanced by giving parents feedback about their language interaction...

There is substantial evidence that newborn hearing screening (NHS) reduces the negative sequelae of permanent childhood hearing loss (PCHL) if performed in programs that aim to screen all newborns in a region or nation (often referred to as Universal Newborn Hearing Screening or UNHS). The World Health Organization (WHO) has called in two resolutio...

Objective: Assess the global status of newborn/infant hearing screening (NIHS) and its effectiveness in early detection and intervention of permanent childhood hearing loss (PCHL). Design: Individuals potentially involved with NIHS in 196 countries/territories (in the following text referred to as countries) received a questionnaire about coverage,...

Objective This study qualitatively explored the factors that influence how parents of children who are Deaf or hard-of-hearing with Down syndrome prioritise hearing care and management and developed an associated theory to explain that priority. Design Grounded theory was used for the purposes of this qualitative study. Data were collected using i...

Purpose This study examined classroom listening experiences reported by students who are deaf or hard of hearing using the Listening Inventory For Education–Revised (LIFE-R). Method Retrospective electronic survey responses from 3,584 school-age participants were analyzed using descriptive statistics to report student perceptions of listening diff...

Early Hearing Detection and Intervention–Pediatric Audiology Links to Services (EHDI-PALS) is a web-based national directory of pediatric audiology facilities in the United States, launched in October 2012. It was created by a committee of national experts to improve diagnostic audiology follow-up for infants and young children who failed the newbo...

Recent prevalence estimates indicate that in 2015 almost half a billion people—about 6.8% of the world’s population—had disabling hearing loss and that prevalence numbers will further increase. The World Health Organization (WHO) currently estimates that at least 34 million children under the age of 15 have disabling hearing loss. Based on a 2012 W...

Universal newborn hearing screening (UNHS), when accompanied by timely access to intervention services, can improve language outcomes for children born deaf or hard of hearing (D/HH) and result in economic benefits to society. Early Hearing Detection and Intervention (EHDI) programs promote UNHS and using information systems support access to follo...

Purpose. The purpose of this study was to assess primary health care providers' knowledge and use of genetic services for children whose hearing screening indicates they may be deaf or hard of hearing (DHH) and identify areas in which health care providers can be supported to increase family education and referral of families for genetic consultati...

Purpose: The aim of the study was to provide an overview of population science as applied to speech and language disorders, illustrate data sources, and advance a research agenda on the epidemiology of these conditions. Method: Computer-aided database searches were performed to identify key national surveys and other sources of data necessary to...

Background: Hearing aid fitting in infancy has become more common in the United States as a result of earlier identification of hearing loss. Consistency of hearing aid use is an area of concern for young children, as well as other hearing aid management challenges parents encounter that may contribute to less-than-optimal speech and language outc...

OBJECTIVES: Our aim with this article is to evaluate whether the prevalence of hearing loss is increasing among adolescents living in the United States. METHODS: All available data about hearing loss among adolescents from the large, federally funded National Health and Nutrition Examination Survey (NHANES) were analyzed. By using the 4 data relea...

This study sought to determine the effectiveness of telepractice as a method of delivering early intervention services to families of infants and toddlers who are deaf or hard of hearing. A comparison group design was applied to ascertain the child, family, and provider outcomes via telepractice compared with traditional in-person home visits. A to...

Objective: In many low- and middle-income countries, the availability of hearing technology is limited, with few options for hearing aid repairs. Minimising moisture damage to hearing aid electronics improves function and longevity; however, desiccants that absorb moisture from hearing aid components are unavailable in many regions. This study com...

A recent highly cited publication, using data from the National Health and Nutrition Examination Survey (NHANES), concluded that the prevalence of childhood hearing loss in the United States is increasing (Shargorodsky, Curan, Curhan, & Eavey, 2010). This article examines the accuracy of that conclusion based on additional data from three nationall...

One in 150 infants is born with cytomegalovirus (CMV) and one in 750 will have lifelong disabilities due to CMV. Even though congenital CMV is the leading viral cause of congenital disabilities and the leading non-genetic cause of childhood hearing loss, most adults have never heard of it. Data from the 2015 and 2016 HealthStyles TM surveys were an...

Objective: To explore parent perceptions of communication and academic experiences of cochlear implant (CI) recipients under the age of 18. Design: Cross-sectional survey design. Two surveys (K-12, birth-5) queried parent perceptions of the impact of CI on communication, listening in various environments and academic achievement. Surveys contain...

Objective: The purpose of this study was to explore the use of virtual visits to monitor hearing aid use with data logging measurements and provide parent support for hearing aid management. Design: A 6-month longitudinal case study design was used. Study sample: Four families and two providers participated. Results: Average hours of daily h...

Objectives: The aim of this study was to investigate parent learning and support needs related to hearing aid management for young children, and factors that influence parent-reported hours of hearing aid use. Design: A cross-sectional survey design was used to collect survey data in seven states. The child's primary caregiver completed a demogr...

Background: Early identification of hearing loss has led to routine fitting of hearing aids in infants and young children. Amplification provides opportunities to optimize child development, although it also introduces challenges for parents to navigate. Audiologists have a central role in providing parents with support to achieve effective manage...

This report describes the development of online training modules to assist in the Implementation of tele-intervention programs for children who are deaf or hard of hearing. Modules are available for families, administrators, and service providers. A URL to access the modules is available at no cost.

The purpose of this study was to evaluate the accuracy of a teacher-administered hearing screening questionnaire to detect hearing loss among first-grade Ecuadorian children in public schools. A cross-sectional design was used to compare screening results from the teacher-administered questionnaire and pure-tone audiometry. Children were randomly s...

Objectives: The aim of this study was to investigate parent-reported challenges related to hearing aid management and parental psychosocial characteristics during the first 3 years of the child's life. Design: Using a cross-sectional survey design, surveys were distributed to parents of children with hearing loss via state Early Intervention pro...

Objective: The purpose of this study was to review the literature on the effectiveness of parent or teacher-completed questionnaires as a tool to screen school-aged children for permanent hearing loss. Design: A rapid evidence assessment was completed to provide a summary of information published between 1980 and 2013 in English or Spanish. To i...

Objective: The aim of this study was to determine the effect of ambient noise on the accuracy of thresholds obtained using the KUDUwave portable clinical audiometer as compared to those obtained using a GSI-61 clinical audiometer in a sound booth. Design: Pure-tone air conduction thresholds were obtained in three conditions: (1) with a clinical...

Optimal outcomes for children who are deaf/hard-of-hearing (DHH) depend on access to high quality, specialized early intervention services. Tele-intervention (TI), the delivery of early intervention services via telehealth technology, has the potential to meet this need in a cost-effective manner. Twenty-seven families of infants and toddlers with...

Background: Optimal outcomes for children who are deaf/hard-of-hearing (DHH) depend on access to high quality, specialized early intervention services. Tele-intervention – the delivery of early intervention services via telehealth technology - has the potential to meet this need in a cost-effective manner. Method: Twenty-seven families of infants a...

OBJECTIVES—Hearing loss is the most common congenital condition screened for at birth in the United States and more than 95% of newborns are currently screened for hearing. Newborn hearing screening is most effective when infants receive timely and effective interventions. Unfortunately follow-up rates for babies not passing their initial hearing s...

The development of proficient communication skills in infants and toddlers is an important component to child development. A popular trend gaining national media attention is teaching sign language to babies with normal hearing whose parents also have normal hearing. Thirty-three websites were identified that advocate sign language for hearing chil...

Because newborn hearing screening has become the standard of care in the United States, every state has established an early hearing detection and intervention (EHDI) program responsible for establishing, maintaining, and improving the system of services needed to serve children with hearing loss and their families. While significant developments h...

Hearing loss is the most common congenital condition screened for at birth in the United States, and more than 95% of newborns are currently screened for hearing. Newborn hearing screening is most effective when infants receive timely and effective interventions. Unfortunately, follow-up rates for newborns not passing their initial hearing screenin...

During the last 20 years, the number of infants evaluated for permanent hearing loss at birth has increased dramatically with universal newborn hearing screening and intervention (UNHSI) programs operating in all US states and many territories. One of the most urgent challenges of UNHSI programs involves loss to follow-up among families whose infan...

To be successful, Early Hearing Detection and Intervention (EHDI) programs require individually identifiable information about children to be shared among people who are responsible for screening, diagnosis, early intervention, family support, and medical home services. Pediatricians and other stakeholders in the EHDI process often point to federal...

Every year, 4000 to 8000 children are born in the United States with permanent hearing losses that pose a risk to their speech and language development.1–3 If children with milder losses and losses that affect only 1 ear are included, that number is almost doubled. Until just a decade ago, late diagnosis was the norm, with the average age at identi...

As newborn hearing-screening programs have expanded, more and more infants and young children need hearing services. Medicaid is one of the primary sources of funding for such services and, by law, must establish payment rates that are sufficient to enlist enough providers to provide services. In this study we compared 2005 Medicaid reimbursement r...

Advancements in videoconferencing equipment and Internet-based tools for sharing information have resulted in widespread use of telemedicine for providing health care to people who live in remote areas. Given the limited supply of people trained to provide early-intervention services to infants and young children who are deaf or hard-of-hearing, an...

Many young children with permanent hearing loss do not receive hearing aids and related professional services, in part because of public and private financing limitations. In 2006 the Children's Audiology Financing Workgroup was convened by the National Center for Hearing Assessment and Management to evaluate and make recommendations about public a...

Examined the intensity hypothesis, which states that more intensive early interventions have better outcomes for children with disabilities. Three sources of evidence are analyzed: (1) previous reviews of early intervention research; (2) a meta-analysis that included data from 155 children, providing information on intensity and outcomes; and (3) p...

In summarizing what we knew a decade ago about the effectiveness of early intervention programs, Ramey, McPhee, and Veates (1982) observed that “little evidence exists for the relative effectiveness of any one program or group of programs over any other”, and called for ”continuing scientific inquiry into the relative efficacy of various [early int...

Identifying and treating children with congenital hearing loss during the first few months of life is a relatively new concept. To assist states in the development of statewide Early Hearing Detection and Intervention programs, the federal government provides grants and/or cooperative agreements to almost all states and has established "National Go...

Physicians and other health-care providers should play a central role in helping families of children with permanent hearing loss receive timely and appropriate screening, diagnostic, and early intervention services. Because the technology and procedures for ensuring timely and appropriate services for infants and young children with hearing loss h...

Each day in the life of a young child with an undetected hearing loss is a day without full access to language. When hearing loss goes undetected, the resulting language deficits can become overwhelming obstacles to literacy, educational achievement, socialization, and school readiness. Several programs, such as Head Start, Early and Periodic Scree...

Most hearing screening programs have historically targeted children with moderate or more severe bilateral hearing loss. Children with unilateral or mild bilateral permanent hearing loss represent a substantial proportion of all children with hearing loss, and there are serious negative consequences for these children if they are not identified ear...

Until recently, no objective tool has been available to help health and early childhood education providers screen young children for hearing loss. The aim of this study was to screen underserved children <or=3 years of age for hearing loss using otoacoustic emissions (OAE) technology and to systematically document multi-step screening and diagnost...

This study assessed the feasibility of doing hearing screening in Migrant, American Indian and Early Head Start programs using otoacoustic emissions (OAE) technology. Staff members were trained to screen 0–3-year-old children for hearing loss using hand-held OAE equipment and a multi-step screening and referral protocol. Of the 3486 children screen...

The value of identifying permanent hearing loss during the first few months of life and providing effective treatment to ameliorate or even eliminate the negative consequences has been recognized for many decades. Unfortunately, improvements in achieving this goal were very gradual until the early 1990s. At that time, the combination of technologic...

Universal newborn hearing screening focuses on providing the earliest possible diagnosis for infants with permanent hearing loss. The goal is to prevent or minimize the consequences of sensorineural hearing loss on speech and language development through timely and effective diagnosis and interventions. Pediatricians are in a key position to educat...

Permanent hearing loss at birth or in early childhood is common and has many genetic and environmental causes. Advances in the identification and characterization of genetic forms, combined with the early identification of children through the implementation of state-based Early Hearing Detection and Intervention programs suggests the need for educ...

The purpose of this study was to identify what stakeholders considered best practices for parent-provider communication regarding newborn hearing screening and diagnosis. We used consensus data to develop educational materials for parents. We conducted 29 focus groups and 23 individual interviews between October 2003 and May 2004. Participants incl...

The benefits associated with universal Newborn Hearing Screening (NHS) are most likely to be achieved when screening is linked to timely and effective interventions. Well-informed primary care physicians (PCPs) are in a key position to educate families about the importance and most effective ways of following-up for infants who do not pass the NHS...

This article is the 1st in a series of 4 articles on a recently completed multistate study of newborn hearing screening. The study examined the efficacy of the 2-stage otoacoustic emission/automated auditory brainstem response (OAE/A-ABR) protocol for identifying hearing loss in newborns. The study found that the 2-stage OAE/A-ABR protocol did miss...

Most newborns are screened for hearing loss, and many hospitals use a 2-stage protocol in which all infants are screened first with otoacoustic emissions (OAEs). In this protocol, no additional testing is done for those passing the OAE screening, but infants failing the OAE are also screened with automated auditory brainstem response (A-ABR). This...

This 3rd of 4 articles on a study of the efficacy of the 2-stage otoacoustic emission/automated auditory brainstem response (OAE/A-ABR) newborn hearing screening protocol describes (a) the behavioral audiometric protocol used to validate hearing status at 8-12 months of age, (b) the hearing status of the sample, and (c) the success of the visual re...

This article examines whether changes in hearing screening practices are warranted based on the results of the recent series of studies by J. L. Johnson, K. R. White, J. E. Widen, J. S. Gravel, B. R. Vohr, M. James, T. Kennalley, A. B. Maxon, L. Spivak, M. Sullivan-Mahoney, Y. Weirather, and S. Meyer (Johnson, White, Widen, Gravel, James, et al., 2...

Ninety percent of all newborns in the United States are now screened for hearing loss before they leave the hospital. Many hospitals use a 2-stage protocol for newborn hearing screening in which all infants are screened first with otoacoustic emissions (OAE). No additional testing is done with infants who pass the OAE, but infants who fail the OAE...

Congenital hearing loss is relatively frequent and has serious negative consequences if it is not diagnosed and treated during the first few months of life. Babies with hearing loss who are identified early and provided with appropriate intervention develop better language, cognitive, and social skills. As a result of improvements in screening equi...

A multistate Centers for Disease Control and Prevention (CDC) study was designed to investigate the etiology of congenital hearing loss in infants ascertained through state-mandated hearing screening or early hearing loss detection and intervention (EHDI) programs. At least 50% of permanent childhood-onset hearing loss is due to genetic causes, and...

The importance of identifying congenital hearing loss during the first few months of life has been recognized for almost 60 years. Unfortunately, until more effective newborn hearing screening equipment and procedures were developed in the late 1980s, it was not practical to implement programs for identifying hearing loss during the first few month...

To estimate the cost and cost-effectiveness of universal newborn hearing screening. Decision analysis model utilizing the hospital perspective. This model evaluated 4 distinct protocols for screening a fixed and defined hypothetical cohort of newborn infants. Cost of screening and the number of infants with hearing loss identified through universal...

Hawaii has been a pioneer and national leader in implementing universal newborn hearing screening. In fact, Hawaii is one of only two states (Rhode Island is the other) which have a statewide newborn hearing screening program in which 95% or more of all newborns are screened. Hawaii is the best example of a truly integrated system of services to pr...

This article describes factors that can affect the refer rate for otoacoustic emission (OAE) based newborn hearing screening, including the population of infants being screened, the adequacy of probe fit, software options used, external ear conditions, screener training, and baby handling. The effect of the infant's age on screening outcomes is als...

Although more and more hospitals are implementing universal newborn hearing screening programs, there is still very little information available about the costs of newborn hearing screening programs. The few articles which have been published evaluate technologies or protocols which are no longer used, are incomplete, or are based on hypothetical e...

The acceptance of universal newborn hearing screening has been affected by the availability of an accurate, cost-effective tool. Transient evoked otoacoustic emission (TEOAE) procedures have been used successfully in hospital-based programs. A modified TEOAE method, using a narrow band signal, may be capable of maintaining accuracy while reducing t...

Debris in the ear canal and ear canal collapse in newborns have been shown to interfere with recording transient evoked otoacoustic emissions (TEOAEs). The purpose of this study was to prospectively evaluate the effects of two simple ear canal cleaning procedures on the TEOAE responses of normal newborns. Three hundred and sixteen ears were studied...

During the past three to four decades, the incidence of acquired sensorineural hearing loss (SNHL) in children living in more developed countries has fallen, as a result of improved neonatal care and the widespread implementation of immunisation programmes. The overall decrease has been accompanied by a relative increase in the proportion of inheri...

Jacobson and Jacobson (Int. J. Pediatr. Otorhinolaryngol. 29 (1994) 235-248) recently questioned whether TEOAE-based newborn hearing screening similar to what was recommended by the National Institutes of Health could be implemented in a typical nursery setting. They concluded that, 'the theoretical advantage of TEOAEs as a method for screening new...

In a recent article, Bess and Paradise (Pediatrics 93 (1994) 330-334) rejected the recommendation of the National Institutes of Health that all infants be screened for hearing loss on being released from their birthing hospital. This article responds to their objections with data from the literature and operational newborn hearing screening program...

Recently, a National Institutes of Health Consensus Statement recommended that all infants be screened for hearing prior leaving the birthing hospital using a two-stage screening process based on transient evoked otoacoustic emissions (TEOAEs). Although the value of identifying hearing loss before 1 year of age is widely recognized, the feasibility...

Focuses on studies dealing with identification of hearing loss in newborns and infants (1960–1995). Studies report that the actual age of identification of hearing loss occurs substantially later than the age of 6 mo recommended by the American Speech-Language-Hearing Association Committee on Infant Hearing (1991). Damage in infancy can have a seve...

Rearing a child with disabilities is a challenge, per- haps even more so for single parents who most often are women. Stress and negative psychological effects have been considered likely outcomes for parents of children with disabilities. With the increased family focus in the provision of services for children with disabilities, it becomes even m...

This article summarizes data regarding the use of transient evoked otoacoustic emissions (TEOAE) in a universal newborn screening program and describes various facets of program implementation. It concludes that data show that TEOAE can be used to significantly reduce the average age of identification for hearing loss in the U.S. (Author/DB)

The importance of identifying hearing loss before 12 months of age is well established. Although recent research provides some evidence for the value of transient evoked otoacoustic emissions (TEOAEs) in newborn hearing screening, data are needed from large-scale clinical evaluations about the value of using TEOAE for screening high-risk and health...