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Previous Volume 354:2131-2141 May 18, 2006 Number 20 Next

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ABSTRACT

Background Children with bilateral permanent hearing impairment often have impaired language and speech abilities. However, the effects of universal newborn screening for permanent bilateral childhood hearing impairment and the effects of confirmation of hearing impairment by nine months of age on subsequent verbal abilities are uncertain.

Methods We studied 120 children with bilateral permanent hearing impairment identified from a large birth cohort in southern England, at a mean of 7.9 years of age. Of the 120 children, 61 were born during periods with universal newborn screening and 57 had hearing impairment that was confirmed by nine months of age. The primary outcomes were language as compared with nonverbal ability and speech expressed as z scores (the number of standard deviations by which the score differed from the mean score among 63 age-matched children with normal hearing), adjusted for the severity of the hearing impairment and for maternal education.

Results Confirmation of hearing impairment by nine months of age was associated with higher adjusted mean z scores for language as compared with nonverbal ability (adjusted mean difference for receptive language, 0.82; 95 percent confidence interval, 0.31 to 1.33; and adjusted mean difference for expressive language, 0.70; 95 percent confidence interval, 0.13 to 1.26). Birth during periods with universal newborn screening was also associated with higher adjusted z scores for receptive language as compared with nonverbal ability (adjusted mean difference, 0.60; 95 percent confidence interval, 0.07 to 1.13), although the z scores for expressive language as compared with nonverbal ability were not significantly higher. Speech scores did not differ significantly between those who were exposed to newborn screening or early confirmation and those who were not.

Conclusions Early detection of childhood hearing impairment was associated with higher scores for language but not for speech in midchildhood.

Source Information

From the Departments of Child Health (C.R.K., D.C.M., S.W.), Public Health Sciences and Medical Statistics (M.M., H.M.Y.), and Psychology (J.S.), University of Southampton, Southampton; the Institute of Primary Care and General Practice, University of Sheffield, Sheffield (M.J.C.); the Institute of Child Health, University College London, London (C.M.L.); the National Perinatal Epidemiology Unit, University of Oxford, Oxford (S.P.); and the Department of Audiology, Whipps Cross University Hospital, London (P.W.) — all in the United Kingdom.

Address reprint requests to Dr. Kennedy at Mailpoint 21, Child Health, Southampton General Hospital, Southampton SO16 6YD, United Kingdom, or at crk1{at}soton.ac.uk.

Full Text of this Article

Related Letters:

Language Ability after Early Detection of Hearing Impairment
Grima J., Kennedy C., Watkin P., Worsfold S.
Extract | Full Text | PDF  
N Engl J Med 2006; 355:734, Aug 17, 2006. Correspondence

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