While previous studies have shown that children with mild-to-severe hearing loss are at risk for poorer language, academic, social and psychological outcomes, these studies were conducted prior to the implementation of universal newborn hearing screening and recent technological advances in amplification. Early identification of hearing loss, improved amplification technologies, and access to quality early intervention programs have the potential to improve the performance of this group of children. The requisite clinical studies needed to provide optimal intervention to this subgroup of children with hearing loss have not been conducted. The proposed research will address this gap. Specifically, there is a critical need to examine outcomes in a large group of children who have benefited from these advances. Thus, the overall goal of the proposed studies is to examine a range of longitudinal outcomes of this subgroup of children with hearing loss. Multi- center, multi-disciplinary evaluations will be conducted in order to gain a comprehensive understanding of the impact of mild to severe hearing loss on these children and their families. It is critical to determine the constellation of factors that support the early development of speech, language, cognitive, and psychosocial skills as well as quality of life issues within the family. A comprehensive set of child outcomes (e.g., speech production and perception, language, academic, psychosocial, cognitive) and family outcomes (e.g., parenting, quality of life, and satisfaction with services) will be examined and compared to results from normal-hearing children with similar backgrounds. One of the largest known contributors to outcomes in children with hearing loss is reduced auditory/linguistic experience. Therefore, the focus of the proposed work will be on variations in receipt and effectiveness of early interventions (e.g., hearing aid use, educational programs) that are intended to enhance auditory/linguistic experiences. In so doing we believe that it is also important to identify barriers to service access and other factors that influence intervention compliance. Educational service provision for children with mild to severe hearing loss may vary in critical ways (e.g., accessibility, intensity and provider specialization). Further, it is likely that family (community of residence, parenting, income) and child (temperament, communication skills, degree of hearing loss) factors will interact with intervention features to influence outcomes. The planned recruitment of a large, representative sample will support the use of multivariate procedures, including Structural Equation Modeling, to examine the ways in which child, home/community and intervention characteristics combine to affect outcomes. Moderators and Functional Outcomes in Children with Mild to Severe Hearing Loss Narrative This project will obtain critical information regarding the extent to which mild to severe hearing loss in early childhood threatens the well-being of children. The project also will provide important insight into the effectiveness of interventions concerned with mitigating the hearing loss and its negative consequences. These data will, therefore, form the foundation for evidenced based practice and policy for the clinical management of children with hearing loss.

National Institute of Health (NIH)
National Institute on Deafness and Other Communication Disorders (NIDCD)
Research Project (R01)
Project #
Application #
Study Section
Special Emphasis Panel (ZDC1-SRB-C (23))
Program Officer
Donahue, Amy
Project Start
Project End
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Support Year
Fiscal Year
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University of Iowa
Other Health Professions
Schools of Arts and Sciences
Iowa City
United States
Zip Code
Walker, Elizabeth; McCreery, Ryan; Spratford, Meredith et al. (2016) Children with Auditory Neuropathy Spectrum Disorder Fitted with Hearing Aids Applying the American Academy of Audiology Pediatric Amplification Guideline: Current Practice and Outcomes. J Am Acad Audiol 27:204-18
Harrison, Melody; Page, Thomas A; Oleson, Jacob et al. (2016) Factors Affecting Early Services for Children Who Are Hard of Hearing. Lang Speech Hear Serv Sch 47:16-30
McCreery, Ryan; Walker, Elizabeth; Spratford, Meredith et al. (2016) Stability of Audiometric Thresholds for Children with Hearing Aids Applying the American Academy of Audiology Pediatric Amplification Guideline: Implications for Safety. J Am Acad Audiol 27:252-63
Ambrose, Sophie E; Thomas, Anne; Moeller, Mary Pat (2016) Assessing Vocal Development in Infants and Toddlers Who Are Hard of Hearing: A Parent-Report Tool. J Deaf Stud Deaf Educ 21:237-48
VanDam, Mark; Silbert, Noah H (2016) Fidelity of Automatic Speech Processing for Adult and Child Talker Classifications. PLoS One 11:e0160588
Walker, Elizabeth A; Holte, Lenore; McCreery, Ryan W et al. (2015) The Influence of Hearing Aid Use on Outcomes of Children With Mild Hearing Loss. J Speech Lang Hear Res 58:1611-25
McCreery, Ryan W; Walker, Elizabeth A; Spratford, Meredith et al. (2015) Speech Recognition and Parent Ratings From Auditory Development Questionnaires in Children Who Are Hard of Hearing. Ear Hear 36 Suppl 1:60S-75S
Walker, Elizabeth A; McCreery, Ryan W; Spratford, Meredith et al. (2015) Trends and Predictors of Longitudinal Hearing Aid Use for Children Who Are Hard of Hearing. Ear Hear 36 Suppl 1:38S-47S
Ambrose, Sophie E; Walker, Elizabeth A; Unflat-Berry, Lauren M et al. (2015) Quantity and Quality of Caregivers' Linguistic Input to 18-Month and 3-Year-Old Children Who Are Hard of Hearing. Ear Hear 36 Suppl 1:48S-59S
Tomblin, J Bruce; Moeller, Mary Pat (2015) Editorial: The Outcomes of Children with Hearing Loss Study. Ear Hear 36 Suppl 1:1S-3S

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