Abstract
Research has shown that the presence of severe unilateral, or mild bilateral, hearing loss in children may have a significant impact on the development of speech and language and on academic performance. Unfortunately, many hearing screening programs may have difficulty identifying these children. Even when these children are identified, clinicians may find themselves forced to make decisions regarding audiologic and educational management based on limited research information. This issue of Trends in Amplification focuses on the myriad of issues surrounding identification and the management of children with unilateral and mild bilateral hearing loss.
In the first article, Anne Marie Tharpe provides a thorough review of the speech, language, academic, and psychoeducational consequences of unilateral and mild bilateral hearing loss and highlights some of the many important research needs in this area. This article also provides an overview of early and more recent research that has shaped our current thinking about the consequences of unilateral and mild hearing loss.
In the next article, Tharpe and Sladen review common causes of unilateral and mild bilateral hearing loss. Surprisingly, they note that etiologies of unilateral hearing loss remain unknown in 35% to 60% of the cases despite improvements in genetic and medical testing procedures. Likewise, they report that the causes of permanent mild bilateral hearing loss are often unknown, in part because of difficulties in early identification of this group of children.
In July 2005, a National Workshop on Mild and Unilateral Hearing Loss was sponsored by the Centers for Disease Control and Prevention Early Hearing Detection and Intervention program and the Marion Downs Hearing Center. Many of the contributors to this issue of Trends attended this workshop, and 2 of the articles in this issue (Ross et al and Holstrum et al) provide a synopsis of information presented during sessions at the meeting. Ross et al, from the Centers for Disease Control and Prevention Early Hearing Detection and Intervention program, and other contributors provide a summary of the information presented at the workshop related to screening and identification of children with unilateral and minimal hearing loss. They note that current screening programs are generally designed to detect more moderate losses and thus, by design, will miss children with mild hearing loss.
Even in cases in which early identification is successful, the appropriate type and scope of intervention and management strategies are not always clear for children with unilateral and mild bilateral hearing loss. In the fourth article, Holstrum et al provide an invaluable summary of federal and state services that may be available for children with unilateral and mild hearing loss. The authors also highlight many of the bureaucratic issues and concerns that may be associated with obtaining services for these children.
In the final article, Mckay et al highlight the fact that even with early identification and access to intervention services the appropriate amplification management strategy for these children is not always clear. Specifically, they discuss the paucity of research support for the use of specific amplification options (eg, sound field FM versus personal FM versus personal hearing aids) for children with unilateral and mild bilateral hearing loss. These authors provide a thorough review of current amplification and assistive listening options for these children and identify and discuss the needs for further research in this area.
In summary, in this issue, the reader will find a thorough, up-to-date review of current information about unilateral and mild bilateral hearing loss in children, resources for the educational management of these children, and state of the knowledge for clinical management, as well as identification of areas requiring further research to guide clinical practice. The compilation of articles in this issue should prove to be a valuable source of information about unilateral and mild bilateral hearing loss in children for clinicians and researchers alike.