One of the many impacts of the COVID-19 pandemic is that it has turned attention to healthcare disparities, particularly related to access to care. Researchers from the UC San Francisco Department of Otolaryngology – Head and Neck Surgery (UCSF OHNS) set out to evaluate the effect of demographic disparities on language outcomes in a diverse group of children who are deaf or hard of hearing (D/HH). Findings from this retrospective cohort study were recently published in Otolaryngology–Head and Neck Surgery.
"Overall, our study took a closer look at specific access-related risk factors for poor language outcomes in children with hearing loss," says Dylan Chan, MD, PhD, associate professor of pediatric otolaryngology, director of the UCSF Children's Communication Center, and lead researcher of this study. "Demographic and clinical data were extracted from the medical records of patients from UCSF Benioff Children's Hospital, and the primary outcome measure was the Preschool Language Scales-5 (PLS)."
Predictors of language outcome were assessed including hearing level at the time of hearing intervention, cochlear implant status, age of identification and intervention, travel time to site of hearing care, home language, race/ethnicity and insurance type.
"We implemented a novel measure – the Access Challenge Index (ACI), which looks at educational environment and family support based on the Child Cochlear Implant Profile (CHIP)," says Dr. Chan. "Our results showed that higher ACI scores were indicative of access barriers, and in turn, were associated with adverse language outcomes in D/HH children."
Therefore, the team concluded that the ACI is a strong independent predictor of language outcomes in D/HH children. Findings help healthcare professionals gain valuable insights and understanding of how factors like family structure and educational barriers can impact access to hearing interventions for children. Now that these issues and factors have been identified, focus can be shifted toward identifying ways to help families address these issues, and work on lowering ACI scores and improve language outcomes.
The full team of authors from UCSF OHNS include Anna Meyer, MD, associate professor of pediatric otolaryngology; Chiara Scarpelli, MS, CCC-SLP, speech-language pathologist; Melissa Ho, AuD, audiologist, and Michelle Florentine, BA, Medical Student at Tel Aviv University working with Dr. Chan. Additional authors include Madeleine Strohl, MD, former UCSF OHNS resident and current fellow at the University of Miami, Sayard Benvenuti, MA, CCC-SLP, former UCSF speech language pathologist now with San Francisco Unified School District, and Molly Eiseman, MA, CCC-SLP, speech language pathologist.
