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Hearing Difficulties in Children with Special Health Care Needs

Russ, Shirley A. MD, MPH; Kenney, Mary K. PhD; Kogan, Michael D. PhD

Journal of Developmental & Behavioral Pediatrics: September 2013 - Volume 34 - Issue 7 - p 478–485
doi: 10.1097/DBP.0b013e3182a39878
Original Articles

Objective: To determine characteristics of children with special health care needs (CSHCN) with hearing difficulties including patterns of hearing aid use, comorbidity, and social and communication function.

Methods: Bivariate and multivariable analysis of cross-sectional data on 40,723 children aged from birth to 17 years from the 2005-2006 National Survey of Children with Special Health Care Needs, including 1,982 (5%) with parent-reported hearing difficulties.

Results: Among CSHCN, 383 (1%) used hearing aids, representing 20% of those with reported hearing difficulties. Odds of hearing aid use increased with age, primary language other than English, and lower income. More than half (58%) of the aided children reported hearing difficulties even with their aid. Among CSHCN with cerebral palsy, 13% had reported hearing difficulties and 3% used hearing aids. Equivalent figures for children with Down syndrome were 24% and 4%, mental retardation/developmental delay 12% and 5%, and autism spectrum disorder 9% and 2%. Overall, two-thirds of CSHCN with hearing difficulties had one or more sensory/developmental comorbidities; CSHCN with both hearing difficulties and a sensory/developmental comorbidity had highest odds of learning difficulties, speaking/communication difficulties, feeling anxious/depressed, acting out/bullying, and difficulty making friends. CSHCN with hearing difficulties alone, or sensory/developmental conditions alone had intermediate odds, after socio-demographic adjustment.

Conclusions: Sensory/developmental comorbidities are common among CSHCN with hearing difficulties, and they are associated with higher odds of poorer social, communication, and educational function. Services for CSHCN must be equipped to address a range of hearing difficulties as well as sensory/developmental comorbidities and to improve social/emotional functioning as well as learning and communication.

*UCLA Center for Healthier Children, Families and Communities, David Geffen School of Medicine, UCLA, Los Angeles, CA;

U.S Department of Health and Human Services, Health Resources and Services, Administration, Maternal and Child Health Bureau, Washington, DC.

Address for reprints: Shirley A. Russ MD, MPH, UCLA Center for Healthier Children, Families, and Communities, 10990 Wilshire Boulevard, Suite 900, Los Angeles, CA 90024; e-mail:

Disclosure: The authors declare no conflict of interest.

Received December , 2012

Accepted June , 2013

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.