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Semin Hear 2018; 39(04): 428-436
DOI: 10.1055/s-0038-1670708
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Profound Hearing Loss: Addressing Barriers to Hearing Healthcare

Sheila R. Pratt
1   Geriatric Research and Clinical Education Center, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
2   Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania
› Author Affiliations
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Publication History

Publication Date:
26 October 2018 (online)

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Abstract

The impact of profound hearing loss on infants and adults is variable and greatly influenced by improved audition derived from hearing aids and cochlear implants. However, barriers to healthcare, hearing healthcare in particular, can offset the benefits provided by these sensory devices. Common barriers include cost, location, availability of trained professionals, acceptance of the hearing loss, language and cultural differences, secondary disabilities, and mental health issues. These barriers and their distinct presentations vary somewhat by age, language, and where people live (urban vs. rural), and can interfere with receiving testing and devices in a timely manner. They also can limit auditory, speech and language therapies, and interfere with acceptance of the hearing loss and devices. Rehabilitation should focus on eliminating or reducing the adverse impact of these barriers on patients and their families. Some of which can be done through professional training and multidisciplinary activities, counseling, and community outreach.

Keywords

hearing loss - barriers - healthcare - rehabilitation
 

  • References

  • 1 Blanchfield BB, Feldman JJ, Dunbar JL, Gardner EN. The severely to profoundly hearing-impaired population in the United States: prevalence estimates and demographics. J Am Acad Audiol 2001; 12 (04) 183-189
    PubMedGoogle Scholar
  • 2 Hudgins C, Numbers F. An investigation of the intelligibility of speech of the deaf. Gen Psych Mono 1942; 25: 289-392
    PubMedGoogle Scholar
  • 3 Markides A. The speech of deaf and partially-hearing children with special reference to factors affecting intelligibility. Br J Disord Commun 1970; 5 (02) 126-140
    CrossrefPubMedGoogle Scholar
  • 4 Smith CR. Residual hearing and speech production in deaf children. J Speech Hear Res 1975; 18 (04) 795-811
    CrossrefPubMedGoogle Scholar
  • 5 Centers for Disease Control. Hearing Loss in Children. Available at: https://www.cdc.gov/ncbddd/hearingloss/ehdi-data2015.html . Accessed August 25, 2018
    PubMedGoogle Scholar
  • 6 American Academy of Pediatrics, Joint Committee on Infant Hearing. Year 2007 position statement: principles and guidelines for early hearing detection and intervention programs. Pediatrics 2007; 120 (04) 898-921
    CrossrefPubMedGoogle Scholar
  • 7 Spencer LJ, Guo LY. Consonant development in pediatric cochlear implant users who were implanted before 30 months of age. J Deaf Stud Deaf Educ 2013; 18 (01) 93-109
    CrossrefPubMedGoogle Scholar
  • 8 Tomblin JB, Peng S-C, Spencer LJ, Lu N. Long-term trajectories of the development of speech sound production in pediatric cochlear implant recipients. J Speech Lang Hear Res 2008; 51 (05) 1353-1368
    CrossrefPubMedGoogle Scholar
  • 9 Uchanski RM, Geers AE. Acoustic characteristics of the speech of young cochlear implant users: a comparison with normal-hearing age-mates. Ear Hear 2003; 24 (1, Suppl): 90S-105S
    CrossrefPubMedGoogle Scholar
  • 10 Sininger YS, Grimes A, Christensen E. Auditory development in early amplified children: factors influencing auditory-based communication outcomes in children with hearing loss. Ear Hear 2010; 31 (02) 166-185
    CrossrefPubMedGoogle Scholar
  • 11 Pandhi N, Schumacher JR, Barnett S, Smith MA. Hearing loss and older adults' perceptions of access to care. J Community Health 2011; 36 (05) 748-755
    CrossrefPubMedGoogle Scholar
  • 12 Helzner EP, Patel AS, Pratt S. , et al. Hearing sensitivity in older adults: associations with cardiovascular risk factors in the Health, Aging and Body Composition Study. J Am Geriatr Soc 2011; 59 (06) 972-979
    CrossrefPubMedGoogle Scholar
  • 13 Thorpe JM, Thorpe CT, Kennelty KA, Pandhi N. Patterns of perceived barriers to medical care in older adults: a latent class analysis. BMC Health Serv Res 2011; 11: 181
    CrossrefPubMedGoogle Scholar
  • 14 Thorpe JM, Thorpe CT, Kennelty KA, Chewning BA. Depressive symptoms and reduced preventive care use in older adults: the mediating role of perceived access. Med Care 2012; 50 (04) 302-310
    CrossrefPubMedGoogle Scholar
  • 15 Genther DJ, Betz J, Pratt S. , et al; Health ABC Study. Association of hearing impairment and mortality in older adults. J Gerontol A Biol Sci Med Sci 2015; 70 (01) 85-90
    PubMedGoogle Scholar
  • 16 Barnett S, Franks P. Health care utilization and adults who are deaf: relationship with age at onset of deafness. Health Serv Res 2002; 37 (01) 105-120
    PubMedGoogle Scholar
  • 17 Napier J, Kidd MR. English literacy as a barrier to health care information for deaf people who use Auslan. Aust Fam Physician 2013; 42 (12) 896-899
    PubMedGoogle Scholar
  • 18 Pollard RQ, Dean RK, O'Hearn A, Haynes SL. Adapting health education material for deaf audiences. Rehabil Psychol 2009; 54 (02) 232-238
    CrossrefPubMedGoogle Scholar
  • 19 Lieu CC, Sadler GR, Fullerton JT, Stohlmann PD. Communication strategies for nurses interacting with deaf patients. Medsurg Nurs 2007; 16 (04) 239-245
    PubMedGoogle Scholar
  • 20 Margellos-Anast H, Estarziau M, Kaufman G. Cardiovascular disease knowledge among culturally Deaf patients in Chicago. Prev Med 2006; 42 (03) 235-239
    CrossrefPubMedGoogle Scholar
  • 21 Zazove P, Meador HE, Reed BD, Sen A, Gorenflo DW. Cancer prevention knowledge of people with profound hearing loss. J Gen Intern Med 2009; 24 (03) 320-326
    CrossrefPubMedGoogle Scholar
  • 22 Scheier DB. Barriers to health care for people with hearing loss: a review of the literature. J N Y State Nurses Assoc 2009; 40 (01) 4-10
    PubMedGoogle Scholar
  • 23 Anderson ML, Wolf Craig KS, Ziedonis DM. Barriers and facilitators to Deaf trauma survivors' help-seeking behavior: Lessons for behavioral clinical trials research. J Deaf Stud Deaf Educ 2017; 22 (01) 118-130
    CrossrefPubMedGoogle Scholar
  • 24 Tannenbaum-Baruchi C, Feder-Bubis P, Adini B, Aharonson-Daniel L. Emergency situations and deaf people in Israel: communication obstacles and recommendations. Disaster Health 2014; 2 (02) 106-111
    CrossrefPubMedGoogle Scholar
  • 25 Lane H. The Mask of Benevolence: Disabling the Deaf Community. New York, NY: Vintage Books; 1999
    Google Scholar
  • 26 Edwards RAR. Sound and fury: much ado about nothing? Cochlear implants in historical perspective. J Am Hist 2005; 92: 894
    PubMedGoogle Scholar
  • 27 Vickrey Van Cleve J. A place of their own in history. Sign Lang Stud 2016; 17: 12-25
    CrossrefPubMedGoogle Scholar
  • 28 Meador HE, Zazove P. Health care interactions with deaf culture. J Am Board Fam Pract 2005; 18 (03) 218-222
    CrossrefPubMedGoogle Scholar
  • 29 Fileccia J. Sensitive care for the deaf: a cultural challenge. Creat Nurs 2011; 17 (04) 174-179
    CrossrefPubMedGoogle Scholar
  • 30 Iezzoni LI, Davis RB, Soukup J, O'Day B. Quality dimensions that most concern people with physical and sensory disabilities. Arch Intern Med 2003; 163 (17) 2085-2092
    CrossrefPubMedGoogle Scholar
  • 31 Kuenburg A, Fellinger P, Fellinger J. Health care access among deaf people. J Deaf Stud Deaf Educ 2016; 21 (01) 1-10
    CrossrefPubMedGoogle Scholar
  • 32 Committee on Early Childhood, Adoption, and Dependent Care; American Academy of Pediatarics. Health care of young children in foster care. Pediatrics 2002; 109 (03) 536-541
    CrossrefPubMedGoogle Scholar
  • 33 Grant R, Shapiro A, Joseph S, Goldsmith S, Rigual-Lynch L, Redlener I. The health of homeless children revisited. Adv Pediatr 2007; 54: 173-187
    CrossrefPubMedGoogle Scholar
  • 34 Shulman S, Besculides M, Saltzman A, Ireys H, White KR, Forsman I. Evaluation of the universal newborn hearing screening and intervention program. Pediatrics 2010; 126 (Suppl. 01) S19-S27
    CrossrefPubMedGoogle Scholar
  • 35 Brach C, Lewit EM, VanLandeghem K. , et al; Child Health Insurance Research Initiative. Who's enrolled in the State Children's Health Insurance Program (SCHIP)? An overview of findings from the Child Health Insurance Research Initiative (CHIRI). Pediatrics 2003; 112 (6, Pt 2): e499
    PubMedGoogle Scholar
  • 36 Shenkman E, Youngblade L, Nackashi J. Adolescents' preventive care experiences before entry into the State Children's Health Insurance Program (SCHIP). Pediatrics 2003; 112 (6, Pt 2): e533
    PubMedGoogle Scholar
  • 37 Newacheck PW, Inkelas M, Kim SE. Health services use and health care expenditures for children with disabilities. Pediatrics 2004; 114 (01) 79-85
    CrossrefPubMedGoogle Scholar
  • 38 Armstrong M, Maresh A, Buxton C. , et al. Barriers to early pediatric cochlear implantation. Int J Pediatr Otorhinolaryngol 2013; 77 (11) 1869-1872
    PubMedGoogle Scholar
  • 39 Bush ML, Bianchi K, Lester C. , et al. Delays in diagnosis of congenital hearing loss in rural children. J Pediatr 2014; 164 (02) 393-397
    CrossrefPubMedGoogle Scholar
  • 40 Fitzpatrick EM, Dos Santos JC, Grandpierre V, Whittingham J. Exploring reasons for late identification of children with early-onset hearing loss. Int J Pediatr Otorhinolaryngol 2017; 100: 160-167
    CrossrefPubMedGoogle Scholar
  • 41 Bush ML, Hardin B, Rayle C, Lester C, Studts CR, Shinn JB. Rural barriers to early diagnosis and treatment of infant hearing loss in Appalachia. Otol Neurotol 2015; 36 (01) 93-98
    PubMedGoogle Scholar
  • 42 Fortnum HM, Summerfield AQ, Marshall DH, Davis AC, Bamford JM. Prevalence of permanent childhood hearing impairment in the United Kingdom and implications for universal neonatal hearing screening: questionnaire based ascertainment study. BMJ 2001; 323 (7312): 536-540
    CrossrefPubMedGoogle Scholar
  • 43 Watkin P, Baldwin M. The longitudinal follow up of a universal neonatal hearing screen: the implications for confirming deafness in childhood. Int J Audiol 2012; 51 (07) 519-528
    CrossrefPubMedGoogle Scholar
  • 44 Barreira-Nielsen C, Fitzpatrick E, Hashem S, Whittingham J, Barrowman N, Aglipay M. Progressive hearing loss in early childhood. Ear Hear 2016; 37 (05) e311-e321
    CrossrefPubMedGoogle Scholar
  • 45 Cunningham M, Cox EO. ; Committee on Practice and Ambulatory Medicine and the Section on Otolaryngology and Bronchoesophagology. Hearing assessment in infants and children: recommendations beyond neonatal screening. Pediatrics 2003; 111 (02) 436-440
    CrossrefPubMedGoogle Scholar
  • 46 Walker EA, Holte L, Spratford M, Oleson J, Welhaven A, Harrison M. Timeliness of service delivery for children with later-identified mild-to-severe hearing loss. Am J Audiol 2014; 23 (01) 116-128
    CrossrefPubMedGoogle Scholar
  • 47 Healthy People 2020. Washington, DC: U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion 2018. Available at: https://www.healthypeople.gov/2020/topics-objectives/topic/hearing-and-other-sensory-or-communication-disorders/objectives . Accessed August 25, 2018
    PubMedGoogle Scholar
  • 48 American Speech-Language-Hearing Association. Guidelines for Audiologic Screening. Rockville, MD: American Speech-Language-Hearing Association 1997. Available at: www.asha.org/docs/html/GL1997-00199.html . Accessed July 9, 2012
    PubMedGoogle Scholar
  • 49 American College of Obstetricians and Gynecologists Committee on Gynecologic Practice. ACOG Committee Opinion No. 483: primary and preventive care: periodic assessments. Obstet Gynecol 2011; 117 (04) 1008-1015
    CrossrefPubMedGoogle Scholar
  • 50 U.S. Preventive Services Task Force. Guide to Clinical Preventive Services: Report of the U.S. Preventive Services Task Force. 2nd ed. Washington, DC: U.S. Department of Health and Human Services, Office of Public Health and Science, Office of Disease Prevention and Health Promotion; 1996
    Google Scholar
  • 51 Moyer VA. ; U.S. Preventive Services Task Force. Screening for hearing loss in older adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2012; 157 (09) 655-661
    CrossrefPubMedGoogle Scholar
  • 52 Chou R, Dana T, Bougatsos C, Fleming C, Beil T. Screening adults aged 50 years or older for hearing loss: a review of the evidence for the U.S. preventive services task force. Ann Intern Med 2011; 154 (05) 347-355
    CrossrefPubMedGoogle Scholar
  • 53 Morris A. An economic model of adult hearing screening. Audiology Res 2011; 1 (01) e16
    PubMedGoogle Scholar
  • 54 Barnett M, Hixon B, Okwiri N. , et al. Factors involved in access and utilization of adult hearing healthcare: a systematic review. Laryngoscope 2017; 127 (05) 1187-1194
    CrossrefPubMedGoogle Scholar
  • 55 Contrera KJ, Wallhagen MI, Mamo SK, Oh ES, Lin FR. Hearing loss health care for older adults. J Am Board Fam Med 2016; 29 (03) 394-403
    CrossrefPubMedGoogle Scholar
  • 56 Beck DL, Alcock CJ. Right product; wrong message. Hear Rev 2014; 21: 16-21
    PubMedGoogle Scholar
  • 57 Goldblat E, Most T. Cultural identity of young Deaf adults with cochlear implants in comparison to Deaf without cochlear implants and hard-of-hearing young adults. J Deaf Stud Deaf Educ 2018; 23 (03) 228-239
    CrossrefPubMedGoogle Scholar
  • 58 Blazer DG. Hearing health care: review of a report from the National Academies of Sciences, Engineering, and Medicine. Ann Intern Med 2016; 165 (06) 441-442
    CrossrefPubMedGoogle Scholar
  • 59 Donahue A, Dubno JR, Beck L. Guest editorial: accessible and affordable hearing health care for adults with mild to moderate hearing loss. Ear Hear 2010; 31 (01) 2-6
    CrossrefPubMedGoogle Scholar
  • 60 Keidser G, Convery E. Self-fitting hearing aids: status quo and future predictions. Trends Hear 2016; 20: 1-15
    PubMedGoogle Scholar
  • 61 Blaiser KM, Behl D, Callow-Heusser C, White KR. Measuring costs and outcomes of tele-intervention when serving families of children who are deaf/hard-of-hearing. Int J Telerehabil 2013; 5 (02) 3-10
    PubMedGoogle Scholar
  • 62 Cason J, Behl D, Ringwalt S. Overview of states' use of telehealth for the delivery of early intervention (IDEA Part C) services. Int J Telerehabil 2012; 4 (02) 39-46
    PubMedGoogle Scholar
  • 63 Meiboom AA, de Vries H, Hertogh CM, Scheele F. Why medical students do not choose a career in geriatrics: a systematic review. BMC Med Educ 2015; 15: 101
    CrossrefPubMedGoogle Scholar
  • 64 Hamdy RC. Do we need more geriatricians or better trained primary care physicians?. Gerontol Geriatr Med 2015; 1: 2333721414567129
    PubMedGoogle Scholar