Download PDF
Semin Hear 2004; 25(4): 333-345
DOI: 10.1055/s-2004-836135
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

When Hearing Loss Occurs with Multiple Disabilities

Jackson Roush1 , Meredith A. Holcomb1 , Patricia A. Roush2 , Maria Luisa Escolar3
  • 1Division of Speech and Hearing Sciences, Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
  • 2Department of Otolaryngology and UNC Hospitals, School of Medicine; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
  • 3Clinical Center for the Study of Development and Learning and Dept of Pediatrics, School of Medicine; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
Further Information

Publication History

Publication Date:
08 November 2004 (online)

    Permissions and Reprints

Many deaf and hard-of-hearing children have, in addition to hearing loss, one or more conditions that result in multiple disabilities. The most prevalent conditions that co-occur with hearing loss are learning disorders, intellectual disabilities, attention disorders, visual impairment, and cerebral palsy. In this article we examine these conditions and their implications for audiologic management, including assessment of hearing, selection and fitting of hearing aids, and clinical application of various hearing technologies. The need for specialized medical management is considered along with the role of the pediatrician and medical home. Also considered are issues relevant to educational placement, assessment, and intervention by professionals from multiple disciplines, and parent-professional communication. The article concludes with the personal perspective of a parent whose child experienced severe illness at birth and now has multiple disabilities.

KEYWORDS

Multiple disabilities - children - hearing loss - pediatric assessment and intervention

REFERENCES

  • 1 Pagon R, Graham J, Zonana J, Yong S. Coloboma, congenital heart disease, and choanal atresia with multiple anomalies: CHARGE association.  J Pediatr. 1981;  99 223-227
    PubMedGoogle Scholar
  • 2 Edwards B, Kileny P, Van Riper L. CHARGE syndrome: a window of opportunity for audiologic intervention.  Pediatrics. 2002;  110 119-126
    CrossrefPubMedGoogle Scholar
  • 3 Vohr B, Widen J, Cone-Wesson B et al.. Identification of neonatal hearing impairment: characteristics of infants in the neonatal intensive care unit and well-baby nursery.  Ear Hear. 2000;  21 373-382
    PubMedGoogle Scholar
  • 4 Gallaudet Research Institute. Regional and National Summary Report of Data from the 2001-2002 Annual Survey of Deaf and Hard of Hearing Children and Youth. Washington, DC; GRI, Gallaudet University 2003
    Google Scholar
  • 5 Beitchman J, Young A. Learning disorders with a special emphasis on reading disorders: a review of the past 10 years.  J Am Acad Child Adolesc Psychiatry. 1997;  36 1020-1032
    CrossrefPubMedGoogle Scholar
  • 6 Cantwell D, Baker L. Developmental Speech and Language Disorders. New York; Guilford 1987
    Google Scholar
  • 7 Cantwell D, Baker L. Psychiatric and Developmental Disorders in Children with Communication Disorders. Washington, DC; American Psychiatric Press 1991
    Google Scholar
  • 8 Hammill D. On defining learning disabilities: an emerging consensus.  J Learn Disabil. 1990;  23 74-84
    PubMedGoogle Scholar
  • 9 Kavale K, Forness S, Lotsbach T. Definition for definitions of learning disabilities.  Learning Disability Quarterly. 1991;  14 257-268
    PubMedGoogle Scholar
  • 10 Kavale K, Forness S. The Nature of Learning Disabilities: Critical Elements of Diagnosis and Classification. Mahwah, NJ; Lawrence Erlbaum 1995
    Google Scholar
  • 11 Shaw S, Cullen J, McGuire J, Brinckerhoff L. Operationalizing a definition of learning disabilities.  J Learn Disabil. 1995;  28 586-597
    PubMedGoogle Scholar
  • 12 Hallahan D, Kauffman J, Lloyd J. Introduction to Learning Disabilities, 3rd ed. Englewood Cliffs, NJ; Prentice Hall 1996
    Google Scholar
  • 13 Love R, Webb W. Neurology for the Speech-Language Pathologist. Boston; Butterworth-Heinemann 1992
    Google Scholar
  • 14 Murdoch, B Acquired Neurological Speech/Language Disorders in Childhood. London; Taylor and Francis 1991
    Google Scholar
  • 15 Rourke B. Nonverbal Learning Disabilities: The Syndrome and the Model. New York; Guilford 1989
    Google Scholar
  • 16 Swanson H. Information processing theory and learning disabilities: an overview.  J Learn Disabil. 1987;  20 3-7
    PubMedGoogle Scholar
  • 17 Swanson H. Memory subtypes in learning disabled readers.  Learn Disabil. 1988;  11 342-357
    PubMedGoogle Scholar
  • 18 Zemlin W. Speech and Hearing Sciences: Anatomy and Physiology, 3rd ed. Englewood Cliffs, NJ; Prentice Hall 1988
    Google Scholar
  • 19 Hurst J, Baraitser M, Auger E, Graham F, Norell S. An extended family with a dominantly inherited speech disorder.  Dev Med Child Neurol. 1990;  32 352-355
    PubMedGoogle Scholar
  • 20 Tomblin J, Buckwalter P. Studies of the genetics of specific language impairment. In: Watkins T, Rice M Specific Language Impairments in Children. Baltimore, MD; Paul H. Brookes 1994: 17-34
    Google Scholar
  • 21 Pennington B. Genetics of learning disabilities.  J Child Neurol. 1995;  10(suppl x1) 69-77
    PubMedGoogle Scholar
  • 22 Huttenlocher J, Haight W, Bryk A, Seltzer M, Lyson T. Early vocabulary growth: relation to language input and gender.  Dev Psychol. 1991;  27 236-248
    CrossrefPubMedGoogle Scholar
  • 23 Shywitz S. Dyslexia.  Sci Am. 1996;  275 98-104
    PubMedGoogle Scholar
  • 24 Torgesen J, Wagner R, Rashotte C. Longitudinal studies of phonological processing and reading.  J Learn Disabil. 1994;  27 276-286
    PubMedGoogle Scholar
  • 25 National Deaf Education Center, Gallaudet University. Deaf children with multiple disabilities. Available at: http://clerccenter.gallaudet.edu/InfoToGo/141.html Accessed February 9, 2004
    Google Scholar
  • 26 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th Washington, DC; APA 1994
    Google Scholar
  • 27 Fraser G. Profound childhood deafness.  J Med Genet. 1964;  1 118-151
    PubMedGoogle Scholar
  • 28 Holland A. Genetic aspects of visual and auditory impairment in mentally handicapped people. In: Ellis D Sensory Impairments in Mentally Handicapped People. Beckenham, KY; Croom-Helm 1986: 149-166
    Google Scholar
  • 29 Balkany T. Otologic aspects of Down’s syndrome.  Semin Speech Lang. 1980;  1 39-48
    PubMedGoogle Scholar
  • 30 Bond D. Mental health in children who are deaf and have multiple disabilities>. In: Hindley P, Kitson N Mental Health and Deafness. London; Whurr Publishers 2000: 127-148
    Google Scholar
  • 31 Hildmann A, Hildmann H, Kessler A. Hearing disorders in children with Down’s syndrome.  Laryngorhinootologie. 2002;  81 3-7
    Article in Thieme ConnectPubMedGoogle Scholar
  • 32 Shott S R, Joseph A, Heithaus D. Hearing loss in children with Down syndrome.  Int J Pediatr Otorhinolaryngol. 2001;  61 199-205
    CrossrefPubMedGoogle Scholar
  • 33 Mazzoni D, Ackley R, Nash D. Abnormal pinna type and hearing loss correlations in Down's syndrome.  J Intellect Disabil Res. 1994;  38 549-560
    PubMedGoogle Scholar
  • 34 Buchanan L. Early onset of presbyacusis in Down syndrome.  Scand Audiol. 1990;  19 103-110
    PubMedGoogle Scholar
  • 35 Yeates S. The incidence and importance of hearing loss in people with severe learning disability: the evolution of a service.  Br J Learn Disabil. 1995;  23 79-84
    PubMedGoogle Scholar
  • 36 Carvill S. Sensory impairments, intellectual disability and psychiatry.  J Intellect Disabil Res. 2001;  45 467-483
    CrossrefPubMedGoogle Scholar
  • 37 Wetherby A. Communication and language disorders in infants, toddlers, and preschool children. In: Shames G, Wiig E, Secord W Human Communication Disorders: An Introduction, 5th ed. Boston; Allyn and Bacon 1998: 155-184
    Google Scholar
  • 38 Levine M. Developmental Variation and Learning Disorders, 2nd ed. Cambridge, MA; Educators Publishing Service Inc 2001
    Google Scholar
  • 39 Kelly D, Aylward G. Attention deficits in school-aged children and adolescents: current issues and practice.  Pediatr Clin North Am. 1992;  39 487-512
    PubMedGoogle Scholar
  • 40 Chess S, Fernandez P. Impulsivity in rubella deaf children: a longitudinal study.  Am Ann Deaf. 1980;  125 505-509
    PubMedGoogle Scholar
  • 41 Levine M. Attention deficits: the diverse effects of weak control systems in childhood.  Pediatr Ann. 1987;  16 117-131
    PubMedGoogle Scholar
  • 42 August G, Garfunkel B. Co-morbidity of ADHD and reading disability among clinic-referred children.  J Abnorm Child Psychol. 1990;  18 29-45
    CrossrefPubMedGoogle Scholar
  • 43 Kelly D, Kelly B, Jones M, Moulton N, Verhulst S, Bell S. Attention deficits in children and adolescents with hearing loss: a survey.  Am J Dis Child. 1993;  147 737-741
    PubMedGoogle Scholar
  • 44 Kelly D, Forney G, Parker-Fisher S, Jones M. The challenge of attention deficit disorder in children who are deaf or hard of hearing.  Am Ann Deaf. 1993;  138 343-348
    PubMedGoogle Scholar
  • 45 Kelly D, Forney G, Parker-Fisher S, Jones M. Evaluating and managing attention deficit disorder in children who are deaf or hard of hearing.  Am Ann Deaf. 1993;  138 349-357
    PubMedGoogle Scholar
  • 46 Barkley R. Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment. New York; Guilford Press 1990
    Google Scholar
  • 47 Van Dijk J. Rubella handicapped children. In: Blank M, Bakker D Modern Approaches to the Diagnosis and Instruction of Multi-Handicapped Children. Lisse, The Netherlands; Swets and Zeitlinger 1982: 7-179
    Google Scholar
  • 48 Aitken S. Understanding deafblindness. In: Aitken S, Buultjens M, Clark C, Eyre J, Pease L Teaching Children Who Are Deaf-Blind. London; David Fulton Publishers Ltd 2000: 1-34
    Google Scholar
  • 49 Baldwin V. Annual Deaf-Blind Census. Monmouth, OR; Teaching Research Division 1994
    Google Scholar
  • 50 Jensema C. A profile of deaf-blind children within various types of educational facilities.  Deaf-Blind News. 1980;  80 896-900
    PubMedGoogle Scholar
  • 51 Miles B. Overview on deaf-blindness. DB-LINK: The National Clearinghouse on Children who are Deaf-Blind. 2003 Available at: http://www.tr.wou.edu/dblink/overview.htm Accessed December 10, 2003
    Google Scholar
  • 52 Shafer S, Moss K. Cerebral palsy and children with vision and hearing loss. http://www.deafblind.com/cerebral.html Accessed December 2003
    Google Scholar
  • 53 Robinson R. The frequency of other handicaps in children with cerebral palsy.  Dev Med Child Neurol. 1983;  15 305-312
    PubMedGoogle Scholar
  • 54 Winter S, Autry A, Boyle C, Yeargin-Allsopp M. Trends in the prevalence of cerebral palsy in a population-based study.  Pediatrics. 2002;  110 1220-1225
    CrossrefPubMedGoogle Scholar
  • 55 Bhushan V, Paneth N, Kiely J. Impact of improved survival of very low birth weight infants on recent secular trends in the prevalence of cerebral palsy.  Pediatrics. 1993;  91 1094-1100
    PubMedGoogle Scholar
  • 56 Centers for Disease Control and Prevention (CDC) . Economic costs associated with mental retardation, cerebral palsy, hearing loss, and vision impairment.  Morb Mortal Wkly Rep. 2004;  53 57-59
    PubMedGoogle Scholar
  • 57 Harrison M, Roush J, Wallace J. Trends in the age of identification and intervention for deaf and hard-of-hearing infants.  Ear Hear. 2003;  24 89-95
    PubMedGoogle Scholar
  • 58 Tharpe A M. Cochlear implantation of children with multiple disabilities. Paper presented at the annual convention of the American Academy of Audiology Salt Lake City, UT; 2004
    Google Scholar
  • 59 Pediatric Working Group of the Conference on Amplification for Children with Auditory Deficits. Amplification for infants and children with hearing loss.  Am J Audiol. 1996;  5 53-68
    CrossrefPubMedGoogle Scholar
  • 60 Desired Sensation Level Method .University of Western Ontario. Available at: http://www.dslio.com Accessed January 2004
    Google Scholar
  • 61 Tharpe A, Ashmead D, Ricketts T, Rothpletz A, Wall R. Optimization of amplification for deaf-blind children. In: Seewald, RC, Gravel JS A Sound Foundation through Early Amplification 2001: Proceedings of the Second International Conference. Suffolk, UK; St. Edmundsbury Press 2000
    Google Scholar
  • 62 Zimmerman-Phillips S, Osberger M, Robbins A. Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS). Sylmar, CA; Advanced Bionics Corp 1997
    Google Scholar
  • 63 Niparko J, Blankenhorn R. Cochlear implants in young children.  Ment Retard Dev Disabil Res Rev. 2003;  9 267-275
    CrossrefPubMedGoogle Scholar
  • 64 Waltzman S, Scalchunes V, Cohen N. Performance of multiply handicapped children using cochlear implants.  Am J Otol. 2000;  21 329-335
    CrossrefPubMedGoogle Scholar
  • 65 Joint Committee on Infant Hearing . Year 2000 position statement: principles and guidelines for early hearing detection and intervention programs.  Pediatrics. 2000;  106 798-817
    CrossrefPubMedGoogle Scholar
  • 66 American Academy of Pediatrics, Ad Hoc Task Force on Definition of the Medical Home. The medical home.  Pediatrics. 1992;  90-774
    PubMedGoogle Scholar
  • 67 Individuals with Disabilities Education Act Amendments of 1997, PL no. 105-17,111, Stat. 38 (1997).  Codified as amended at 20 USC Section. 1400-1485
    Google Scholar
  • 68 Diefendorf A, Bull M, Casey-Harvey D et al.. Down syndrome: a multidisciplinary perspective.  J Am Acad Audiol. 1995;  6 39-46
    PubMedGoogle Scholar
  • 69 Cherow E, Matkin N, Trybus R Hearing Impaired Children and Youth with Developmental Disabilities: An Interdisciplinary Foundation for Service. Washington, DC; Gallaudet University Press 1985
    Google Scholar
  • 70 Jones T. Behavior modification studies with hearing-impaired students: a review.  Am Ann Deaf. 1984;  129 451-458
    PubMedGoogle Scholar
  • 71 Ewing K, Jones T. An educational rationale for deaf students with multiple disabilities.  Am Ann Deaf. 2003;  148 267-271
    PubMedGoogle Scholar

Jacksonm RoushPh.D. 

Division of Speech and Hearing Sciences, CB 7190, Wing D-School of Medicine

University of North Carolina at Chapel Hill

Chapel Hill, NC 27599

Email: jroush@med.unc.edu

      >