Objective: To examine the impact of slight to mild hearing loss in children by studying its association with academic performance and behavioral problems.
Methods: This study was embedded within a prospective birth cohort in Rotterdam, the Netherlands. Participants underwent audiometric and behavioral evaluations between ages 9-11 (April 2012-October 2015) and 13-15 (May 2017-September 2019). At 13-15, a multiple linear regression was conducted to explore the relationship between hearing acuity and both academic and behavioral outcomes. A cross-lagged analysis using data from ages 9 to 11 investigated bidirectional associations between hearing loss and behavioral problems.
Results: The cross-sectional part of the study involved 4688 participants at the age of 13-15 years. The relative risk for children with slight to mild hearing loss of being placed in a lower educational level compared with the highest level was 1.52 (95% confidence interval (CI) [1.14, 2.02]). Among boys, elevated high-frequency pure-tone average (HPTA) was associated with a higher total problem score (per 1 dB HPTA: β = 0.01; 95% CI [0.00, 0.02]). For girls, elevated low-frequency pure-tone average (LPTA) was associated with a higher attention problem score (per 1 dB LPTA: β = 0.02; 95% CI [0.01, 0.02]). Cross-lagged effects showed that participants with increased pure-tone averages in low frequencies at 9-11 years had more social problems at ages 13-15 years (Z-score difference: 0.01; 95% CI [0.01, 0.02]).
Conclusion: Elevated hearing thresholds in slight to mild hearing loss were linked to poorer academic performance and increased behavioral problems.
Level of evidence: 2 (prospective cohort study) Laryngoscope, 2024.
Keywords: academic performance; audiometry; behavior; child; hearing loss.
© 2024 The Author(s). The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.