Children with Unilateral Hearing Loss (CUHL) study: Does early hearing device fitting improve language and psychosocial outcomes?

Despite early detection of congenital Unilateral Hearing Loss (UHL) via universal newborn hearing screening (UNHS), there is a lack of evidence on the efficacy of early intervention (in the form of device fitting) for improving outcomes, and the benefit vs harms of early detection and treatment is uncertain. This study will follow children from diagnosis to 3 years of age to investigate the impact of UHL, and examine the benefit (if any) of device fitting. By agreeing to participate, a child with a unilateral hearing impairment would be allocated to one of two groups, 1) a device ‘fitting’ group , or 2) a ‘no fitting’ group. By participating in the study, all families and their children will be offered a study-specific program of support commensurate with best practice. Parents will be asked to complete a consent form before being informed as to which group their child has been allocated. For children assigned to the ‘fitting’ group, each child’s Australian Hearing (AH) clinician will choose a device in consultation with the child’s parents, and fit the device in accordance with standard procedures. All families in both groups will be offered a support program that involves intensive monitoring through tympanometry every 3 months. If a child consistently exhibits middle ear disorders in the good ear for longer than 6 months, the child will be referred to AH for review (and potential fitting), irrespective of experimental assignment. Standard audiometry will be offered annually, around the time of outcomes assessments. Significant changes in hearing thresholds will be referred to AH audiologists. In addition, all parents will be provided with a starter kit that contains information on childhood unilateral hearing loss, child development, communication strategies and activities on how to help the child, and where to get further support if needed. All families will also be offered access to information sessions to be organised by parent-support groups throughout the duration of the study.