La Trobe
1297522_Carew,P_2023.pdf (951.87 kB)
Download file

Spoken Expressive Vocabulary in 2-Year-Old Children with Hearing Loss: A Community Study.

Download (951.87 kB)
journal contribution
posted on 2023-08-11, 03:59 authored by Peter Carew, Daisy A Shepherd, Libby Smith, Tegan Howell, Michelle Lin, Edith BavinEdith Bavin, Sheena Reilly, Melissa Wake, Valerie Sung
Through a cross-sectional community study of 2044 children aged 2 years, we (1) examine the impact of hearing loss on early spoken expressive vocabulary outcomes and (2) investigate how early intervention-related factors impact expressive vocabulary outcomes in children with hearing loss predominantly identified through universal newborn hearing screening. We used validated parent/caregiver-reported checklists from two longitudinal cohorts (302 children with unilateral or bilateral hearing loss, 1742 children without hearing loss) representing the same population in Victoria, Australia. The impact of hearing loss and amplification-related factors on vocabulary was estimated using g-computation and multivariable linear regression. Children with versus without hearing loss had poorer expressive vocabulary scores, with mean scores for bilateral loss 0.5 (mild loss) to 0.9 (profound loss) standard deviations lower and for unilateral loss marginally (0.1 to 0.3 standard deviations) lower. For children with hearing loss, early intervention and amplification by 3 months, rather than by 6 months or older, resulted in higher expressive vocabulary scores. Children with hearing loss demonstrated delayed spoken expressive vocabulary despite whole-state systems of early detection and intervention. Our findings align with calls to achieve a 1-2-3 month timeline for early hearing detection and intervention benchmarks for screening, identification, and intervention.


D.A.S. was supported by The Lorenzo and Pamela Galli Medical Research Trust. V.S. was supported by the Australian National Health and Medical Research Council (NHMRC) Early Career Fellowship 1125687, a Melbourne Children’s Clinician Scientist Fellowship 2021, and a L’OréalUNESCO Australian and New Zealand For Women in Science Fellowship 2019. M.W. was supported by the NHMRC Principal Research Fellowship 1160906, and S.R. was supported by the NHMRC Practitioner Fellowship 491210. Research at the Murdoch Children’s Research Institute is supported by the Victorian Government’s Operational Infrastructure Support Program. The funding organizations are independent of all researchers. The VicCHILD project received funding from the Royal Children’s Hospital Foundation [2018–999] and [2014–430]; the Murdoch Children’s Research Institute; the Phyllis Connor Memorial Trust; the Deafness Foundation; the National Health and Medical Research Council (NHMRC) Centre of Research Excellence Grant [1023493]; the Kyle Patrick Lamsam Convery Foundation; the Nelson Alexander Charitable Foundation; and a Royal Australasian College of Physicians Cottrell Research Establishment Fellowship.


Publication Date








Article Number








Rights Statement

© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (

Usage metrics

    Journal Articles