Posters
Presenting Author Academic/Professional Position
Courtney J Austin
Academic Level (Author 1)
Medical Student
Discipline/Specialty (Author 1)
Otolaryngology-Head and Neck Surgery
Academic Level (Author 2)
Faculty
Discipline/Specialty (Author 2)
Otolaryngology-Head and Neck Surgery
Academic Level (Author 3)
Staff
Discipline/Specialty (Author 3)
Otolaryngology-Head and Neck Surgery
Discipline Track
Community/Public Health
Abstract Type
Research/Clinical
Abstract
Background: Children who are deaf or hard-of-hearing (DHH) are required by United States law to have access to educational services through the Individuals with Disabilities in Education Act (IDEA). However, access to language-congruent providers, as well as supplemental services, varies considerably. Household income is associated with poorer hearing care access and outcomes in DHH children. We predict that access to supplemental, language-congruent DHH services is poorer in DHH children from lower-income homes.
Methods: This is a secondary, ad hoc exploratory study of DHH children aged 0-27 months enrolled in a randomized clinical trial (CT.gov: NCT04928209). Children were enrolled across all income strata and dichotomized based on 266% Federal Poverty Level into higher and lower income cohorts matched on hearing level. Upon enrollment, a comprehensive assessment of each participant's DHH service providers, including their language proficiency, was performed based on parent report and review of each child's Individualized Family Service Plan (IFSP). The number of unique DHH providers and whether supplemental speech-language therapy was being used was quantified for each participant. Language congruency was defined as the child having a DHH provider proficient in the same language as the primary language of the home. Low- and high-income cohorts were compared by Student's t-test or Pearson's chi-squared test for continuous or binary dependent variables, respectively.
Results: Among 205 DHH children, 69 (33.7%) were of higher income, and 64 (31.2%) had a primary language other than English at home. Overall, 179 (87.3%) of families had a languagecongruent DHH provider. Children from lower-income homes were significantly less likely to have a language-congruent provider (81.6% vs 98.6% for higher-income children, p < 0.001) and less likely to receive supplemental specialized speech-language therapy (4.4%, vs 13.0% for higher-income children, p = 0.025). Lower-income children had more DHH providers overall (2.5 providers vs 1.9 for higher-income children, p = 0.031).
Conclusion: Though lower-income children had more DHH providers than their higher-income counterparts, they were significantly less likely to have language-congruent providers or supplemental speech-language services beyond their IDEA-mandated IFSP. Therefore, we can conclude that DHH children from low-income households receive less equitable hearing health care. Equitable access to linguistically matched, specialized DHH support services is critical to optimizing language outcomes for children from lower-income homes.
Presentation Type
Poster
Recommended Citation
Austin, Courtney J.; Chan, Dylan; and Stephans, Jihyun, "Educational Services and Language Congruency in Low-Income Children who are Deaf of Hard-of-Hearing" (2025). Research Colloquium. 34.
https://scholarworks.utrgv.edu/colloquium/2025/posters/34
Included in
Disability Studies Commons, Health Communication Commons, Otolaryngology Commons, Pediatrics Commons, Speech Pathology and Audiology Commons
Educational Services and Language Congruency in Low-Income Children who are Deaf of Hard-of-Hearing
Background: Children who are deaf or hard-of-hearing (DHH) are required by United States law to have access to educational services through the Individuals with Disabilities in Education Act (IDEA). However, access to language-congruent providers, as well as supplemental services, varies considerably. Household income is associated with poorer hearing care access and outcomes in DHH children. We predict that access to supplemental, language-congruent DHH services is poorer in DHH children from lower-income homes.
Methods: This is a secondary, ad hoc exploratory study of DHH children aged 0-27 months enrolled in a randomized clinical trial (CT.gov: NCT04928209). Children were enrolled across all income strata and dichotomized based on 266% Federal Poverty Level into higher and lower income cohorts matched on hearing level. Upon enrollment, a comprehensive assessment of each participant's DHH service providers, including their language proficiency, was performed based on parent report and review of each child's Individualized Family Service Plan (IFSP). The number of unique DHH providers and whether supplemental speech-language therapy was being used was quantified for each participant. Language congruency was defined as the child having a DHH provider proficient in the same language as the primary language of the home. Low- and high-income cohorts were compared by Student's t-test or Pearson's chi-squared test for continuous or binary dependent variables, respectively.
Results: Among 205 DHH children, 69 (33.7%) were of higher income, and 64 (31.2%) had a primary language other than English at home. Overall, 179 (87.3%) of families had a languagecongruent DHH provider. Children from lower-income homes were significantly less likely to have a language-congruent provider (81.6% vs 98.6% for higher-income children, p < 0.001) and less likely to receive supplemental specialized speech-language therapy (4.4%, vs 13.0% for higher-income children, p = 0.025). Lower-income children had more DHH providers overall (2.5 providers vs 1.9 for higher-income children, p = 0.031).
Conclusion: Though lower-income children had more DHH providers than their higher-income counterparts, they were significantly less likely to have language-congruent providers or supplemental speech-language services beyond their IDEA-mandated IFSP. Therefore, we can conclude that DHH children from low-income households receive less equitable hearing health care. Equitable access to linguistically matched, specialized DHH support services is critical to optimizing language outcomes for children from lower-income homes.
