Hearing loss in children has a well-documented impact on language development, which in turn is tightly linked to cognitive development, literacy and educational outcomes. Most research has focused on the impact of moderate to severe/profound hearing loss (>40 dB in the worst hearing ear), based on clinical populations. However hearing sensitivity is a continuum, and there is developing evidence that “lesser” degrees of hearing loss, not always identified or managed through Audiology clinics, may have an impact on children’s development although much is still unknown.

This lack of evidence leads to within- and between-country differences in how hearing loss is managed in children. In the UK for example, communication and educational interventions are available as standard for those with moderate or worse bilateral hearing loss in both ears, with regional differences as to how milder hearing losses are managed, if at all. By contrast, in Canada, children with any degree of hearing loss in either ear, receive intensive communication, hearing and educational intervention from birth. There is no evidence as to which approach is best.

To develop interventions which are effective across the range of hearing losses, it is necessary to first understand the impact of hearing sensitivity (examined as a continuum) on children's development. This requires a population rather than a clinical approach. This study therefore aims to examine the impact of childhood hearing loss on language, cognitive, educational and employment outcomes through childhood and early adulthood in the ALSPAC cohort.

ALSPAC has detailed measures of hearing at ages 7, 9, 11 and 15 years on around 4-7000 of the cohort. We will conduct an in-depth statistical analysis of these hearing data to understand the range and continuum of children's hearing sensitivity in the population, how it changes with age and how it links to clinical categories of hearing loss.

We will then examine whether the continuum and range of hearing levels in childhood are associated with child development and outcomes into young adulthood. We will focus on language, cognition, literacy, education, well-being and employment outcomes. Finally if there are adverse outcomes for those with hearing loss, we will examine whether there are factors that moderate outcomes.