“It was the clinic setting that informed and fueled my efforts and interests because the patients that we see have some tear-jerking stories,” Bush said. “They didn’t have access to services, or they were totally unaware that there were options to help their hearing impaired child. So they show up at the clinic very delayed, well past the optimal age for intervention, and the child has already lost a lot of language development potential.”
About 1 in 1,000 children experience pediatric hearing loss, and Bush said the rate is much higher in Kentucky, 1.7 out of 1,000 in Kentucky. Though hearing loss isn’t life-threatening, it can greatly impact the quality of life, influencing speech, language and cognitive development in children. Early detection is important for successful treatment. “The consequences of delaying care in the first few years of life are amplified dramatically,” Bush said.
Rural residents deal with many health disparities, and “delays in pediatric hearing health care are unfortunately common,” Powell writes. “Children with hearing loss in rural areas are diagnosed later than children in urban areas and subsequently receive interventions like hearing aids and cochlear implants at a later age.”
This rural hearing-health disparity results from factors such as distance from health-care facilities and inadequate knowledge of the importance of timely care for pediatric hearing loss. Bush says he hopes to employ telemedicine to reduce the effects of distance from facilities, with “diagnostic testing, patient counseling and hearing loss rehabilitation with hearing aids and implants. These services have not been offered before in Appalachia.”
Bush is also working to increase parental knowledge about pediatric hearing loss and educate rural primary-care physicians in diagnosing and treating pediatric hearing loss. “This is not something that they’re seeing on a daily basis, so provider knowledge about next steps and resources is limited,” Bush said. He and his colleagues have created online educational modules that will be circulated to providers.
“In an ideal world . . . there would be a seamless transition from the birthing hospital to resources for hearing testing and treatment, whether face-to-face or via telemedicine. We’d like the quality of care and access to care to be the same for all children. That’s really what our passion is,” Bush said. (Read more)