Unmet health-related social needs impact quality of life in preschool-age children with hearing loss

Introduction Hearing loss (HL) in children can impede speech and language development, impacting pragmatic social skills which can influence one’s perceived quality of life (QoL). This study sought to understand how factors relating to hearing interventions and audiological data, as well as social determinants of health (SDOH) and health-related social needs (HRSN), influence QoL in preschool-aged children with HL. Methods A cross-sectional, single-institution retrospective chart review was conducted of children ages 2-7 with HL receiving care through an interdisciplinary Hearing Program from 2015-2024. Outcome measures included QoL as measured by the Preschool Hearing Environments and Reflection on Quality-of-Life Questionnaire (HEAR-QL). HEAR-QL scores were evaluated within the context of hearing, language, and socioeconomic factors including parent-reported HRSNs and Childhood Opportunity Index (COI). Statistical significance was evaluated via regression analysis. Results Fifty children were included in this study. Individual hearing-related factors were not associated with differences in QoL outcomes. At the same time, children with at least one unmet HRSN risk factor were found to have lower overall QoL scores both before and after adjustment for degree and laterality of HL (mean difference -10; 95% CI -20,-1.4; p=0.024 and mean difference -13; 95% CI -22,-3.6; p=0.008, respectively). Measures of community-level SDOH via COI were not found to be associated with HEAR-QL. Conclusions Unmet HRSNs can negatively impact QoL in children with HL. Further work is needed to characterize interactions between these factors within larger and more diverse populations and will help clinicians identify patients who may need specialized interventions to improve outcomes.