{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T16:14:17Z","timestamp":1781540057135,"version":"3.54.5"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T00:00:00Z","timestamp":1678924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Identify the age at diagnosis and intervention of immigrant and\/or non\u2010English\u2010speaking children with hearing loss (HL) and risk factors associated with delays. Identify barriers for non\u2010English\u2010speaking caregivers of deaf\/hard\u2010of\u2010hearing children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Sequential mixed methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary care center in an urban city.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The analysis includes descriptive statistics, and 1\u2010way and 2\u2010way analysis of variance of the retrospective chart review. The quantitative study demonstrated foreign\u2010born experienced disparities, so we conducted semistructured interviews on a subset of non\u2010English\u2010speaking families in the cohort that was then thematically analyzed using a human\u2010centered design strategy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We divided 532 children into 3 groups: US\u2010born with English as the preferred language (N\u2009=\u2009294), US\u2010born and non\u2010English language preferred (N\u2009=\u2009173), and foreign\u2010born (N\u2009=\u200967). The laterality of HL and pure\u2010tone averages were similar among the groups (<jats:italic>p<\/jats:italic>\u2009=\u2009.972 and .071, respectively). Age at diagnosis and time to the intervention were significantly different (39.7, 31.5, 75.8 months, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001 and 24.6, 29.2, 48.9 months, <jats:italic>p<\/jats:italic>\u2009=\u2009.001, respectively). Ages at diagnosis and intervention were associated with birthplace (<jats:italic>p<\/jats:italic>\u2009=\u2009.005, <jats:italic>p<\/jats:italic>\u2009=\u2009.0005, respectively) but not preferred language (<jats:italic>p<\/jats:italic>\u2009=\u2009.667, <jats:italic>p<\/jats:italic>\u2009=\u2009.343, respectively). Included in the qualitative interviews were Mandarin\u2010 (n\u2009=\u20095), Arabic\u2010 (n\u2009=\u20094), and Spanish\u2010speaking families (n\u2009=\u20093). Insights revealed participants' quest for anticipatory guidance and social support, the consequences of cultural stigma, and the complexity of caring for a child with HL in an immigrant family.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Foreign\u2010born children with HL have significant delays in diagnosis and intervention compared to US\u2010born children. For non\u2010English\u2010speaking parents, the diagnosis of HL presents challenges beyond that of the immigrant experience.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.322","type":"journal-article","created":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T04:40:18Z","timestamp":1678941618000},"page":"701-709","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Understanding Barriers to Timely Diagnosis and Intervention Among Immigrant Children With Hearing Loss"],"prefix":"10.1002","volume":"169","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0357-5892","authenticated-orcid":false,"given":"Katrin","family":"Jaradeh","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California, San Francisco  California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth N.","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California, San Francisco  California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6166-8432","authenticated-orcid":false,"given":"Lara Z.","family":"Chehab","sequence":"additional","affiliation":[{"name":"Department of General Surgery University of California, San Francisco  California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6401-7923","authenticated-orcid":false,"given":"Kathleen P.","family":"Tebb","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of California, San Francisco  California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle M.","family":"Florentine","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California, San Francisco  California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Bellfort\u2010Salinas","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California, San Francisco  California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dylan K.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California, San Francisco  California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,16]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"World Health Organization. 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