{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T18:31:55Z","timestamp":1786386715595,"version":"build-2736575974"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Children who are deaf or hard\u2010of\u2010hearing (DHH) receive educational services through the Individuals with Disabilities in Education Act (IDEA). However, access to language\u2010congruent providers varies considerably. Sociodemographic factors are associated with poorer hearing care access and outcomes in DHH children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Prospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>4 tertiary children's hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a secondary, ad hoc exploratory study of DHH children aged 0 to 27 months enrolled in a randomized clinical trial (CT.gov: NCT04928209). Participants were dichotomized based on 266% Federal Poverty Level into higher and lower income cohorts. Comprehensive assessment of each participant's DHH service providers, including their language proficiency, was performed. The number of unique DHH providers and their characteristics was quantified. Associations between participant and DHH provider characteristics were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 205 DHH children, 69 (33.7%) were of higher income, and 64 (31.2%) had a primary language other than English at home. 179 (87.4%) of families had a language\u2010congruent DHH provider. Compared with DHH children from high\u2010income homes, those from lower\u2010income homes had a similar overall number of DHH providers, but were significantly less likely to have a language\u2010congruent provider (81.6% vs 98.6% for higher\u2010income children,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.001), receive supplemental, private specialized speech\u2010language therapy (1.5% vs 10.1%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.004), and have access to teletherapy (11.8% vs 34.8%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Lower\u2010income children had a similar number of DHH providers as their higher\u2010income counterparts. However, they were significantly less likely to have language\u2010congruent providers or supplemental speech\u2010language teletherapy services beyond their IDEA\u2010mandated IFSP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70116","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T10:41:58Z","timestamp":1767868918000},"page":"540-546","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Educational Services and Language Congruency in Low\u2010Income Children Who Are Deaf or Hard\u2010of\u2010Hearing"],"prefix":"10.1002","volume":"174","author":[{"given":"Courtney","family":"Austin","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery University of California San Francisco USA"},{"name":"School of Medicine University of Texas Edinburg Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery University of California San Francisco USA"},{"name":"School of Medicine University of California San Francisco USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joy M.","family":"Kearns","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery University of California San Francisco USA"},{"name":"Department of Audiology UCSF Benioff Children's Hospital Oakland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihyun R.","family":"Stephans","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery University of California San Francisco USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dylan K.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery University of California San Francisco USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0000000000000388"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21460"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.106.3.e43"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/DBP.0000000000001225"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599817725695"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/mao.0b013e31815f668b"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/AUD.0000000000001218"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/IYC.0000000000000090"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.5195\/ijt.2013.6129"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.5001\/omj.2020.40"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.3109\/17549507.2015.1032351"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2024-089118"},{"key":"e_1_2_8_14_1","unstructured":"Social Vulnerability Index. Accessed October 27 2025.https:\/\/www.atsdr.cdc.gov\/place-health\/php\/svi\/index.html."},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/10810730.2012.712621"},{"key":"e_1_2_8_16_1","unstructured":"U.S. Census Bureau. U.S Department of Commerce. Language Spoken at Home for the Population 5 Years and Over American Community Survey ACS 1\u2010Year Estimates Detailed Tables Table C16001 2023. Accessed September 15 25.https:\/\/data.census.gov\/table\/ACSDT1Y2023.C16001"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/deafed\/enac029"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ohn.322"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/ohn.1123"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/01945998211040017"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.70116","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ohn.70116","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.70116","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T18:26:39Z","timestamp":1786386399000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.70116"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,8]]},"references-count":19,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1002\/ohn.70116"],"URL":"https:\/\/doi.org\/10.1002\/ohn.70116","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,8]]},"assertion":[{"value":"2025-10-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}