{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T16:32:32Z","timestamp":1785342752541,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,9,12]],"date-time":"2017-09-12T00:00:00Z","timestamp":1505174400000},"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":[[2017,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aims to describe the effects of primary language and insurance status on care utilization among deaf or hard\u2010of\u2010hearing children under active otolaryngologic and audiologic care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Cross\u2010sectional analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Multidisciplinary hearing loss clinic at a tertiary center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Demographics, hearing loss data, and validated survey responses were collected from 206 patients aged 0 to 19 years. Two\u2010sided <jats:italic>t<\/jats:italic> tests and \u03c7<jats:sup>2<\/jats:sup> tests were used to obtain descriptive statistics and hypothesis testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the sample, 52.4% spoke primarily English at home. Non\u2010English\u2010speaking children and families were less likely to receive psychiatric counseling (12.2% vs 35.2% in the English group, <jats:italic>P<\/jats:italic> &lt;. 001) and reported more difficulty obtaining educational interventions (<jats:italic>P<\/jats:italic> =. 016), and 68.9% had public insurance. Parents of publicly insured children were less likely to know the type or degree of their child\u2019s hearing loss (56.9% vs 75.4%, <jats:italic>P<\/jats:italic> =. 022), and these children were older on presentation to the clinic (8.5 vs 6.5 years of age, <jats:italic>P<\/jats:italic> =. 01) compared to privately insured children. Publicly insured children were less likely to receive cochlear implants (<jats:italic>P<\/jats:italic> =. 046) and reported increased difficulty obtaining hearing aids (<jats:italic>P<\/jats:italic> =. 047). While all patients reported impairment in hearing\u2010related quality of life, publicly insured children aged 2 to 7 years were more likely to perform below minimum thresholds on measures of auditory\/oral functioning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Even when under active care, deaf or hard\u2010of\u2010hearing children from families who do not speak English at home or with public insurance face more difficulty obtaining educational services, cochlear implants, and hearing aids. These findings represent significant disparities in access to necessary interventions.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599817725695","type":"journal-article","created":{"date-parts":[[2017,9,12]],"date-time":"2017-09-12T08:01:27Z","timestamp":1505203287000},"page":"722-730","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Impact of Primary Language and Insurance on Pediatric Hearing Health Care in a Multidisciplinary Clinic"],"prefix":"10.1002","volume":"157","author":[{"given":"Brooke M.","family":"Su","sequence":"first","affiliation":[{"name":"Department of Head &amp; Neck Surgery University of California\u2013Los Angeles Los Angeles California USA"},{"name":"School of Medicine University of California\u2013San Francisco San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason S.","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California\u2013San Francisco 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\u2013San Francisco San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,9,12]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2008.12.022"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.130.5.524"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.102.5.1161"},{"key":"e_1_2_10_5_1","first-page":"20","article-title":"Early hearing detection and intervention among infants\u2014hearing screening and follow\u2010up survey, United States, 2005\u20102006 and 2009\u20102010","volume":"63","author":"Centers for Disease Control and Prevention","year":"2014","journal-title":"Morb Mortal Wkly Rep"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21460"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2013.08.031"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2015.02.030"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-2906"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/13557850903248639"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/13670050.2012.758686"},{"key":"e_1_2_10_12_1","first-page":"391","article-title":"Assessing parental perceptions of self\u2010efficacy and involvement in families of young children with hearing loss","volume":"103","author":"DesJardin JL","year":"2003","journal-title":"Volta Rev"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2009.09.036"},{"key":"e_1_2_10_14_1","volume-title":"LittlEARS Auditory Questionnaire Manual","author":"Med\u2010El Medical Electronics","year":"2011"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.3766\/jaaa.18.3.4"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.3766\/jaaa.22.10.3"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24336"},{"key":"e_1_2_10_18_1","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2016"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2011.05.019"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2014.06.002"},{"key":"e_1_2_10_21_1","volume-title":"National Healthcare Quality and Disparities Report and 5th Anniversary Update on the National Quality Strategy","author":"Agency for Healthcare Research and Quality","year":"2015"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/mao.0b013e31815f668b"},{"key":"e_1_2_10_23_1","unstructured":"California Healthcare Foundation.Covering kids: children\u2019s health insurance in California.2012.http:\/\/www.chcf.org\/~\/media\/MEDIALIBRARYFiles\/PDF\/PDFC\/PDFChildrensHealthCoverage2012.pdf. 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