Nearly half of LEP children wore hearing aids 15 min or less per day versus 10 percent of English-proficient children

Description #

Beyond the mean difference, near-zero device use was far more common in the LEP group. Nearly half of the LEP children — 10 of 24 (42%) — wore their hearing aids for 15 minutes or less per day, compared with only about 10% (7 of 69) of children from English-proficient families. No child in the LEP group reached the ~10 hr/day benchmark associated with better language outcomes.

"Moreover, nearly half of children in the limited-English proficiency group (n = 10 of 24; 42%) wore their hearing aids for 15 min or less each day as compared to only about 10% of children from English-proficient families (n = 7 of 69)." (Brigham, 2024, p. 325)

"None of the children in the limited-English proficiency group demonstrated daily wear times of 10 or more hours a day." (Brigham, 2024, p. 325)

Methods Context #

What? #ⓘ

The observable: the proportion of children in each group with effectively negligible daily hearing aid use (data-logged wear time of 15 minutes or less per day), and the proportion reaching the 10 hr/day benchmark.

"Moreover, nearly half of children in the limited-English proficiency group (n = 10 of 24; 42%) wore their hearing aids for 15 min or less each day as compared to only about 10% of children from English-proficient families (n = 7 of 69)." (Brigham, 2024, p. 325)

How? #ⓘ

Retrospective chart review at one academic medical center; LEP status operationalized by interpreter presence at appointments, with daily wear time obtained from hearing aid data logging and children counted as near-nonusers if logged use was 15 minutes or less per day.

"A retrospective chart review was completed to evaluate hearing aid wear time based on data logging information available at the time of a follow-up visit following an initial hearing aid fitting." (Brigham, 2024, p. 321)

Who? #ⓘ

Children aged 2-60 months with permanent bilateral hearing loss seen for hearing aid follow-up between April 2020 and April 2022 at Vanderbilt University Medical Center (Nashville, TN): 69 from English-proficient families and 24 from LEP families (79% Spanish-speaking).

"This chart review included children from one of two types of families: (a) families who were English proficient (n = 69) and (b) families with limited English proficiency (n = 24); with 79% of this group being Spanish speaking." (Brigham, 2024, p. 323)

Other Notes #

This distributional finding (mass at near-zero use) shows the group gap is not driven only by a few outliers but reflects widespread near-nonuse among LEP children. The authors interpret this as scarce access to sound throughout the day.

Caveats #

• Wear-time estimates are biased by including only children with available data logging The wear-time estimates include only children who returned for a follow-up visit and for whom data logging was available; children fit with hearing aids who never returned, or who were recommended hearing aids but never returned for a fitting, are excluded. Because LEP families are generally less likely to access health care services, this selection likely biases the wear-time estimates (probably toward overestimating use among LEP children, since the most disengaged families never appear in the data).
• Small single-region LEP sample (n=24) likely unrepresentative of LEP families generally The limited-English-proficiency group was small (n = 24) and drawn from a single clinic in one geographic region (Nashville, TN), so the authors caution the sample is likely not representative of LEP families generally and the findings may not generalize to other regions or language groups.
• Socioeconomic status was confounded with language group and could not be controlled Insurance type, used as a proxy for socioeconomic status, differed sharply between groups (about 96% of LEP families on public insurance vs about 30% of English-proficient families). Because socioeconomic status (and the related caregiver educational level, which is itself associated with pediatric hearing aid wear time) could not be controlled or even measured, the observed wear-time gap cannot be cleanly attributed to language discordance rather than to socioeconomic disadvantage.