COVID-19 lockdowns associated with increased quiet time and less spoken communication for children with cochlear implants

1. During the COVID-19 pandemic lockdowns, schoolchildren with cochlear implants were exposed to more quiet time and less spoken communication, with a speech:quiet ratio of 0.9:1.0 during the lockdowns, compared to a 1.6:1.0 ratio prior to lockdowns.

2. Children with fewer household members did not experience less spoken communication, but experienced more quiet time, with a 0.15 daily hour decrease in quiet time per increase in household by 1 individual.

Evidence Rating Level: 2 (Good)

Study rundown: The COVID-19 pandemic resulted in the emergency closure of schools, leaving children to learn and socialize from the confines of their own homes. Not only has this impacted psychosocial health, as evidenced by the 350% increase in a kids mental health helpline, but the lack of socialization has limited conversational opportunities for children relying on hearing devices. Specifically, hearing devices like cochlear implants contribute significantly to language development, when they are used on a consistent basis. To gauge any changes in sound exposure and spoken communication due to the pandemic, the current study analyzed data from cochlear implants of the same cohort of schoolchildren, both before and during the lockdowns. This data included records of the type, level, and duration of sound input from the children’s environment. However, speech from conversations and from electronic media could not be distinguished in the data. The results showed that although the usage of cochlear implants was similar to pre-lockdown periods, the children received quieter sound inputs overall and reduced exposure to speech. In particular, children with fewer household members experienced a greater percentage of daily quiet time.

Click to read this article in JAMA Otolaryngology- Head & Neck Surgery

Relevant Reading: Early Hearing Detection and Vocabulary of Children With Hearing Loss

In-Depth [prospective cohort]: The study population consisted of 45 schoolaged children from Ontario, Canada, who used cochlear implants. The mean ± SD age was 7.7 ± 5.0 years, with 51.1% girls, and 64.4% using bilateral implants. Data from the implants were considered pre-COVID-19 lockdown between February 1 and March 15, 2020, whereas the peri-COVID-19 lockdown period lasted until early July. When analyzing the levels of sound input, there was a slight increase during the peri-COVID-19 period in daily hours of 40-49 dBA input (0.26 h, 95% CI 0.03-0.55 h). As well, there was a decrease in input at 60-69 dBA (-0.49 h, 95% CI -0.21 to -0.8 h) and 70-79 dBA (-1.70 h, 95% CI -1.42 to -1.99 h). Furthermore, there was more time spent in quiet (0.76 h, 95% CI 0.27-1.26 h), and less time spent in speech alone versus speech with competing background noise (-1.38 h, 95% CI -0.88 to -1.87 h). Overall, during the pre-COVID-19 period, children were exposed 1.6 times more to speech than to quiet (4.27 h versus 2.73 h daily), whereas during the peri-COVID-19 period, children were exposed to speech 0.9 times that of quiet exposure (3.34 h versus 3.50 h daily). Children with fewer household members did not experience less exposure to speech, but did experience more quiet time, with an estimated decrease ± standard error of 0.15 ± 0.17 daily hour of quiet time per 1 individual increase.

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