OUTCOME RESULTS 2015
No limits For Children Who Are Deaf
ABOUT THE CORA BARCLAY CENTRE
Hearing loss is one of the most common disabilities in newborns, affecting approximately 2 in 1,000 babies each year.
Australian Hearing, 2013 #
About the Cora Barclay Centre
The Cora Barclay Centre The aim of the Cora Barclay Centre Thanks to early diagnosis and is to help children who are deaf or continuing advances in hearing is the oldest and most hearing impaired, achieve life-long technologies, the vast majority of comprehensive dedicated social and emotional well-being and children attending the Cora Barclay Listening and Spoken economic independence. Centre (and other First Voice centres*), who have no additional disabilities, Language (LSL) program The Centre provides evidence-based, achieve speech, language and multi-disciplinary services for children comprehension that is comparable to in Australia providing who are deaf or hearing impaired, children of the same age with normal intensive, evidence- the majority of whom are fitted with hearing by the time they go to school. based intervention hearing aids, cochlear implants or other listening devices. Programs through Auditory-Verbal include early childhood intervention, Therapy (AVT). student services, social participation programs, and ongoing monitoring and assessment to children from birth to 18 years and their families.
1 per 1,000 live births is the estimated rate of permanent childhood hearing loss that is identified at, or very close to, birth. By the time each
‘birth cohort’ has reached 5 years of age, this rate has risen to approximately 3 per 1,000 children. National Framework for Neonatal Hearing Screening August 2013, Page 4 http://health.gov.au/internet/main/publishing.nsf/Content/neonatal-hearing-screening
- First Voice is the national voice for six centres providing listening and spoken language early intervention for children with hearing loss in Australia and New Zealand. Members are the Cora Barclay Centre (SA), Hear and Say (QLD), The Shepherd Centre (NSW/ACT), Taralye (VIC), Telethon Speech and Hearing (WA) and the Hearing House (NZ). First Voice champions the right of all people who are deaf or hearing impaired to listen and to speak.
CORA BARCLAY CENTRE
ASSESSMENT PROTOCOLS
In February 2010, the Cora Barclay The Cora Barclay Centre is committed to evidence-based practice. Cora Barclay Centre Programs are continually reviewed in light of national and international research and its own program evaluations. The Centre uses its own assessment data to:
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Obtain objective measurements of each child’s speech and language development to inform their individual therapy plan.
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Enable objective comparisons between children who are deaf or hearing impaired undertaking the Cora Barclay Centre AVT Program and children with normal hearing of the same age in order to determine whether their spoken language skills are equivalent to their hearing peers.
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Monitor and evaluate the effectiveness of Cora Barclay Centre Therapy Programs.
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CORA BARCLAY CENTRE
ASSESSMENT METHOD
92% of children with permanent hearing loss are born to hearing parents.
Mitchell & Karchmer, 2004
CORA BARCLAY CENTRE ASSESSMENT METHOD
95 children aged between 6 months Cora Barclay Centre programs are and 12 years who were enrolled in the continually reviewed in the light of AVT Early Intervention (EI) or Student national and international research Services (SS) program at the Cora Barclay and its own program evaluations. Centre were assessed from January As part of its evidence-based approach, 2015 to the end of December 2015. the Cora Barclay Centre contributes its data to the First Voice national 5 year old data will be reported in both clinical database. Data collected in the EI and SS outcomes reports as some 2014 from 628 children from across students are assessed before they start Australia and New Zealand in the school at age 5 and others once they Early Intervention programs offered have started school. in First Voice Centres was reported in the ‘Sounds Outcomes’ project. Our results will be compared with the data from the First Voice report. This is available at firstvoice.org.au
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Hearing Loss
Permanent childhood hearing loss can be congenital, late-onset, progressive, or acquired in nature.
Congenital Hearing loss refers to hearing loss that is present at birth and is often identified through a newborn hearing screening conducted shortly after birth.
The Cora Barclay Centre defines Late Diagnosis as congenital hearing loss diagnosed after 12 months of age.
Length of time optimally aided with hearing aids or cochlear implants
Presence of an additional disability
Presence of an additional speech and language disorder not related to hearing loss.
asha.org/Practice-Portal/Clinical-topics/ Permanent-childhood-Hearing-Loss/ The Cora Barclay Centre supports children who experience one or more of the above factors and their assessment results have been included with the exception of those children who were unable to participate in standardized testing. It is consistently reported that close to 40% of children with hearing loss have an additional disability.
The Cora Barclay Centre 2015 Outcomes document highlights the outcomes for children late diagnosed with hearing loss. In addition to late diagnosis other factors can contribute to outcomes below the average range. These can include:
- Consistency of wear of amplification device
- Family engagement to early intervention and capacity to implement strategies in all communication settings
agbell.org/Document.aspx?id=454
For Children Affected
by hearing loss, the future prospects are positive.
Thanks to early diagnosis, continuing advances in hearing technologies and access to listening and spoken language early childhood intervention at a very young age, children who are deaf or hearing impaired have the potential to learn to listen and to speak.
THE KEY ASSESSMENT TOOLS USED BY THE CORA BARCLAY CENTRE
Early Intervention
- Pre-School Peabody Picture Goldman Fristoe
- Language Scale Vocabulary Test Test Of Articulation
- Edition (PLS-5) Edition 4 (PPVT-4) (GFTA)
The PLS-5 is divided into 2 parts: (1) Auditory Comprehension which assesses the understanding of spoken language and (2) Expressive Communication which assesses the child’s verbal language. Both parts of the assessments are used to calculate the total language score.
The PPVT-4 tests a child’s understanding of words used to name objects and describe actions and attributes. It is a norm-referenced assessment of vocabulary which provides standard scores, percentiles, and age-equivalent scores from early childhood to adulthood.
The GFTA is a norm-referenced assessment of articulation which provides standard scores and percentiles from early childhood to adulthood. The test provides information about a child’s articulation ability by sampling both spontaneous and imitative sound production of consonants and vowels. The distribution of errors is greatly skewed across ages and does not approach a normal distribution at most ages. Therefore it may be better to refer to the percentile rather than the standard score when interpreting results for this particular assessment.
The PLS-5 is a norm-referenced assessment which provides standard scores, percentiles, and age-equivalent scores for children from birth to six years. Standard scores have a mean or average of 100 and one standard deviation is a difference of 15. Therefore children who score between 85 and 115 fall within one standard deviation of the mean of 100 and are within the ‘average range’.
Sixty-eight percent (68%) of the population fall within one standard deviation of the mean. A percentile is a way of comparing a child’s score to scores obtained by other children of the same age. For example, a percentile rank of 5 indicates that out of 100 of the same age children, that child is performing at the same level or better than 5 out of 100 children. A percentile between 16 and 84 indicates abilities that are within the average range. Percentiles below 16 represent some developmental delay or impairment. Percentiles below 3 indicate a significant degree of delay or impairment.
Student Services
The Clinical Evaluation of Language Fundamentals Edition 4 (CELF-4)
The CELF-4 Australian identifies children with delayed or disordered language from ages 5 to 21 and assists in determining the student’s language strengths and weaknesses in:
- Receptive Language
- Expressive Language
- Language Structure
- Language Content
- Language Memory
- Working Memory
The test provides information about a child’s understanding and use of spoken language by assessing the components of spoken language such as syntax, semantics, vocabulary, memory and comprehension.
The standard score system for the CELF-4 is similar to the PPVT-4, in that it has a mean or average of 100 and one standard deviation is a difference of 15. Therefore, children who score between 85 and 115 fall within one standard deviation of the mean of 100 and are within the ‘average range’.
EARLY
INTERVENTION
Better Ear Hearing Loss
Figure 1: Degree of hearing loss of children assessed receiving services from the Cora Barclay Centre Early Intervention Team.
The severity of hearing in the better ear was predominately moderate (27%), with equal numbers of children with severe and profound (20%), mild (13%) and children with normal hearing in one ear (20%).
| Mild (21-40dBHL) | Moderate (41-70dBHL) |
|---|---|
| 44 15 Severe (71-90dBHL) | 11 |
Profound (>90dBHL)
Normal (-10-20dBHL) 13+27+20+20+20+L
Assessment Age
Figure 2: Number of children assessed grouped by assessment age in 2015.
A total of 55 children were assessed using standardized assessments in 2015. Not all children were assessed using the entire battery of Early Intervention Assessments.
| 6 mth 2 |
|---|
| 12 mth 12 |
| ––––––––––––––––––– |
| 24 mth 6 |
| —————————–– |
| 3 yrs 12 |
| –––––––––––––––––––––––––– |
| 4 yrs 18 |
| ——————————————————————— |
| 5 yrs 5 |
| –––––––––––––––––––––––––––– |
| 9 |
Hearing Devices
Figures 3 and 4: Hearing devices
The children in Early Intervention were reported to have the following types of aiding:
- Two hearing aids 51%
- Two cochlear implants 20%
- One cochlear implant and one hearing aid 2%
- One hearing aid 15%
- One bone conduction hearing aid 2%
- No device 10%
Bilateral Unilateral 1 1 3 1 11 2CI 1BC 2HA 5 1HA 44 1BC/1HA 11 None 5 1HA 28 None25+64+2+7+2+L 45+46+9+L CI - Cochlear Implant HA - Hearing Aid BC - Bone Conduction Hearing Aid 10
EARLY INTERVENTION - ASSESSMENT TOOL RESULTS
Pre-School Language Scale Edition
(PLS-5) 1
Figure 5: Total Language Standard Scores for children aged between 6 months and 4 years.
An overview of the total language scores for the Early Intervention data set (including students with additional disabilities and English as an additional language and/or dialect). The average range is a standard score falling between Score 115 85 and 115. Results found:
85 Standard71% of children scored within the
average range or above (85 and above). Of that number 30% were late diagnosis. 45 38% of children aged between 12 1 Children Assessed 42 months and 4 years are considered to have a late diagnosis.
6 mths 12 mths - late diagnosis Average range (85-115)
12 mths 24 mths - late diagnosis
29% of children were below average range (below 85). Of that number 24 mths 3 yrs - late diagnosis 50% were late diagnosis. 3 yrs 4 yrs - late diagnosis 4 yrs
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EARLY INTERVENTION - Assessment Tool Results
Peabody Picture Vocabulary Test Edition 4
(PPVT-4) 2
Figure 6: Standard Scores for children aged 3, 4 and 5 years.
An overview of the scores for the Early Intervention data set (including students with additional disabilities and English as an additional language and/or dialect). The average range is a standard score falling between 85 and 115. Results found:
Score 95
79% of children scored within the 85average range or above (85 and above). Of that number 23% were late diagnosis.
27% of children aged between 3 years and 5 years are considered to have late diagnosis.
21% of children were below average range (below 85). Of that number 42% were late diagnosis.
Results on the PPVT-4 are consistent with those on the PLS-5, again identifying children diagnosed after 12 months of age representing just below half of the children assessed with a vocabulary standard score below average range. This result reinforces the critical importance of early diagnosis and early intervention on listening and language outcomes.
EARLY INTERVENTION - Assessment Tool Results
Goldman Fristoe Test of Articulation
(GFTA) 3
Figure 7: Percentile ranks for children aged between 3, 4 and 5 years.
An overview of the scores for the Early Intervention data set (including students with additional disabilities 100 and English as an additional language and/or dialect). The average range is a percentile between 16 and 84. Rank Results found: 60 79% of children scored within Percentile 40 the average range or above (between 16 and 84).
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Of the children that fell below the average range 71% were children 0 that were late diagnosis. 1 Children Assessed 34
The results demonstrate that 79% of children with a hearing loss reported in this data have age appropriate speech 3 yrs 3 yrs - late diagnosis Average range (85-115) while highlighting the significant impact 4 yrs 4 yrs - late diagnosis of late diagnosis on the development of 5 yrs 4 yrs - late diagnosis children’s speech.
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Page Heading
Section Subheading
This section contains information about early intervention programs.
The following statistics are reported:
e. The program has been successful in improving language skills among participants.
e. A significant percentage of enrolled individuals have shown improvement.
e. Continued support will be provided based on performance metrics.
Table Data
| Metric | Value |
|---|---|
| Participation Rate | High |
| Improvement Rate | Moderate |
| Satisfaction Level | Positive |
STUDENT SERVICES
Figure 8: Degree of hearing loss in children assessed receiving services from the Cora Barclay Centre Student Services Team.
Mild (21-40dBHL) The severity of hearing in the better Moderate (41-70dBHL)ear was predominately moderate (30%), with equal numbers of children with Severe (71-90dBHL)mild and profound (13%), severe (10%) and children with normal hearing in one ear (34%).
Profound (>90dBHL)
9 20+45+15+20+L
Figure 9: Number of children assessed grouped by assessment age in 2015.
5 yrs 3 A total of 30 children were assessed in 2015.
9 yrs 17
12 yrs 10
15
Figures 10 and 11: Hearing Devices
The children in Student Services were reported to have the following types of aiding:
- Bilateral hearing aids 37%
- Bilateral cochlear implants 17%
- Unilateral hearing aid 27%
- Bilateral bone anchored hearing aids 3%
- No device 16%
| Bilateral | Unilateral |
|---|---|
| 3 | |
| 2HA | 1HA |
| 1 | |
| 2CI | None |
| 5 | |
| 5 | 20 |
| 2BC | 10 |
| 11 | 5 |
| 1HA55+25+5+15+L | 50+50+L |
CI - Cochlear Implant HA - Hearing Aid BC - Bone Conduction Hearing Aid
Children Diagnosed After 12 Months Of Age
when provided with ongoing support from the Cora Barclay Centre can achieve outcomes within or above the average range.
STUDENT SERVICES - ASSESSMENT TOOL RESULTS
Clinical Evaluation of Language Fundamentals – 4
(CELF-4) 4
Figure 12: Total Language Standard Scores for children aged 5, 9 and 12 years.
An overview of the total language 130 scores for the Student Services data set (including students with additional 115 disabilities and English as an additional 110 language and/or dialect). The average Score range is a standard score falling between 85 and 115. Results found: 70 85 Standard 86% of children scored within the average range or above (85 or 70 above). Of that number 42% were late diagnosis. 50
1 Children Assessed 30
43% of children assessed are considered to have a late diagnosis.
14% of children were below average 5 yrs 5 yrs - late diagnosis Average range (85-115) range (below 85). Of that number 9 yrs 9 yrs - late diagnosis 50% were a late diagnosis. 12 yrs 12 yrs - late diagnosis
Results on CELF-4 are consistent with data collected from children in the Early Intervention program identifying children diagnosed after 12 months of age representing half of the students assessed with a language standard score below average range.
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WHAT DO THESE ASSESSMENT RESULTS TELL US?
These assessment results National Comparison demonstrate that in 2015: At the national level, all five Australian First Voice centres follow the same
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Over 70% of children in Early standardised assessment protocols Intervention and Student Services yielding a consolidated national achieved spoken language outcomes outcomes database of over 700 children in our listening and spoken commensurate to their hearing peers. language programs. Analysis of the First Voice clinical database shows
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Close to 80% of children in the outcomes very similar to those reported Early Intervention Program achieved above, providing further validation of the effectiveness of listening and speech outcomes commensurate to spoken language early childhood their hearing peers. intervention as practised in Australia.
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The majority of children diagnosed The Cora Barclay Centre uses these objective assessments: (1) to review after the age of 12 months had poorer and modify each child’s individual speech and language outcomes service plan in order to achieve the compared to children diagnosed best possible outcomes for each child and (2) to evaluate our programs before 12 months of age. and compare them with those of comparable organisations.
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Children diagnosed after 12 months of age when provided with ongoing support can continue to improve their spoken language and achieve outcomes within or above the average range.
SUMMARY
The results reinforce the critical importance of early diagnosis and early intervention on listening and spoken language outcomes and the continuing need for ongoing intervention at school age to ensure any gaps in language are addressed. The data demonstrates that a higher percentage of students diagnosed after 12 months of age are now performing with a standard score within or above the average range and the critical importance of ongoing intervention.
Design Art Direction kindly donated by Brighter Design [brighter.comau]
The Cora Barclay Centre is a not-for-profit organisation and has Deductible Gift Recipient (DGR) status with the Australian Tax Office
NDIS Registered Number 88043740 ABN 44 598 581 496
185 Melbourne Street North Adelaide 5006
08 8267 9200
corabarclay.com.au