Communication outcomes of children with hearing loss enrolled in programs implementing different educational approaches: a systematic review

Following the diagnosis of hearing loss in a child, parents are required to make a number of important decisions, including the type of educational approach to adopt in intervention. Many professionals hold strong biases about the various educational approaches, which can make it difficult for parents to make informed decisions. A systematic review was conducted to address two main aims. First, to examine the communication outcomes of children with hearing loss enrolled in programs that follow an auditory-oral, auditory-verbal, total communication, simultaneous communication, or a bilingual–bicultural approach. Second, to investigate whether there are differences in outcomes for children enrolled in different programs. A systematic search of peer-reviewed journal articles published in English between 2000 and 2014 was conducted in five electronic databases. Additional articles were identified by perusing the reference lists of selected papers. A total of 835 records were retrieved through the systematic search. After screening of full-text papers, 14 articles reporting on 10 studies were selected for inclusion in the review and assessed with a critical appraisal tool. Data synthesis indicated that communication outcomes in children with hearing loss are highly variable, and evidence regarding the impact of different educational approaches on outcomes is inconclusive. It is important that professionals talk to parents about the uncertainties related to child outcomes, as well as discuss the possible advantages and disadvantages of each educational approach. The review highlights the need to make recommendations for educational approach based on the needs and goals of individual families, rather than being influenced by ideologies