EFFECT OF HEARING IMPAIRMENT ON EDUCATIONAL OUTCOMES AND EMPLOYMENT UP TO THE AGE OF 25 YEARS IN NORTHERN FINLAND

The association between hearing impairment in adolescence and school p erformance and the outcome of education was studied among 25-year-old subjects followed since pregnancy in the Northern Finland birth cohort . The series, 395 subjects with abnormal hearing and 977 randomly sele cted controls, was based on a questionnaire on hearing and school achi evement sent to 11780 members of the cohort alive at the age of 14 yea rs, and on audiometric screening test requested from health centres. H earing loss was defined as 'clinically significant' if the pure tone a verage (PTA; mean of the thresholds at 0.5, 1 and 2 kHz) exceeded 25 d B in the better ear; a threshold of greater than or equal to 30 dB at 4 kHz and a PTA of I 25 dB as '4 kHz loss'; and as 'slightly abnormal' if any of the thresholds exceeded 20 dB at any frequency and the case did not belong to the above two categories. The more severe the heari ng impairment, the poorer was the child's performance at elementary sc hool. Those with normal hearing and those with a slightly abnormal or 4 kHz loss were equally often accepted for intermediate education (88% ), while those with a clinically significant loss had the lowest accep tance figures (64%). When adjusting for neurological and social confou nders, excluding mental disability, the risk of not qualifying from in termediate or higher education at all was twice as high among those wi th a clinically significant loss as among the controls (OR 2.1, 95% CI 1.13-3.8), and was still elevated after adjustment had been made for all the relevant perinatal, neurological and social factors (OR 1.9, 9 5% CI 1.02-3.6). 14% of those with a clinically significant hearing lo ss, 9% of the subjects with a 4 kHz loss and 7% of those with normal h earing were unemployed at the age of 25 years. Hearing impairment appe ars to have effects on both the outcome of education and employment st atus.