Grade Repetition and Parents' Perception of Hearing Loss: An Analysis of Data from Children in the United States

Objectives/Hypothesis: To determine whether parent-perceived hearing problems are associated with grade repetition among children in the United States. Study Design: Retrospective cohort analysis of a contemporary national database. Methods: The National Survey of Children's Health 2011 to 2012 was analyzed. Hearing loss, as perceived and reported by parents, was categorized as: no hearing problem, history of a hearing problem, or current hearing problem. Children never repeating a grade versus repeating one or more grades (kindergarten-high school) were identified. Univariate statistics and multivariate logistic regression analyzed the association of hearing problems with grade repetition. Patients with mental retardation, autism, and attention-deficit/hyperactivity disorder were excluded from the analysis. After adjusting for race, sex, and poverty level, odds ratios for grade repetition were computed. Results: Among 66.1 million (average age, 8.3 years, 49.0% male) children, 97.3% never had a hearing problem, 1.7% had a history of a hearing problem, and 1.0% had a current hearing problem. Overall, 7.1% repeated a grade. Grade repetition was reported in 6.9% of children without a hearing problem versus 9.4% with a history of a hearing problem and 19.3% with a current hearing problem (P < 0.001). After adjustment for race, poverty level, and sex, a history of a hearing problem demonstrated an odds ratio of 1.9 (95% confidence interval 0.82-4.13) for grade repetition, whereas a current hearing problem demonstrated an odds ratio of 3.0 (1.90-4.80). Conclusion: Parents' perception of children's hearing problems is strongly associated with grade repetition. This trend is noticed in elementary school more than in high school.