2026 Early Hearing Detection & Intervention Conference
March 15-17, 2026 • Jacksonville, FL
| BDI-3 Communication Outcomes in Infants and Toddlers with Hearing Loss: Effects of Severity and Birth Weight
BDI-3 Communication Outcomes in Infants and Toddlers with Hearing Loss: Effects of Severity and Birth Weight
Hearing loss in young children can significantly impair communication development, often leading to language acquisition delays. The Battelle Developmental Inventory, Third Edition (BDI-3), released in 2020, is a widely used early intervention tool with enhanced sensitivity in its communication domain. This study evaluates communication outcomes in 67 infants and toddlers with permanent hearing loss, using data from Hawaii’s Newborn Hearing Screening Program (NHSP) and Early Intervention Services (EIS).
BDI-3 communication z-scores were categorized as low (= -1.0) or typical (> -1.0) and stratified by degree of hearing loss in the better ear (normal, slight/mild, mild-moderate/moderate, moderate-severe or worse, or undetermined) and birth weight (<1500 g, 1500–2499 g, =2500 g, or unknown). Cell counts below 5 were suppressed for privacy. Preliminary findings, based on collapsed hearing loss categories (slight/mild to moderate [n=33] vs. moderate-severe or worse [n=22]), show infants with moderate-severe or worse hearing loss had a higher prevalence of low communication scores (13/22, 59%) compared to those with slight/mild to moderate hearing loss (11/33, 33%; p=0.059). Similarly, among infants with known birth weight (n=55), those with low birth weight (1500–2499 g; n=14) showed elevated rates of low scores (8/14, 57%) versus normal birth weight (=2500 g; n=41; 12/41, 29%; p=0.061). Suggestive associations emerged via logistic regression (OR=2.89 for moderate-severe or worse hearing loss; OR=3.22 for 1500–2499 g birth weight; both p about 0.06–0.07), though limited sample size yielded wide CIs and non-significant results at p<0.05. These results suggest that hearing loss severity is a primary risk factor for communication delays, with low birth weight amplifying risk, particularly when combined with severe hearing loss.
The BDI-3 communication z-score is a valuable tool for identifying at-risk infants and toddlers and guiding language acquisition to support early intervention and mitigate developmental delays.
- The participant will be able to identify the impact of hearing loss severity on communication outcomes in infants and toddlers using the BDI-3 communication z-score.
- The participant will be able to recognize the role of low birth weight as a contributing risk factor for communication delays in young children with hearing loss.
- The participant will be able to describe how the BDI-3 communication domain supports early intervention for mitigating developmental delays in infants with permanent hearing loss.
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Presenters/Authors
Jin Dong
(Primary Presenter,Author), Children with Special Health Branch, State Department of Health, Hawaii, jin.dong@doh.hawaii.gov;
Jin Dong is a dedicated Research Statistician with the Hawai?i State Department of Health, supporting the Newborn Screening Program through multi-dataset analysis, data-driven reporting, and collaborative data sharing. With a PhD and extensive molecular biology experience from the University of Hawai?i and Temasek Life Sciences Laboratory, she blends rigorous research with a mother’s passion to improve the health of Hawai?i’s keiki.
ASHA DISCLOSURE:
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No relevant financial relationship exists.
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No relevant nonfinancial relationship exists.
AAA DISCLOSURE:
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No relevant financial relationship exists.
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No relevant nonfinancial relationship exists.
Jasmine Jones
(Co-Presenter,Author,Co-Author), Newborn Hearing Screening Program, jasmine.jones@doh.hawaii.gov;
Jasmine Jones is a dedicated public health professional with a Bachelor’s of Science in Speech Pathology and Audiology. For several years, she worked as the Grant Activities Coordinator for Hawaii’s Newborn Hearing Screening Program under the State Department of Health. In her newest role as Genomics Section Supervisor in the Children with Special Health Needs Branch, Jasmine is in charge of newborn hearing screening, newborn metabolic screening, and birth defects programs. She is thrilled to bring her expertise to this evolving area of children’s health.
ASHA DISCLOSURE:
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No relevant financial relationship exists.
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No relevant nonfinancial relationship exists.
AAA DISCLOSURE:
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No relevant financial relationship exists.
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No relevant nonfinancial relationship exists.
Lloyd Miyashiro
(Author,Co-Author), Children with Special Health Needs Branch, DOH,HAWAII, Lloyd.Miyashiro@doh.hawaii.gov;
Lloyd M. Miyashiro is a Senior Research Statistician with the Hawai‘i State Department of Health in Honolulu. With 29 years of experience in dataset linkage and comprehensive reporting, he plays a key role in supporting public health initiatives through rigorous data analysis, helping to shape evidence-based policies and improve health outcomes for Hawai‘i’s communities.
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Leanne Locano
(Co-Presenter,Co-Author), Children with Special Health Needs Branch, DOH, Hawaii, leanne.locano@doh.hawaii.gov;
Leanne Locano is a dedicated Children & Youth Program Specialist with Hawai‘i’s Newborn Hearing Screening Program (Genomics Section, State Department of Health). She holds a Bachelor of Science in Public Health from San Diego State University and is passionate about ensuring every newborn in Hawai‘i receives timely hearing screenings, diagnostic evaluation, and early intervention follow-up. In her role, she also provides valuable assistance in the overall planning, development, and evaluation of the Newborn Hearing Screening Program, helping ensure services are culturally responsive, family-centered, and evidence-based for infants and toddlers. With her strong background in public health, Leanne enthusiastically supports families and works to improve outcomes for infants with hearing loss across the state.
ASHA DISCLOSURE:
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No relevant financial relationship exists.
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No relevant nonfinancial relationship exists.
AAA DISCLOSURE:
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No relevant financial relationship exists.
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No relevant nonfinancial relationship exists.
Stacy Kong
(Co-Author), Children with Special Health needs Branch, DOH, Hawaii, stacy.kong@doh.hawaii.gov;
Stacy Kong serves as the EIS Supervisor and Part C Coordinator for the Early Intervention Section, Children with Special Health Needs Branch, at the Hawai‘i State Department of Health. Based in Honolulu, she oversees early intervention services, ensuring young children with developmental needs receive comprehensive support to thrive.
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Ruben Frescas
(Co-Author), Children with Special Health Needs Branch, DOH, Hawaii, ruben.frescas@doh.hawaii.gov;
Ruben Frescas, Jr., MD, MPH, FAAFP, serves as Chief of the Children with Special Health Needs Branch at the Hawai‘i State Department of Health. Based in Honolulu, he leads efforts to support children with special needs, ensuring access to vital health services and improving outcomes for keiki statewide.
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Anita Huang
(Co-Author), Hawaii P-20, University of Hawaii, anitahua@hawaii.edu;
Anita Huang, an experienced institutional analyst, works for Hawai‘i P-20 Partnerships for Education. Based in Honolulu, she leverages data to support educational initiatives, driving informed policies to enhance student outcomes across Hawai‘i’s public education system.
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Tracy Hongo
(Co-Author), Hawaii P-20, University of Hawaii, tlh@hawaii.edu;
Tracy Hongo serves as the Data Governance Coordinator for Hawai‘i P-20 Partnerships for Education in Honolulu. She oversees data management and integrity, ensuring accurate, secure data systems to support educational policies and improve student outcomes across Hawai‘i’s public education system.
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Jean Osumi
(Co-Author), Hawaii P20, University of Hawai'i, josumi@hawaii.edu;
Jean Osumi, Ed.D., serves with Hawai‘i P-20 Partnerships for Education at the University of Hawai‘i. Based in Honolulu, she contributes to advancing educational initiatives, fostering collaboration to enhance student success and equity across Hawai‘i’s public education system.
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