Teletherapy for deaf kids: a new way to bridge language gaps?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Age 0-27 months; * Hearing loss, as determined by auditory brainstem response (ABR) or behavioral audiometry (average of pure-tone air-conduction hearing thresholds (0.5-4 kHz; PTA) calculated from at least 2 frequencies from ABR (dB eHL) or behavioral audiometry (dB HL)): * bilateral sensorineural, mixed, or permanent conductive hearing loss with better-ear PTA \> 20 dB. * single-sided deafness (unilateral SNHL with PTA \> 70 dB); * unilateral complete aural atresia; or * bilateral auditory-neuropathy spectrum disorder, as determined by ABR. * Primary home language is English or Spanish, determined by electronic medical record or direct parent report. * For children with PTA \> 20 dB, either: * Currently fit with hearing aid or using a cochlear implant; OR * Date identified for hearing-aid fitting or cochlear-implant activation within 3 months of enrollment. Exclusion Criteria: * Family does NOT have the intention to pursue listening and spoken language for their child, based on parent report; * Moderate to severe global developmental delay, as determined by managing audiologist and/or otolaryngologist, based on: * ICD-10 diagnosis code or chart review of medical progress notes indicating global developmental delay; * presence of syndrome known to be associated with this delay (such as Trisomy 21, 22q11 syndrome, or CHARGE syndrome); OR * parent report. * Speech-language teletherapy received through a clinical provider outside of this study at the time of enrollment, based on parent report. * No prognosis for access to sound as determined by managing audiologist and/or otolaryngologist. All children with bilateral severe-to-profound SNHL must have imaging to confirm this criterion prior to enrollment in the study. Children will be excluded if they have bilateral severe-to-profound sensorineural hearing loss and either: * Contraindication to cochlear implantation, OR * Temporal bone abnormalities that lead to great concern for poor cochlear-implant outcomes, including common cavity and/or cochlear nerve deficiency on imaging.