Prescribing and Verifying Hearing Aids Applying the American Academy of Audiology Pediatric Amplification Guideline: Protocols and Outcomes from the Ontario Infant Hearing Program

2016 ◽  
Vol 27 (03) ◽  
pp. 188-203 ◽  
Author(s):  
Marlene Bagatto ◽  
Sheila Moodie ◽  
Christine Brown ◽  
April Malandrino ◽  
Frances Richert ◽  
...  
Keyword(s):  
Hearing Loss ◽  
American Academy ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Typically Developing ◽  
Hearing Aid Fitting ◽  
Amplification Protocol ◽  
Measurement Protocol ◽  
Children With Hearing Loss ◽  
The Impact

Background: Guidelines and protocols for pediatric hearing aid fitting are necessary to meet the goals of Early Hearing Detection and Intervention (EHDI) programs. The American Academy of Audiology published an update to their Pediatric Amplification Guideline in 2013. Ontario's Infant Hearing Program (IHP) offers specific protocols that aim to fulfill recommended guidelines. It has recently been updated to align with the American Academy of Audiology Guideline and other evidence. Purpose: A summary of the updates to the Ontario IHP’s Amplification Protocol is described. In addition, data illustrating hearing-related outcomes of the program are offered. Research Design: The updated Ontario protocol is based on evidence, wherever possible. Where research is not yet available, clinical decision support has been described in a systematic way. Outcomes of the Ontario IHP were obtained through a longitudinal clinical observation study. Study Sample: One hundred and fifteen children with hearing loss, who wore hearing aids, were included in the outcome analyses (mean = 28.6 mo; range = 1.3–115.3 mo). Hearing losses ranged from mild to profound, unilateral or bilateral sensorineural (pure-tone average = 52.3 dB HL). They were recruited from four IHP clinics within Ontario. Children with complexities in addition to hearing loss were included. Intervention: The children were fitted with hearing aids following Ontario's Amplification Protocol. Data Collection and Analyses: During routine clinical appointments, IHP Audiologists administered questionnaires to the parents of their pediatric patients using a systematic outcome measurement protocol (University of Western Ontario Pediatric Audiological Monitoring Protocol). Hearing aid fitting details (e.g., speech intelligibility index) were also gathered to describe the quality of the hearing aid fittings in relation to the functional outcomes. Regression analyses were conducted to characterize scores on the questionnaires and the impact of important variables. Children with complexities were analyzed separately from those who were typically developing. Results: Important updates to Ontario's Amplification Protocol offer new details about candidacy considerations as well as technical updates. Outcomes from the IHP reveal protocol elements can be executed clinically and when they are, typically developing children who wear hearing aids are meeting auditory development and performance milestones. Conclusions: Updates to Ontario's Amplification Protocol are necessary to support the evolution of EHDI programs and the evidence which sustains them. With advances in technology and additional research, pediatric hearing aid fitting will continue to progress and support systematic measurement of outcomes for children who wear hearing aids. The application of state-of-the-art hearing aid fitting practices to the pediatric population within EHDI programs supports good outcomes for infants and children with hearing loss.

scholarly journals Audibility-Based Hearing Aid Fitting Criteria for Children With Mild Bilateral Hearing Loss

2020 ◽  
Vol 51 (1) ◽  
pp. 55-67 ◽  
Author(s):  
Ryan W. McCreery ◽  
Elizabeth A. Walker ◽  
Derek J. Stiles ◽  
Meredith Spratford ◽  
Jacob J. Oleson ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Language Development ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
Language Outcomes ◽  
Hearing Aid Fitting ◽  
Modeling Approach ◽  
Speech Intelligibility Index ◽  
Children With Hearing Loss

Purpose Because of uncertainty about the level of hearing where hearing aids should be provided to children, the goal of the current study was to develop audibility-based hearing aid candidacy criteria based on the relationship between unaided hearing and language outcomes in a group of children with hearing loss who did not wear hearing aids. Method Unaided hearing and language outcomes were examined for 52 children with mild-to-severe hearing losses. A group of 52 children with typical hearing matched for age, nonverbal intelligence, and socioeconomic status was included as a comparison group representing the range of optimal language outcomes. Two audibility-based criteria were considered: (a) the level of unaided hearing where unaided children with hearing loss fell below the median for children with typical hearing and (b) the level of unaided hearing where the slope of language outcomes changed significantly based on an iterative, piecewise regression modeling approach. Results The level of unaided audibility for children with hearing loss that was associated with differences in language development from children with typical hearing or based on the modeling approach varied across outcomes and criteria but converged at an unaided speech intelligibility index of 80. Conclusions Children with hearing loss who have unaided speech intelligibility index values less than 80 may be at risk for delays in language development without hearing aids. The unaided speech intelligibility index potentially could be used as a clinical criterion for hearing aid fitting candidacy for children with hearing loss.

FM Verification for the 21 st Century

2008 ◽  
Vol 18 (1) ◽  
pp. 4-9 ◽  
Author(s):  
Leisha Eiten ◽  
Dawna Lewis
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Current Technology ◽  
The Past ◽  
Technological Advances ◽  
Children With Hearing Loss

Background: For children with hearing loss, the benefits of FM systems in overcoming deleterious effects of noise, distance, and reverberation have led to recommendations for use beyond classroom settings. It is important that audiologists who recommend and fit these devices understand the rationale and procedures underlying fitting and verification. Objectives: This article reviews previousguidelines for FM verification, addresses technological advances, and introduces verification procedures appropriate for current FM and hearing-aid technology. Methods: Previous guidelines for verification of FM systems are reviewed. Those recommendations that are appropriate for current technology are addressed, as are procedures that are no longer adequate for hearing aids and FM systems utilizing more complex processing than in the past. Technological advances are discussed, and an updated approach to FM verification is proposed. Conclusions: Approaches to verification andfitting of FM systems must keep pace with advances in hearing-aid and FM technology. The transparency approach addressed in this paper is recommended for verification of FM systems coupled to hearing aids.

Hearing Technology Use and Management in School-Age Children: Reports from Data Logs, Parents, and Teachers

2017 ◽  
Vol 28 (10) ◽  
pp. 883-892 ◽  
Author(s):  
Samantha J. Gustafson ◽  
Todd A. Ricketts ◽  
Anne Marie Tharpe
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Parent Report ◽  
School Age Children ◽  
School Age ◽  
Data Logging ◽  
Hearing Aid Use ◽  
System Use ◽  
Children With Hearing Loss

Background: Consistency of hearing aid and remote microphone system use declines as school-age children with hearing loss age. One indicator of hearing aid use time is data logging, another is parent report. Recent data suggest that parents overestimate their children’s hearing aid use time relative to data logging. The potential reasons for this disparity remain unclear. Because school-age children spend the majority of their day away from their parents and with their teachers, reports from teachers might serve as a valuable and additional tool for estimating hearing aid use time and management. Purpose: This study expands previous research on factors influencing hearing aid use time in school-age children using data logging records. Discrepancies between data logging records and parent reports were explored using custom surveys designed for parents and teachers. Responses from parents and teachers were used to examine hearing aid use, remote microphone system use, and hearing aid management in school-age children. Study Sample: Thirteen children with mild-to-moderate hearing loss between the ages of 7 and 10 yr and their parents participated in this study. Teachers of ten of these children also participated. Data Collection and Analysis: Parents and teachers of children completed written surveys about each child’s hearing aid use, remote microphone system use, and hearing aid management skills. Data logs were read from hearing aids using manufacturer’s software. Multiple linear regression analysis and an intraclass correlation coefficient were used to examine factors influencing hearing aid use time and parent agreement with data logs. Parent report of hearing aid use time was compared across various activities and school and nonschool days. Survey responses from parents and teachers were compared to explore areas requiring potential improvement in audiological counseling. Results: Average daily hearing aid use time was ˜6 hr per day as recorded with data logging technology. Children exhibiting greater degrees of hearing loss and those with poorer vocabulary were more likely to use hearing aids consistently than children with less hearing loss and better vocabulary. Parents overestimated hearing aid use by ˜1 hr per day relative to data logging records. Parent-reported use of hearing aids varied across activities but not across school and nonschool days. Overall, parents and teachers showed excellent agreement on hearing aid and remote microphone system use during school instruction but poor agreement when asked about the child’s ability to manage their hearing devices independently. Conclusions: Parental reports of hearing aid use in young school-age children are largely consistent with data logging records and with teacher reports of hearing aid use in the classroom. Audiologists might find teacher reports helpful in learning more about children’s hearing aid management and remote microphone system use during their time at school. This supplementary information can serve as an additional counseling tool to facilitate discussion about remote microphone system use and hearing aid management in school-age children with hearing loss.

scholarly journals Survey of Hearing Aid Conditions for Hearing Impaired Persons While Driving

2020 ◽  
pp. 132-136
Author(s):  
Hiroshi Ikeda ◽  
Shigeyuki Minami
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Visual Information ◽  
Hearing Aid ◽  
Hearing Impaired ◽  
Safe Driving ◽  
Actual Usage ◽  
Hearing Ability ◽  
Acquired Hearing Loss ◽  
The Impact

Hearing impaired persons are required to drive with hearing aids to supplement their hearing ability, however, there has not been sufficient discussion regarding the impact of the use of a hearing aid on driving a vehicle. In order to investigate the actual usage and driving conditions of using hearing aids while driving a vehicle, this paper uses a questionnaire to survey (1) how easy it is to drive when wearing hearing aids, and (2) how often hearing aids are not worn while driving. Concerning the ease of driving when wearing a hearing aid, it was suggested that people with congenital hearing loss were more likely to rely on visual information, and those with acquired hearing loss continue to use their experience of hearing. When the level of disability is high, it is difficult to drive when using the hearing aid, and when the disability level is low, it is easier to drive. Regarding the frequency of driving without wearing hearing aids, about 60 % of respondents had such an experience. Those who often drive without hearing aids had experienced headaches due to noise from wearing hearing aids compared to those who wear hearing aids at all times. Hearing aids are necessary assistive devices for hearing impaired persons to obtain hearing information, and to provide a safe driving environment. Therefore, this paper addresses issues to maintain a comfortable driving environment while wearing a hearing aid.

Low-level Speech Recognition of Children with Hearing Aids

2021 ◽  
Author(s):  
Jace Wolfe ◽  
Mila Duke ◽  
Sharon Miller ◽  
Erin Schafer ◽  
Christine Jones ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Word Recognition ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Phase 1 ◽  
Second Phase ◽  
Phase 2 ◽  
Low Level ◽  
Children With Hearing Loss

Background: For children with hearing loss, the primary goal of hearing aids is to provide improved access to the auditory environment within the limits of hearing aid technology and the child’s auditory abilities. However, there are limited data examining aided speech recognition at very low (40 dBA) and low (50 dBA) presentation levels. Purpose: Due to the paucity of studies exploring aided speech recognition at low presentation levels for children with hearing loss, the present study aimed to 1) compare aided speech recognition at different presentation levels between groups of children with normal hearing and hearing loss, 2) explore the effects of aided pure tone average (PTA) and aided Speech Intelligibility Index (SII) on aided speech recognition at low presentation levels for children with hearing loss ranging in degree from mild to severe, and 3) evaluate the effect of increasing low-level gain on aided speech recognition of children with hearing loss. Research Design: In phase 1 of this study, a two-group, repeated-measures design was used to evaluate differences in speech recognition. In phase 2 of this study, a single-group, repeated-measures design was used to evaluate the potential benefit of additional low-level hearing aid gain for low-level aided speech recognition of children with hearing loss. Study Sample: The first phase of the study included 27 school-age children with mild to severe sensorineural hearing loss and 12 school-age children with normal hearing. The second phase included eight children with mild to moderate sensorineural hearing loss. Intervention: Prior to the study, children with hearing loss were fitted binaurally with digital hearing aids. Children in the second phase were fitted binaurally with digital study hearing aids and completed a trial period with two different gain settings: 1) gain required to match hearing aid output to prescriptive targets (i.e., primary program), and 2) a 6-dB increase in overall gain for low-level inputs relative to the primary program. In both phases of this study, real-ear verification measures were completed to ensure the hearing aid output matched prescriptive targets. Data Collection and Analysis: Phase 1 included monosyllabic word recognition and syllable-final plural recognition at three presentation levels (40, 50, and 60 dBA). Phase 2 compared speech recognition performance for the same test measures and presentation levels with two differing gain prescriptions. Results and Conclusions: In phase 1 of the study, aided speech recognition was significantly poorer in children with hearing loss at all presentation levels. Higher aided SII in the better ear (55 dB SPL input) was associated with higher CNC word recognition at a 40 dBA presentation level. In phase 2, increasing the hearing aid gain for low-level inputs provided a significant improvement in syllable-final plural recognition at very low-level inputs and resulted in a non-significant trend toward better monosyllabic word recognition at very low presentation levels. Additional research is needed to document the speech recognition difficulties children with hearing aids may experience with low-level speech in the real world as well as the potential benefit or detriment of providing additional low-level hearing aid gain

Hearing Impaired Children's Preference for, and Performance with, Four Combinations of Directional Microphone and Digital Noise Reduction Technology

2013 ◽  
Vol 24 (09) ◽  
pp. 832-844 ◽  
Author(s):  
Andrea L. Pittman ◽  
Mollie M. Hiipakka
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Noise Reduction ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Directional Hearing ◽  
Short Period ◽  
Children With Hearing Loss ◽  
And Performance ◽  
Noise Management

Background: Before advanced noise-management features can be recommended for use in children with hearing loss, evidence regarding their ability to use these features to optimize speech perception is necessary. Purpose: The purpose of this study was to examine the relation between children's preference for, and performance with, four combinations of noise-management features in noisy listening environments. Research Design: Children with hearing loss were asked to repeat short sentences presented in steady-state noise or in multitalker babble while wearing ear-level hearing aids. The aids were programmed with four memories having an orthogonal arrangement of two noise-management features. The children were also asked to indicate the hearing aid memory that they preferred in each of the listening conditions both initially and after a short period of use. Study Sample: Fifteen children between the ages of 8 and 12 yr with moderate hearing losses, bilaterally. Results: The children's preference for noise management aligned well with their performance for at least three of the four listening conditions. The configuration of noise-management features had little effect on speech perception with the exception of reduced performance for speech originating from behind the child while in a directional hearing aid setting. Additionally, the children's preference appeared to be governed by listening comfort, even under conditions for which a benefit was not expected such as the use of digital noise reduction in the multitalker babble conditions. Conclusions: The results serve as evidence in support of the use of noise-management features in grade-school children as young as 8 yr of age.

Large Vestibular Aqueduct Syndrome: A Case Study

2005 ◽  
Vol 16 (10) ◽  
pp. 822-828 ◽  
Author(s):  
Jackie L. Clark ◽  
Ross J. Roeser
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Behavioral Testing ◽  
Hearing Aid Fitting ◽  
Hearing Sensitivity ◽  
Vestibular Aqueduct ◽  
Brainstem Response ◽  
Large Vestibular Aqueduct Syndrome ◽  
Large Vestibular Aqueduct

A 23-month-old female was referred for hearing aid fitting after failing newborn hearing screening and being diagnosed with significant hearing loss through subsequent diagnostic testing. Auditory brainstem response (ABR) and behavioral testing revealed a moderate-to-severe bilateral mixed hearing loss. Prior to the hearing aid evaluation, tympanostomy tubes had been placed bilaterally with little or no apparent change in hearing sensitivity. Initial testing during the hearing aid fitting confirmed earlier findings, but abnormal middle ear results were observed, requiring referral for additional otologic management. Following medical clearance, binaural digital programmable hearing aids were fit using Desired Sensation Level parameters. Behavioral testing and probe microphone measures showed significant improvements in audibility. Decrease in hearing sensitivity was observed six months following hearing aid fitting. Radiological studies, ordered due to the mixed component and decreased hearing sensitivity, revealed large vestibular aqueduct syndrome (LVAS). Based on the diagnosis of LVAS, a cochlear implant was placed on the right ear; almost immediate speech-language gains were observed.

Quality In, Quality Out: Supporting Good Outcomes for Children Who Wear Hearing Aids

2013 ◽  
Vol 23 (2) ◽  
pp. 31-42
Author(s):  
Marlene P. Bagatto
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Hearing Aid Fitting ◽  
Essential Components ◽  
Stage Process ◽  
Outcomes For Children ◽  
Key Aspects ◽  
Speech And Language Development ◽  
Fitting Hearing Aids

Fitting hearing aids to infants with hearing loss can be completed in a systematic and evidence-based manner. This is because there are clinical protocols and technologies available so that pediatric audiologists can fit hearing aids to their patients with hearing loss during the early months of life. Early hearing aid fitting supports speech and language development, however, the way in which the hearing aid is fitted can significantly impact the infant’s progress. A four-stage process for infant hearing aid fitting is offered as a framework with which to execute the essential components of the procedure. Key aspects of the pediatric hearing aid fitting process are described with a focus on elements that may impact an infant’s progress with hearing aids if not implemented.

The Impact of Hearing Aids on Quality of Life of Hearing Impaired Individuals

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Fatima Zafar ◽  
Hafiz Muhammad Usama Basheer ◽  
Amber Hassan ◽  
Wajeeha Zaib ◽  
Tehmeena Waheed
Keyword(s):  
Quality Of Life ◽  
Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Residual Activity ◽  
Hearing Impaired ◽  
P Value ◽  
Daily Routine ◽  
The Impact

The regular use of hearing aids (more than 8 hours a day) benefits people in hearing for bettercommunication than those who are less-likely to use hearing aids Objective: The objective of thestudy was to assess the impact of hearing aids on the quality of life of hearing impaired individualsMethods: In this cross-sectional study total 50 participants were recruited by convenient samplingtechnique from Lahore, Pakistan. 50 patients who were diagnosed with hearing loss and wererecommended with hearing aids of both genders were included in the study. The International OutcomeInventory for Hearing Aids (IOI-HA), questionnaire was used for data collection. Data were analyzedthrough Statistical Package for Social Sciences (SPSS) version 23.0 Results: In this research 50hearing impaired individuals who were hearing aid users, participated. The mean age of participants was64.10+15.88 years. Among which 25 (50%) were males and 25(50%) were females. The average time ofhearing aid use was 3.88 hours, majority of patients responded that hearing aid helped quite a lot in thedaily routine (mean score of IOI-HA, 3.62), have moderate difficulty in residual activity (mean score of IOIHA,3.26), moderately satisfied with their hearing aid (mean score of IOI-HA, 3.28), moderately affect theparticipation restriction (mean score of IOI-HA, 3.20), impact of their hearing loss bothered moderately(mean score of IOI-HA, 3.14) and quality of life (QOL) was very much better (3.90). There was insignificantassociation between the QOL of males and females (p-value>0.05) Conclusions: It was concluded fromthe study that the hearing aids have a greater impact on the quality of life and socio-economic aspectsof hearing impaired individuals. Hearing loss is such a problem, which separates certain community ofhearing impaired individuals from the normal population. Individuals with hearing impairment not onlyhave to face personal communication problems but also it affects their health, independency and qualityof life in their daily routine.

Parent Hearing Aid Experiences in the United States

2013 ◽  
Vol 24 (01) ◽  
pp. 005-016 ◽  
Author(s):  
Karen Muñoz ◽  
Kristina Blaiser ◽  
Karianne Barwick
Keyword(s):  
United States ◽  
Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Wait Time ◽  
The United States ◽  
Population Based ◽  
Cross Sectional ◽  
Hearing Aid Fitting ◽  
Parent Experiences

Background: Children born with permanent hearing loss have the opportunity to receive services earlier as a result of newborn hearing screening (NHS). We conducted a survey to address three aspects within the early hearing detection and intervention (EHDI) process: (1) timeliness of service delivery, (2) hearing device access, and (3) hearing aid management. Parent experiences provide valuable information in identifying existing challenges for these components of the EHDI system. Purpose: The aim was to investigate parent experiences as they access and manage hearing aids for their child. Research Design: A cross-sectional, population-based survey was used. Study Sample: Three hundred fifty-two completed surveys from parents of children born between 1977 and 2010 were returned from 45 states in the United States. Data Collection and Analysis: Responses were obtained online and through the mail, and were analyzed using descriptive statistics. Results: Over time, the age of hearing loss identification has decreased to a median of 2 mo, age of first hearing aid fitting has decreased to a median of 5 mo, and the delay between hearing loss identification and hearing aid fitting has remained the same with a median of 2 mo. For children born between 2007 and 2010, the top three challenges parents reported in obtaining hearing aids were (1) paying for hearing aids, (2) accepting the need for hearing aids, and (3) wait time for an appointment. Almost one-half (48%) of the parents reported that they did not receive adequate support from their audiologist in how to check the function of their child's hearing aids. Conclusions: Significant progress has been made over the past two decades in reducing the age of hearing loss identification and hearing aid fitting for children who do not pass the NHS. However, many children continue to experience delays between hearing loss diagnosis and hearing aid fitting that exceed Joint Committee on Infant Hearing recommendations. The experiences parents reported provide valuable information about areas that need further investigation to improve the process for children with hearing loss.

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