Comparing criteria for deviation from hearing aid prescriptive targets in children
Kathryn B Wiseman1, Elizabeth A Walker2, Meredith Spratford3
1Child Auditory Technology Laboratory, Boys Town National Research Hospital, Omaha, NE, USA.
Insights
A stricter hearing aid fitting target (<3 dB root-mean-square error) improves audibility and language skills in children. This finding supports using precise fitting measures for better pediatric hearing aid outcomes.
Area of Science:
- Audiology
- Pediatric audiology
- Speech-language pathology
Background:
- Accurate hearing aid fitting is crucial for pediatric audibility and language development.
- Current fitting criteria may not fully optimize outcomes for children with hearing aids.
- Understanding the impact of fitting accuracy on various developmental domains is essential.
Purpose of the Study:
- To compare a stricter (<3 dB RMS error) versus a standard (<5 dB RMS error) hearing aid fitting criterion in children.
- To investigate the relationship between fitting accuracy (RMS error) and aided audibility across different hearing loss degrees.
- To evaluate the effect of fitting accuracy on speech recognition, vocabulary, and morphosyntax in pediatric hearing aid users.
Main Methods:
- Analysis of 2314 hearing aid verification measurements from 307 children.
- Categorization of fittings based on root-mean-square (RMS) error: <3 dB, 3-5 dB, and >5 dB.
- Assessment of aided audibility, speech recognition, expressive vocabulary, and morphosyntax in relation to RMS error categories.
Main Results:
- Children meeting the <3 dB criterion demonstrated significantly higher aided audibility compared to those with >5 dB error.
- No significant differences in speech recognition or vocabulary were observed across RMS error categories.
- Children with <3 dB RMS error showed superior morphosyntax development compared to those with 3-5 dB and >5 dB error.
Conclusions:
- Hearing aid fittings closer to prescriptive targets (<3 dB RMS error) lead to better outcomes in children.
- Utilizing probe microphone measures for precise hearing aid adjustments (within 3 dB) may enhance language abilities in pediatric users.
- Stricter fitting criteria are recommended for optimizing the benefits of hearing aids in children.
Objective:
To determine if a stricter criterion for paediatric hearing aid fitting for proximity of fit-to-target of <3 dB root-mean-square (RMS) error produces better audibility and outcomes compared to the current <5 dB criterion, and to examine the relationship between aided audibility and RMS error by degree of hearing loss.
Design:
We evaluated the influence of unaided hearing level on the relationship between RMS error and aided audibility. We assessed the effect of RMS error category (<3, 3-5, >5 dB) on aided audibility, speech recognition, expressive vocabulary, and morphosyntax.
Study Sample:
The study included 2314 hearing aid verification measurements from 307 children with hearing aids.
Results:
Children who met a <3 dB criterion had higher aided audibility than children who met no criterion (>5 dB error). Results showed no differences in speech recognition or vocabulary by error category, but children with <3 dB error demonstrated better morphosyntax than children with 3-5 and >5 dB RMS error.
Conclusions:
Fittings that are close to prescriptive targets provide a more positive outcome for children with hearing aids. Using probe microphone measures to adjust hearing aids to within 3 dB may benefit language abilities in children.
