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Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
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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.

International Journal of Audiology
|December 26, 2023
PubMed
Summary

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.

Keywords:
RMS errorSIIchildrenhearing aidsprescriptive targets

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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.