Evaluation of real-world preferences and performance of hearing aids fitted according to the NAL-NL1 and DSL v5 procedures in children with moderately severe to profound hearing loss

Perception of voice cues in school-age children with hearing aids

The just-noticeable differences (JNDs) of the voice cues of voice pitch (F0) and vocal-tract length (VTL) were measured in school-aged children with bilateral hearing aids and children and adults with normal hearing. The JNDs were larger for hearing-aided than normal-hearing children up to the age of 12 for F0 and into adulthood for all ages for VTL. Age was a significant factor for both groups for F0 JNDs, but only for the hearing-aided group for VTL JNDs. Age of maturation was later for F0 than VTL. Individual JNDs of the two groups largely overlapped for F0, but little for VTL. Hearing thresholds (unaided or aided, 500-400 Hz, overlapping with mid-range speech frequencies) did not correlate with the JNDs. However, extended low-frequency hearing thresholds (unaided, 125-250 Hz, overlapping with voice F0 ranges) correlated with the F0 JNDs. Hence, age and hearing status differentially interact with F0 and VTL perception, and VTL perception seems challenging for hearing-aided children. On the other hand, even children with profound hearing loss could do the task, indicating a hearing aid benefit for voice perception. Given the significant age effect and that for F0 the hearing-aided children seem to be catching up with age-typical development, voice cue perception may continue developing in hearing-aided children.

The Complexity of Hearing Aid Fitting: Children with Congenital Hearing Loss and Middle Ear Dysfunction

BACKGROUND

The early diagnosis of hearing loss (HL) and hearing rehabilitation facilitate language and communication development. Some children exhibit mixed HL due to middle ear effusion (MEE) or acute otitis media (AOM). Mixed HL can affect HL evaluation and hearing aid (HA) fitting. The present study retrospectively evaluated the prevalence of MEE/AOM among children with congenital sensorineural HL (SNHL) who were fitted with HAs and its effect on the HA fitting.

METHODS

Thirty-six HA fittings carried out between 2017 and 2020 at one rehabilitation center were examined. Medical and audiological information was retrieved for children between 6 and 32 months old. The number of appointments and HA fitting times were recorded.

RESULTS

Twenty-eight children were included in the study. Eighteen children, in addition to SNHL, had a conductive component resulting from MEE/AOM. The children with these pathologies required significantly more HA fitting sessions and hearing tests, fewer real ear to coupler difference (RECD) measurements and longer HA fitting periods.

CONCLUSION

The findings indicate that a large number of children fitted with HAs have an additional conductive component that makes the fitting process longer. Since early rehabilitation is necessary for language development, otolaryngologists should be aware of the adverse effects of MEE/AOE on the HA fitting process. It is important to inform parents that when there is a conductive component, the HA fitting process may take longer and that treatment by an otolaryngologist is vital. This study stresses the importance of multidisciplinary cooperation for optimal HA fitting.

Investigation of hearing aid fitting according to the national acoustic laboratories' prescription for non-linear hearing aids and the desired sensation level methods in Japanese speakers: a crossover-controlled trial

OBJECTIVE

Some studies have directly compared the National Acoustic Laboratories' prescription for non-linear hearing aids (HAs) version 2 (NAL-NL2) and Desired Sensation Level for non-linear HAs version 5 (DSLv5), although none were performed in Japan. As the Japanese language is a tonal language that has different linguistic characteristics than those of the studied languages, we compared the outcomes of the NAL-NL2 and DSLv5 in hearing-impaired Japanese participants.

METHODS

A crossover-controlled trial was conducted on 18 first-time HA users with bilateral moderate sensorineural hearing loss. Participants wore HAs adjusted with each prescriptive method for four weeks. The prescriptions were assessed using speech discrimination testing and the abbreviated profile of hearing aid benefit (APHAB). Consequently, participants were asked to select their preferred prescription and determine which was better for "listening to a conversation" and when "noisy."

RESULTS

The mean DSLv5 real ear insertion gain for an input level of 65 dB sound pressure level (SPL) was higher than that of the NAL-NL2 at 250 and 500 Hz. The average speech discrimination score was 78 ± 14% at a 65-dB SPL and 75 ± 17% at an 80-dB SPL for the NAL-NL2, and 79 ± 11% at a 65-dB SPL and 77 ± 17% at an 80-dB SPL for the DSLv5. These differences were not significant. No significant differences were observed in APHAB subscale scores between the two prescription methods. Ultimately, 11 (61%) and 7 (39%) participants preferred the NAL-NL2 and DSLv5, respectively, with no significant differences.

CONCLUSION

Although the gain of the NAL-NL2 is smaller than that of the DSLv5, both had the same hearing effect. Therefore, the NAL-NL2 may be more useful than the DSLv5 in Japanese.

Optimising hearing aid output to paediatric prescriptive targets improves outcomes in children

OBJECTIVE

This study examined the accuracy of hearing aid output to DSL v5.0 Child targets in a group of children who wear hearing aids, and the impact on their auditory outcomes.

DESIGN

For each participant, the output of the initial hearing aid fitting was compared to DSL v5.0 Child prescriptive targets and again after the fitting was adjusted using coupler-based verification and RECD measures. Outcomes for initial and adjusted fittings were examined using the Speech Intelligibility Index (SII), Parent's Evaluation of Aural/Oral Performance of Children (PEACH) rating scale, and speech perception tests in quiet and noise.

STUDY SAMPLE

Sixty-eight children aged 3 months to 17 years with moderate to profound hearing loss participated in the study.

RESULTS

Fit-to-targets improved significantly after hearing aids were adjusted to match targets to within 5 dB RMSE. Adjusted hearing aids provided increased aided audibility compared to initial fittings and resulted in improved speech perception scores and parent-reported hearing performance. Fifty percent of the children aged 6 to 17 years preferred their adjusted fitting compared to 10% who preferred their initial fitting.

CONCLUSIONS

Improvement in fit-to-target to a validated paediatric prescriptive formula using best practice procedures can result in improved auditory outcomes and possible self-reported satisfaction.