WSU AUD 5420 week 7 pediatric hearing aid fittings & early childhood hearing loss

congenital

present at birth

acquired

onset after birth due to trauma or disease

prelingual

occurring prior to language significantly acquired

perilingual

occurring during language development

postlingual

occurring after language development

social effects of pediatric hearing loss

anxiety from anticipated miscommunication, either dominates conversations or socially withdraws

academic effects of pediatric hearing loss

missed/misunderstood info provided during class, difficulty hearing teachers/classmates’ questions/comments

job security effects of hearing loss

reduced security, missed/misunderstood info from group meetings, interpersonal conversations, instructions

strained personal relationships and hearing loss

frustration due to having to repeat speech, increased television volume, difficulty understanding phone conversations

listening fatigue

strain from trying to hear

prognosis: patient/caregiver motivation

patient and/or caregiver must be sufficiently self-motivated and committed to helping child use hearing aids, often a difficult task

BTE (behind the ear)

most recommended hearing aid for children because it’s more durable & more affordable than RITE (receiver in the ear)

wireless capabilities of hearing aids

made hearing aids much more accessible/functional for children & adults

pediatric hearing aid selection

degree of hearing loss, style (usually BTE), cost, lifestyle (classroom = FM system), gain & frequency response

additional features of pediatric hearing aids

telecoil, remote control/phone app, accessories, sweat guards, special retention features (clips for clothing)

factors affecting pediatric fittings

similar to adult fittings except style-related issues, classroom considerations; young children usually wear BTEs with earmolds, earmolds provide better retention, receiver is inside the hearing aid/outside of the ear where it’s less likely to be damaged

FM system

wireless technology that uses frequency modulation (FM) radio waves to transmit speech to a listener

FM capabilities

this technology is critical for children in the classroom; pediatric hearing aid lines can be programmed to automatically switch to FM mode

goals of pediatric hearing aid fitting

make speech & environmental sounds audible, development of speech & language through hearing; optimize intelligibility & sound quality, assure that loud inputs are not distorted/uncomfortable, make sure physical fit is comfortable

verification

objective/does NOT require patient’s response/opinion; use of a procedure to determine if the hearing aid is meeting measurable expectations (electroacoustic analysis, probe-tube measurements)

validation

subjective/DOES require the patient’s response/opinion; questionnaires

electroacoustic analysis

test performed in a test box to determine hearing aid meets standards defined by American National Standards Institute (ANSI); specifications provided by hearing aid manufacturer, especially important to perform for young children since kids cant’ always say if hearing aid isn’t working

speech mapping aka probe-tube measurements/real ear measurements

measurement made with probe microphone (thin tube inserted in ear canal w mic at the end just outside the ear) in ear and hearing aid in place & functioning, targets for hearing aid output calculated based on the audiogram, specific signal delivered from the loudspeaker on real ear equipment

why do we do real ear measures?

need to determine if hearing aid is functioning the way it was intended to function in the patient’s ear; prescriptive targets for hearing aids based on resonance characteristics of average ears; ears are NOT average; esp important in pediatric ears which are smaller, hearing aid output louder at various frequencies than adult ears, children can’t always verbalize what they are hearing

fitting appointment for pediatric hearing aids

check of physical fit, programming, adjustments for patient’s comfort, on-ear verification, orientation, what to expect

orientation of instrument operation

caregivers must be shown how to regularly perform listening checks, turn the hearing aid on/off, charge batteries, work the program button, use of any other hardware or remote controls, written instructions helpful

follow-up appointments

always perform otoscopy, validation measures, review maintenance, listening check, review hearing aid troubleshooting, update audiogram if needed, update earmolds, counseling

Ling 6 Sounds

theoretically demonstrates benefits gained in speech understanding with hearing aid versus without; compared to unaided speech recognition testing scores; sounds are ah, oo, eee, sh, sss, mmm

hearing loss self-concept

higher risk of having negative views about themselves, hearing aids still often have a negative association

hearing loss emotional development

part of language development is interpreting/understanding emotions, language delay often leads to emotional immaturity; may lack the vocabulary to describe emotions

hearing loss family concerns

approximately 90% of hearing-impaired children are born to 2 hearing parents, research has shown mother-child interactions can be more rigid & negative; parents’ response to diagnosis is often grief, shock, denial, depression, acceptance/resignation, need to acknowledge parents as the expert on the child

hearing loss social competence

fewer opportunities for peer interactions makes it harder to learn social rules/pragmatics (eye contact, turn-taking); adolescent years are even tougher for establishing and maintaining healthy peer relationships, teens may refuse to wear hearing aids for fear of not fitting in

hearing aid effect

negative assumptions about hearing aid user caused by the visibility of hearing aid

incidental learning

children with hearing loss miss out on overhearing conversations of others, children learn to speak by mimicking speech they actively hear & also passively hear