Comparing criteria for deviation from hearing aid prescriptive targets in children.
Kathryn B Wiseman, Elizabeth A Walker, Meredith Spratford and 2 others
PMID 38147879WHAT IT FOUND
Tightening hearing aid fit to within 3 dB of target improves audibility and grammar skills in children, especially those with milder loss.
Current 5 dB guidelines may be too loose for optimal language development. Speech recognition and vocabulary scores did not change with the stricter fit.
Key findings
01Children fitted within 3 dB of target had significantly better morphosyntax skills than those with 3-5 dB or >5 dB error, but speech recognition and vocabulary showed no difference.
02Meeting the stricter 3 dB criterion improved aided audibility compared to >5 dB error, but did not improve audibility compared to the 3-5 dB range.
03The benefit of the <3 dB criterion on grammar was most pronounced in children with milder hearing loss, likely due to a floor effect in audibility for those with severe loss.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This was an observational analysis of existing data, not a randomized trial, so it cannot prove that tightening the fit caused the language improvements. The study did not assess whether the hearing aids could physically be fitted to the 3 dB target, as no adjustments were made during the study. Speech recognition and vocabulary were measured at single time points rather than tracking growth over time. The benefit of the stricter fit was less clear for children with severe-to-profound hearing loss due to technological limits on audibility.
The easy way to misread this
Do not assume that tightening the hearing aid fit to 3 dB will improve all communication skills. The study found no significant benefit for speech recognition in quiet or expressive vocabulary, meaning the improvement is specific to grammatical structure and audibility.