Hearing Thresholds, Speech Recognition, and Audibility as Indicators for Modifying Intervention in Children With Hearing Aids.
Kathryn B Wiseman, Ryan W McCreery, Elizabeth A Walker
PMID 36627755WHAT IT FOUND
Aided speech recognition in noise, aided SII, and auditory dosage flagged risk for spoken language delay in children with hearing aids, while quiet word recognition and unaided thresholds did not.
Scores in noise below 55-62% or aided SII below .53-.68 warrant closer monitoring.
Key findings
01Children with aided speech recognition in noise scores below 55-62% phonemes correct were at greater risk for language delay.
02An aided SII value between .53 and .68 or lower indicated heightened risk for language delay.
03Auditory dosage below 5.3-6.7 hours was associated with language delay risk, but daily hearing aid use alone did not predict language outcomes.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study used a cross-sectional analysis of the most recent language scores, which may explain why hearing aid use alone did not predict language, whereas previous longitudinal studies found it did. Hearing aid use was estimated by parent report, which likely overestimates actual wear time compared to device datalogging. The sample was homogeneous (monolingual English speakers, no cognitive/motor delays), so findings may not generalize to bilingual children, those with additional diagnoses, or children who use sign language. Statistical models showed considerable individual variability, so the proposed cut-offs are 'red flags' for monitoring rather than strict diagnostic thresholds.
Declared interests
The authors declared no financial relationships relevant to this article. The research was supported by grants from the NIH/NIDCD.
The easy way to misread this
Do not interpret the aided SII or speech recognition in noise cut-offs as strict diagnostic criteria for cochlear implant candidacy. These values are indicators of risk that should prompt further monitoring and multidisciplinary discussion, not automatic changes to a child's hearing technology.