Role of Cortical Auditory Evoked Potentials in Reducing the Age at Hearing Aid Fitting in Children With Hearing Loss Identified by Newborn Hearing Screening.

The study was a single-center service evaluation, so the pathway may not match other audiology services. It compared children from two time periods rather than randomly assigning hearing aid pathways, so changes over time could have influenced the results. The authors note that changing attitudes of audiologists, hearing support staff, and parents may have contributed to earlier fitting. The study did not measure speech or language outcomes, so it cannot show that earlier hearing aid fitting improved communication. Cortical auditory evoked potential responses were not always present even when sounds were expected to be audible, so the test had to be interpreted with other hearing tests. Free-field testing could not assess hearing levels below 55 dB SPL, so mild losses could be missed. Children with auditory neuropathy spectrum disorder, long-term mixed hearing loss, additional learning or sensory disabilities, and comorbidities were excluded, so the findings do not apply to those groups. One child in Cohort B remained unaided at the time of analysis, although the authors say this had minimal effect. The sample size and narrow demographics limit how far the findings can be applied to other populations.

Do not conclude that cortical auditory evoked potential testing improves speech or language outcomes. This service evaluation measured the timing of hearing aid fitting and cochlear implant referral, not communication results. It also compared two sequential cohorts in one centre, so changing attitudes of audiologists, support teams, and parents may also have contributed to the earlier fitting.