A critical review of audiological outcome measures for infants and children.

Outcome evaluation is an important stage in the pediatric hearing aid fitting process, however a systematic way of evaluating outcome in the pediatric audiology population is lacking. This is in part due to the need for an evidence-based outcome evaluation guideline for infants and children with hearing loss who wear hearing aids. As part of the development of a guideline, a critical review of the existing pediatric audiology outcome evaluation tools was conducted.

Adaptation of the BKB-SIN test for use as a pediatric aided outcome measure.

Background: There is a need for objective pediatric hearing aid outcome measurement and thus a need for the evaluation of outcome measures. We explored a commercially available pediatric sentence-in-noise measure adapted for use as an aided outcome measure.

Purpose: The purposes of the current study were (1) to administer an adapted BKB-SIN (Bamford-Kowal-Bench Speech-in-Noise test) to adults and children who have normal hearing and children who use hearing aids and (2) to evaluate the utility of this adapted BKB-SIN as an aided, within-subjects outcome measure for amplification strategies.

Fit to targets, preferred listening levels, and self-reported outcomes for the DSL v5.0 a hearing aid prescription for adults.

Study Objective: This study evaluated how closely the DSL v5.0 a prescription could be approximated with hearing aids, its relationship to preferred listening levels (PLLs) of adults with acquired hearing loss, and the self-reported outcomes of the resulting fittings.

Participants: Thirty adults with varying degrees and configurations of hearing loss ranging from mild to severe.

Children's speech perception and loudness ratings when fitted with hearing aids using the DSL v.4.1 and the NAL-NL1 prescriptions.

This paper reports speech and loudness measures on a group of children in a double-blind cross-over trial comparing the NAL-NL1 and DSL[i/o] prescriptions. Twenty-four children with hearing impairment were fitted with digital WDRC hearing aids at each site (Australia, Canada). Speech recognition was measured for nonsense syllables and for the 50% correct threshold for sentence recognition in noise.

Evaluation of the desired sensation level [input/output] algorithm for adults with hearing loss: the acceptable range for amplified conversational speech.

Objectives: This study had two related purposes: first, to define the range of optimal ear canal levels of aided speech in both high frequency and low frequency regions for adults, using both subjective and objective definitions of optimal; and second, to determine whether a prescribed frequency response, such as that given by Desired Sensation Level [Input/Output], falls within the adult listener's optimal range.

Design: Twenty-three adult listeners with mild to moderately severe sensorineural hearing loss were selected from a pool of research volunteers. They were fitted in the laboratory with the Siemens Signia hearing instrument and tested with 20 nominally different frequency responses.

Evaluation of a probe-tube insertion technique for measuring the real-ear-to-coupler difference (RECD) in young infants.

A common strategy for measuring the real-ear response of the real-ear-to-coupler difference (RECD) in the pediatric population is to insert a probe-tube separately from the eartip. This strategy is at times difficult to implement while attempting to obtain the measurement from a young infant. An RECD probe-tube insertion technique that involves connecting the probe-tube to an eartip with plastic film for simultaneous insertion was examined on 30 infants.

An approach for ensuring accuracy in pediatric hearing instrument fitting.

Hearing instrument fitting with infants and young children differs in several important ways relative to the fitting process with adults. In developing the Desired Sensation Level method, we have attempted to account for those factors that are uniquely associated with pediatric hearing instrument fitting. Within this article we describe how the external ear acoustics of infants and young children have been systematically accounted for in developing the Desired Sensation Level method.

Evaluation of electroacoustic test signals II: development and cross-validation of correction factors.

Objective: To develop and cross-validate corrections for improving the match between amplified speech levels and frequency response measurements with hearing aids.

Design: Previously published correction approaches were reviewed. Two regression-based corrections and two nonregression corrections were developed from an existing database of hearing aid responses measured with clinically available test signals and speech (Scollie & Seewald, 2002).

Evaluation of electroacoustic test signals I: comparison with amplified speech.

Objective: To evaluate the ability of clinical test signals to match the aided levels of real speech, across a range of hearing aid circuit types and strengths.

Design: Hearing aids (N = 41) were set to DSL targets for moderate, severe, and profound hearing losses. These hearing aids were tested with three test signals (Fonix Pure Tones, Fonix Composite Noise, and Audioscan Swept), as well as with running speech.

Real-ear-to-coupler difference predictions as a function of age for two coupling procedures.

The predicted real-ear-to-coupler difference (RECD) values currently used in pediatric hearing instrument prescription methods are based on 12-month age range categories and were derived from measures using standard acoustic immittance probe tips. Consequently, the purpose of this study was to develop normative RECD predicted values for foam/acoustic immittance tips and custom earmolds across the age continuum. To this end, RECD data were collected on 392 infants and children (141 with acoustic immittance tips, 251 with earmolds) to develop normative regression equations for use in deriving continuous age predictions of RECDs for foam/acoustic immittance tips and earmolds.