Objective-The purpose of this study was to characterize the sensorineural hearing losses of a group of children and adults along three parameters important to the hearing instrument fitting process: 1) audiometric configuration, 2) asymmetry of loss between ears, and 3) progression of loss over several years.Design-Audiograms for 248 60-and 61-year-old adults and 227 6-year-old children were obtained from the audiological database at Boys Town National Research Hospital. Based on right-ear airconduction thresholds, the configurations were assigned to one of six categories: sloping, rising, flat, u-shaped, tent-shaped and other. Left-and right-ear thresholds were compared to determine asymmetry of loss. Progression of loss was evaluated for 132 children for whom additional audiograms over an 8-year period were available.Results-In general, the children's hearing losses were more evenly distributed across configuration categories while most of the adult's audiograms were sloping or u-shaped in configuration. The variability of loss at each frequency was greater for the children than the adults for all configuration categories. Asymmetrical losses were more common and the degree of asymmetry at each frequency was more extensive among the children than the adults. A small number of children showed either improved or deteriorated hearing levels over time. In those children for whom progressive hearing loss occurred, no f requency was more vulnerable than another.
Conclusions-The results of the present study suggest that substantial differences in audiological characteristics exist between children and adults. Implications for amplification include the development of appropriate fitting protocols for unusual audiometric configurations as well as protocols for binaural amplification in cases of asymmetric hearing losses.Studies have shown a number of areas in which the auditory skills of children with normal hearing differ from those of adults. For example, children have poorer behavioral detection thresholds (Olsho, Koch, Carter, Halpin, & Spetner, 1988) and require higher signal-to-noise ratios to perform certain listening tasks as compared to adults (Hall, III & Grose, 1991;Veloso, Hall, III, & Grose, 1990). Children have also been found to have poorer use of temporal cues (Elliott, 1986;Elliott, Busse, Partridge, Rupert, & DeGraaff, 1986;Wightman, Allen, Dolan, Kistler, & Jamieson, 1989), poorer phoneme and word recognition (Hnath-Chisolm, Laipply, & Boothroyd, 1998), and poorer speech recognition in reverberant conditions (Nabelek & Robinson, 1982;Neuman & Hochberg, 1983).The impact of hearing loss on the development of auditory skills, has sparked a debate regarding the amplification needs of children relative to those of adults. Some investigators suggest that children and adults with similar hearing losses require similar amplification strategies (Ching, Dillon, & Byrne, 2001 1995). Others suggest that young children may have unique amplification needs during the development of speech and language (Boo...