Auditory performance of young children with hearing aids: the Nijmegen experience

Abstract

Paper presented at the 3rd International Congress of Paediatric Audiology, 9-12 May 2000, Copenhagen. During recent years, signi cant progress has been made in the development of methods for screening hearing sensitivity in toddlers. Nowadays, in several countries, nationwide screening programmes are carried out. Much less attention has been paid to the next step, namely treatment of very young hearing-impaired children with hearing devices. A review of published data indicate that the DSL (Desired Sensation Level) hearing aid prescription method, developed especially for young children, is at least a good point to begin hearing aid tting. DSL target values for gain and output seems to be adequate for young children. Documenting the bene t for hearing aid use in young children is still cumbersome. One option is to measure the development of basal auditory functions. A review of available data showed that for this purpose, speech material can only be used in children of 3 years and older. For children of 1 year and older, tests with environmental sounds can be applied. It is concluded that, although growing, there is a lack of tests and limited knowledge on how to optimize hearing aid ttings and how to document hearing aid bene t in toddlers.

The Relationship between Obligatory Cortical Auditory Evoked Potentials (CAEPs) and Functional Measures in Young Infants

“…Systematic prescriptive methods, such as NAL-NL1 (National Acoustic Laboratories-nonlinear, version 1) or DSL [i/o] (desired sensation level [input/ output]), use behavioral threshold inputs or estimates based on electrophysiological thresholds to derive target gain, but methods that verify the success of the fitting process in infants are limited. This is particularly the case before the infant is able to respond to behavioral threshold-seeking techniques and before speech recognition tests can be administered (Snik et al, 2001). For these young infants, evidence of the appropriateness of the fit may be based on direct observation of behaviors (either by behavioral observation audiometry [BOA] or parental questionnaire) or electrophysiological test outcomes.…”