Perceptual Benefits of Extended Bandwidth Hearing Aids With Children: A Within-Subject Design Using Clinically Available Hearing Aids

Abstract

Purpose The aim of the study was to investigate the achieved audibility with clinically available, modern, high-end, behind-the-ear hearing aids fitted using the Desired Sensation Level v5.0 child prescription for a clinical sample of children with hearing impairment and the effect of the extended bandwidth provided by the hearing aids on several outcome measures. Method The achieved audibility was measured using the maximum audible output frequency method. Twenty-eight children (7–17 years old) with mild to severe hearing losses completed this study. Two hearing aid conditions were fitted for each participant: an extended bandwidth condition, which was fitted to targets as closely as possible, and a restricted bandwidth condition, for which aided output was restricted above 4.5 kHz. Consonant discrimination in noise, subjective preference, aided loudness growth, and preferred listening levels were evaluated in both conditions. Results The extended bandwidth hearing aid fittings provided speech audibility above 4.5 kHz for all children, with an average maximum audible output frequency of 7376 Hz ( SD = 1669 Hz). When compared to a restricted bandwidth, the extended bandwidth condition led to an improvement of 5.4% for consonant discrimination in noise scores, mostly attributable to /s/, /z/, and /t/ phoneme perception. Aided loudness results and preferred listening levels were not significantly different across bandwidth conditions; however, 65% of the children indicated a subjective preference for the extended bandwidth. Conclusion The study suggests that providing the full bandwidth available, with modern, behind-the-ear hearing aids, leads to improved audibility, when compared to restricted bandwidth hearing aids, and that it leads to beneficial outcomes for children who use hearing aids, fitted to the Desired Sensation Level v5.0 child prescription, without causing significant increases in their loudness perception.

Narrative Review of Loudness Perception Measures in Children

“…Studies reporting variability across children of similar ages show that this variability is substantial but similar to that which has been reported with adult listeners (Dorfman & Megling 1966; Bond & Stevens 1969; Teghtsoonian 1980; Collins & Gescheider 1989; Baruch et al 1993; Fucci et al 1999; Davidson et al 2000, 2009; Serpanos & Gravel 2000, 2004; Khalfa et al 2004; Serpanos 2004; Scollie et al 2010; Crukley & Scollie 2012, 2014; Wolfe et al 2015; Van Eeckhoutte et al 2020). Despite this across-child variability, children were highly consistent in their loudness growth reports across tests (O’Loughlin 1978; Collins & Gescheider 1989; Serpanos & Gravel 2000, 2004; Serpanos 2004; Wolfe et al 2015).…”

Predicting Hearing aid Benefit Using Speech-Evoked Envelope Following Responses in Children With Hearing Loss

“…Speech discrimination was assessed using the University of Western Ontario Distinctive Features Differences test (DFD; Cheesman & Jamieson, 1996 ). The DFD is a closed-set consonant discrimination task and has been commonly used to measure hearing aid benefit in children and adults ( Easwar et al, 2015b ; Eeckhoutte et al, 2020 ; Jenstad et al., 2007 ; Scollie, 2008 ). Twenty-one consonants are presented in a word-medial context (/aCil/ where C is the consonant).…”

Characteristics of Speech-Evoked Envelope Following Responses in Infancy

“…The rationale for using certain speech stimuli, such as individual vowel formants and modified fricatives, has been to assess audibility, using EFRs, at a wide range of frequencies with reasonable specificity ( Easwar et al., 2015c ). Such frequency-specific assessment of audibility is clinically desirable in light of varying audiometric configurations in individuals, particularly children with hearing loss, both with and without hearing aids, and the contribution of individual frequency regions to phoneme and overall speech recognition with hearing aids (e.g., McCreery et al., 2017 ; Van Eeckhoutte et al., 2020 ). To date, the majority of studies in children have evaluated the characteristics of EFRs elicited by natural or synthesized (broadband) vowel stimuli at the vocal fundamental frequency ( f 0 ).…”