Relationship of Head Circumference and Age in the Prediction of the Real-Ear-to-Coupler Difference (RECD)

Abstract

Background: Pediatric hearing instrument fitting is optimally performed with individually obtained realear-to-coupler difference (RECD) measurements. If these measurements cannot be obtained, predictedvalues based on age are used. Recent evidence obtained from children aged 3–11 years suggests thathead circumference (HC) may be a viable alternative or addition to age for use in RECD prediction.Purpose: The purpose of the present study was to determine if HC can be used to predict RECDs ininfants, children, and adults.Research Design: A correlational design was used. HC and RECD values were measured in allparticipants.Study Sample: Participants were 278 North American infants and children (136 males and 142 females)aged 1.6 months to 11 years and 109 adults (42 males and 67 females) aged 18 years to 83 years.Data Collection and Analysis: After otoscopic inspection and immittance measurements were performedto assess candidacy for inclusion in the study, HC was measured twice for all participantsand a single RECD measure was obtained for each participant at twelve frequencies (250 through12500 Hz). The reliability of HC measurements was assessed with an intraclass correlation analysis.Linear regression analyses were performed with age and HC as predictor variables and RECDs asthe dependent variable.Results: Analysis indicated good reliability of the HC measurement. The relationships between RECDand HC were comparable with the relationships between RECD and age. Combining HC and age did notimprove predictive accuracy.Conclusions: HC can be used in children and adults as an alternative metric in the prediction of RECDswhen individual RECDs cannot be obtained.

Applying the reference values of real-ear-to-coupler-difference for deaf and hard-of-hearing children in Taiwan: Cautions and considerations

“…This could be due to differences in the volume of the ear canals of DHH children from Eastern and Western countries. As previous studies have suggested, individual variations in RECDs can range from ±5.6 dB at 500 Hz to ±10.9 dB at 6000 Hz compared to reference values, and these variations may be influenced by factors such as head circumference and ear canal growth [18,20,21]. In the present study, we observed higher measured RECDs at low frequencies and smaller measured RECDs at high frequencies compared to the reference values, which could be attributed to differences in the ear canal geometry of DHH children from Eastern and Western countries.…”