The DSL Method for Pediatric Hearing Instrument Fitting: Historical Perspective and Current Issues

Seewald, Richard C.; Moodie, Sheila; Scollie, Susan; Bagatto, Marlene

doi:10.1177/108471380500900402

Cited by 69 publications

(47 citation statements)

References 24 publications

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“…As described by Seewald et al (2005) in this issue, the DSL[i/o] algorithm is a generic prescriptive algorithm that computes targets for hearing instrument performance that are matched to the hearing threshold levels, age, and hearing instrument fitting characteristics of the individual hearing instrument user. Version 4.1 of DSL was designed with a WDRC stage at each frequency.…”

Section: Target Generationmentioning

confidence: 99%

The Desired Sensation Level Multistage Input/Output Algorithm

Scollie

Seewald

Cornelisse³

et al. 2005

Trends in Amplification

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326

300

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The Desired Sensation Level (DSL) Method was revised to support hearing instrument fitting for infants, young children, and adults who use modern hearing instrument technologies, including multichannel compression, expansion, and multimemory capability. The aims of this revision are to maintain aspects of the previous versions of the DSL Method that have been supported by research, while extending the method to account for adult-child differences in preference and listening requirements. The goals of this version (5.0) include avoiding loudness discomfort, selecting a frequency response that meets audibility requirements, choosing compression characteristics that appropriately match technology to the user's needs, and accommodating the overall prescription to meet individual needs for use in various listening environments. This review summarizes the status of research on the use of the DSL Method with pediatric and adult populations and presents a series of revisions that have been made during the generation of DSL v5.0. This article concludes with case examples that illustrate key differences between the DSL v4.1 and DSL v5.0 prescriptions. et al., 1995).Since that revision, DSL[i/o] has been evaluated in both adult and pediatric populations in a number of studies. In this chapter, we will summarize the current status of DSL evaluation work in children and adults and argue the need for different prescriptive targets for adults and children. We will also present research describing electroacoustic and signal processing issues that have motivated us to make modifications to the input/output structure of the DSL target functions. These modifications will be described, and several case studies will illustrate the magnitude and type of changes to prescriptive targets in DSL v5.0. Outcomes for ChildrenStudies using the DSL Method with the pediatric population have been done with various aims and purposes. Some studies have sought to determine whether DSL-related outcomes differ from those of alternative fittings (Snik and Stollman, 1995;Ching et al., 1997;Scollie et al. 2000) or to compare subversions of DSL such as linear vs nonlinear (Jenstad et al., 1999;Jenstad et al., 2000). Other studies have used DSL as the fitting method within general pediatric hearing and amplification research, such as when evaluating signal processing options or audibility effects in children with hearing loss (Moeller et al., 1996;Bamford et al., 1999;Christensen, 1999;Gravel et al., 1999;Hanin, 1999;Lear et al., 1999;Pittman and Stelmachowicz, 2000;Stelmachowicz et al., 2000;Stelmachowicz et al., 2001;Condie et al., 2002;Stelmachowicz et al., 2002). Other authors incorporate the DSL Method, including the associated clinical procedures described by Bagatto et al., 2005, within recommended clinical guidelines for pediatric amplification (e.g., The Pediatric Working Group 1996; American Academy of Audiology, 2004). Ongoing research will, therefore, likely always strive to determine the best methods for prescribing the signal processing ch...

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Section: Target Generationmentioning

confidence: 99%

The Desired Sensation Level Multistage Input/Output Algorithm

Scollie

Seewald

Cornelisse³

et al. 2005

Trends in Amplification

Self Cite

326

300

View full text Add to dashboard Cite

show abstract

“…This represented the basic clinical procedures at the time. Hearing aid fitting typically was based on the DSL method (desired sensation level [22]) that aims at placing amplified speech within the residual auditory area by considering individual characteristics of the child, such as real ear transfer functions. Children with multiple disabilities were excluded.…”

Section: Participantsmentioning

confidence: 99%

Real-World Verbal Communication Performance of Children Provided With Cochlear Implants or Hearing Aids

Meister¹,

Keilmann²,

Leonhard³

et al. 2015

Otology &Amp; Neurotology

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“…We know that an infant's ear is much smaller than an adult's ear. The output of a hearing aid fitted to an infant's ear using these "average" adult transformation values could be 30 decibels greater at some frequencies than the same hearing aid on an adult's ear (Seewald, Moodie, Scollie, & Bagatto, 2005;Seewald & Scollie, 1999). Speech sounds and loud environmental sounds could be overamplified, potentially causing discomfort and increased risk of additional hearing loss.…”

Section: Difficulties In Applying Evidence In the Care Of Individual mentioning

confidence: 99%

Knowledge Translation in Audiology

Moodie

Kothari

Bagatto

et al. 2011

Trends in Amplification

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The origins of evidence-based practice (EBP) come largely from clinical medicine. The EBP paradigm provides techniques and procedures to critically examine the abundance of scientific evidence in order to assist clinical decision making and improve the quality, effectiveness, and efficiency of health services received by the public. The desired clinical outcome of EBP is an increase in the number of patients who get treatment of proven quality and effectiveness. The generally agreed-upon definition of EBP is that it is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients." Evidence-based practice integrates "individual clinical experience with the best available external clinical evidence from systematic research" (Sackett, Rosenberg, Muir Gray, Haynes, & Richardson, 1996, p. 71). Incorporating evidence into practice is regarded as a process that begins with a search for research literature about how best to solve specific clinical problems and results in treatment decisions based on the best possible evidence (Stetler, 2001). As clinicians and their organizations learn more about EBP and the components of EBP, workshops, seminars, training kits, books, and educational opportunities have been developed to assist clinicians in developing the necessary EBP skill set that includes the ability to develop focused and appropriately structured clinical questions, search and locate high-quality evidence in the literature, evaluate the strength of the evidence, critically appraise the evidence, and implement evidence within the clinical context. Evaluating the Strength of the Evidence: Hierarchy of EvidenceIn order to provide professionals with a method for ranking the quality of research, hierarchies of evidence were intro- AbstractThe impetus for evidence-based practice (EBP) has grown out of widespread concern with the quality, effectiveness (including cost-effectiveness), and efficiency of medical care received by the public. Although initially focused on medicine, EBP principles have been adopted by many of the health care professions and are often represented in practice through the development and use of clinical practice guidelines (CPGs). Audiology has been working on incorporating EBP principles into its mandate for professional practice since the mid-1990s. Despite widespread efforts to implement EBP and guidelines into audiology practice, gaps still exist between the best evidence based on research and what is being done in clinical practice. A collaborative dynamic and iterative integrated knowledge translation (KT) framework rather than a researcher-driven hierarchical approach to EBP and the development of CPGs has been shown to reduce the knowledge-to-clinical action gaps. This article provides a brief overview of EBP and CPGs, including a discussion of the barriers to implementing CPGs into clinical practice. It then offers a discussion of how an integrated KT process combined with a community of practice (CoP) might facilitat...

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The DSL Method for Pediatric Hearing Instrument Fitting: Historical Perspective and Current Issues

Cited by 69 publications

References 24 publications

The Desired Sensation Level Multistage Input/Output Algorithm

The Desired Sensation Level Multistage Input/Output Algorithm

Real-World Verbal Communication Performance of Children Provided With Cochlear Implants or Hearing Aids

Knowledge Translation in Audiology

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