This pilot study of conventional hearing aid use in eight children with mild to moderately-severe UHL showed no significant changes, especially no decrease, on speech perception as measured by the BKB-SIN and NST. Thus, conventional hearing aid use did not cause any detriment for children with UHL. These results contrast with those from Updike (8
) who concluded that the use of a conventional hearing aid was detrimental, particularly in a noisy environment. Instead, a majority of the children demonstrated improved scores on all the BKB-SIN conditions, supporting an overall trend towards better performance in noise on a test that may be considered more representative of real world listening conditions than the NST. These results may also differ from Updike (8
) because the current study utilized digital hearing aids verified with electroacoustic measures using a prescriptive formula that has been validated on children. Furthermore, the present study ensured that subjects were audiologically appropriate hearing aid candidates with mild to moderately severe UHL and usable speech recognition, and provided an acclimatization period with the device.
Although there were no significant changes on speech perception results, there were large (>1 standard deviation) improvements on all child and parent subjective assessments for a variety of listening environments. There were clinically important improvements in the average post-hearing aid scores on both the Child CHILD and the Parent CHILD. These improvements agree with previous parent report findings (11
) and suggest that benefits of hearing aid use at home were apparent to both the child and the parent.
Significant improvements on the Student LIFE demonstrate that students noticed benefit from a conventional hearing aid in the classroom and in other difficult listening situations at school. The teachers’ assessments were more mixed, with half reporting benefit on the LIFE Teacher, but no significant change on the SIFTER scores. Fitting of a hearing aid alone was not enough to produce major academic changes during the 3-4 month period, such as shifting a child from the “at risk for educational failure” category to “not at risk.” Overall, the findings from the student and teacher questionnaires imply that children with UHL may benefit from the use of a conventional hearing aid in the classroom, and benefits apparent to the student may or may not be recognized by the teacher.
Quality of life, as measured by the HEAR-QL, increased significantly with hearing aid use. Recent studies have shown children with UHL reported lower total QOL and psychosocial functioning than their normal hearing peers (6
). Thus the fitting of a hearing aid may improve the QOL for some children with UHL, and further supports the perception of benefit.
Data logging from the hearing aids of seven subjects showed hearing aid use varied widely, with differing levels of hearing aid acceptance for each child. Most subjects reported greater hearing aid use on the subjective questions than recorded from data logging, indicating that objective recordings are important for obtaining accurate estimates of hearing aid use.
Subjective reports on hearing aid usage for this study are lower than those reported by parents in the McKay (12
) study, which found 100% of UHL users wore their hearing aid in school and 59% wore their hearing aid outside of school. This difference may be due to child versus parent reports and a larger sample size in the McKay study. Despite less hearing aid use at home and on the weekends than at school, significant improvements observed with the hearing aid on the Child CHILD, Parent CHILD, and the HEAR-QL demonstrate benefit outside of school.
Each child reported more than one situation in which they found the hearing aid beneficial, though specific benefits varied by individual. Importantly, only two subjects reported a situation where they heard worse with the hearing aid, suggesting few detrimental effects from conventional amplification on children with UHL.
The main limitations of this study were a small sample size and no control subjects. Future research using a larger sample size with varied types, degrees, and configurations of hearing loss are needed to confirm the results of this study. In addition, speech perception measures that reflect real world listening environments, including sound localization abilities, should be evaluated.