Children’s hearing aid fitting Raiders [summary finishing]
Selecting, debugging, and evaluating hearing aids for hearing-impaired children has always been a huge challenge, as the hearing system development, mental state, vision, intelligence, and responsiveness of hearing-impaired children are quite different from those of adults. Hearing warnings: Children’s hearing aid fitting requires the cooperation of a special child hearing aid fitter and parents to achieve the desired results.
If you are not careful, it is easy to cause the following misunderstandings, causing a layer of damage to the hearing impaired children.
One: ignore the importance of the main observation
Pediatric examination is significantly different from adulthood. Children do not have good coordination ability. General hospital examinations are used to obtain children’s hearing conditions through objective examinations, such as otoacoustic emissions, auditory brainstem evoked potentials and multi-frequency steady-state tests. However, we must fully understand the hearing situation of the child when we do the hearing aid fitting. Only objective examination is not enough. The combination of subjective and objective examination can be more realistic and close to the hearing situation of the child. Pediatric behavioral testing is the “gold standard” for understanding the degree of hearing loss in children. 6 children and children can use pediatric behavioral audiometry, including behavioral observation, visual enhanced audiometry and game audiometry. Different test methods and frequency of detection are used according to the different age characteristics of the hearing loss children.
Two: wearing a hearing aid can understand the speech
The first reaction of many parents after their children wear a hearing aid is to ask the child to be called “Mother and Dad.” If the child can’t do it or even can’t understand it completely, the parents will be disappointed and think that the hearing aid is not working well. In fact, the main function of the hearing aid is to help the hearing-impaired child to improve the perception of the sound, that is, the hearing. You can “listen” before you can “understand”. “Listening” is an “acceptable” improvement in the psychoacoustic process that can be qualitatively and quantitatively. It takes a certain amount of time and requires long-term listening and rehabilitation training in order to have a good effect. Therefore, it is unrealistic to hope that the child can just hear the speech and respond accordingly when wearing the hearing aid.
Three: Does the hearing aid threshold indicate that the compensation is good in the “banana map”?
“Banana map” refers to the range of language frequency distribution and intensity distribution of normal people on the audiogram, and is the “gold standard” for hearing aid fitting. The hearing aid threshold indicates in the “banana map” that you can hear the greatest in daily life. Part of the speech sound (the closer to the upper edge, the better the listening), but not absolute.
The hearing aid threshold for children under two years of age should be under the banana map, because the measured results are often inaccurate, and the actual hearing is definitely about 15 decibels above the threshold. The principle of giving a hearing aid to a child is safe, comfortable, and audible, so the compensation should not be large when fitting.
Pediatric hearing compensation assessment also needs to be included in the real ear analysis, speech assessment comprehensive assessment of children’s hearing compensation.
Four: follow the adult fitting method
At present, the fitting of children’s hearing aids in China basically follows the method of adults. Most hearing aid fitting centers lack the hardware and software foundation required for the fitting of children’s hearing aids. It is impossible to effectively carry out the fitting of children’s hearing aids, and the effect will be affected.
Pediatric hearing rehabilitation takes ten years or more to achieve better results. Strict selection of qualified hearing aid fitting and service centers is one of the prerequisites for successful rehabilitation.
Five: one-time fitting, ignoring long-term hearing management
Infants and young children’s ears are in the process of continuous development after birth, especially in the first two years after birth. They are gradually shaped after 7 years old and stop after 10. During this period, the size of the auricle, the size of the external auditory canal, hardness, direction, etc. will constantly change. However, current ear canal acoustic parameters for hearing aid fitting are based on average adult data. Studies have shown that the peak frequency of the neonatal ear canal resonance curve is 2 ~ 3 times that of adults; the child’s true ear-coupled cavity difference is gradually approaching the adult mean when 5 is old. Therefore, it is wrong to use the average adult value to calculate the target gain and other important parameters for the child hearing aid fitting. In addition, the fitting needs to consider the characteristics of the outer ear of the child. The softer ear mold is better for children and needs to be replaced constantly to adapt to the development of the external auditory canal and avoid sound.Feedback or over-amplification. Therefore, regular review and evaluation are essential.
Different use environments, different auxiliary devices will affect the child’s hearing ability, so hearing loss children also need a comprehensive comprehensive hearing management service.
Link：Children's hearing aid fitting Raiders [summary finishing]
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