According to age, the number of people using hearing aids is dumbbell-shaped, that is, patients under 16 and those with 60 or older are the most used groups of hearing aids, while those with ages around 30 are relatively few. Proper use of hearing aids is a crucial step in pediatric hearing rehabilitation. However, in real life, children face more problems than older people. This is because children are young and cannot express their needs clearly. Feedback hearing aids use good or bad, more importantly, the children’s hearing aid fitting involves more artificial links, including the opinions of the children’s parents, the views of the school-age children’s teachers, the doctors and other doctors and other experts and friends, can Whether the left and right pediatric hearing aids are used successfully or not. Of course, in the whole process, the biggest problem is that because the hearing condition of children can not be obtained in time, the hearing aid fittings can only blindly touch the eyes, look at the flowers in the fog, rely on intuition and experience to fit the hearing aids. Therefore, problems are inevitable.
From the perspective of the theory and practice of hearing aids, it is a consensus that children are not “small adults”. The former is different from adults in terms of their own characteristics: for example, the degree of development of the auditory system, mental state, vision, intelligence, and responsiveness. There are differences in adults. As a special rehabilitation technology, hearing aids can’t be different from person to person. They must rely on the cooperation of hearing aid fittings and parents to achieve the best results.
In view of this, according to the reality and specific characteristics of domestic children’s hearing aid fitting, with reference to the provisions of foreign children’s hearing aid fitting, the problems and confusions of the current children’s hearing aid fitting are analyzed, and the following five phenomena with certain influence are summarized. This is a misunderstanding because if these problems cannot be resolved in time, it will inevitably cause misunderstanding, confusion and even misleading to parents and related professionals.
(1) The most expensive hearing aid is the best hearing aid for children.
This view represents a standard that some parents use when choosing a hearing aid, a common misunderstanding. In fact, the price of the product is mainly reflected in the technology and product market positioning of the product itself. The price and effect are not directly related. In short, the more expensive the hearing aid, the better the effect. This rule is the same in other industries, especially in the field of hearing rehabilitation. The pricing of hearing aids mainly depends on two factors: First, the technical content of the hearing aids directly reflects the R&D investment of the products. For example, most of the high-end hearing aids launched on the market now have wireless technology and information transmission capabilities, because these technologies require specialization. The technical support and processing is not possible with general hearing aids, so these technologies are very expensive and relatively expensive to understand; but is this technology the first choice for 6 months baby-assisted hearing aids? It is worthy of scrutiny and belongs to the fitting Category decision making.
The second factor determining the price of the hearing aid is the market positioning of the product. Usually, according to the position of each hearing device in the market, the manufacturer divides it into an entry-oriented economy, a medium-priced business type and an expensive high-end type according to the price. This classification and hearing aids There is no corresponding relationship between the fitting age groups. Obviously, considering the hearing aid only from the price, you may have chosen one that has all the advanced technology, but it is not necessarily suitable for children, it is wasteful and the effect is not obvious.
Therefore, we recommend that when choosing a hearing aid, do not use the price as a standard, but purchase the required hearing aid according to the specific hearing conditions of the child and the desired hearing rehabilitation purpose. In fact, most powerful manufacturers, in addition to classifying hearing aids according to price and market strategy, there are other methods, such as children’s characteristics, manufacturers generally design children’s hearing aids. The shape of this hearing aid is specially designed for children, such as children’s ear hooks, 13 battery hearing aids with extra power but small size, hearing aids with battery door locks, and inductive and audio inputs suitable for connection with wireless FM devices.
(2) After bringing the hearing aid, my baby still can’t be called “Mother and Dad.”
The first reaction of many parents after they have just brought a hearing aid is to let the child call the father and mother. If the child can’t do it or even can’t understand it completely, the parents are often very disappointed, and then the hearing aid is not good. This eagerness to seek is understandable and reflects our high expectations for hearing aids. Hearing aids are not medicines, nor surgery. A needle can’t be seen immediately. Hearing rehabilitation is a long and orderly process. Any luck is bound to affect the systematic rehabilitation training for children. The main function of hearing aids is to help children with hearing loss and to improve their perception of sound, which we call audibility. I can hear it before I can understand it later. The two cannot draw an equal sign. It is a psychoacoustic process that can be qualitatively and quantitatively: on the basis of satisfying other conditions, as the hearing aid gain increases, the hearing-impaired children can hear more and more loudness (loudness) and become clearer (signal noise) More than the improvement), the sound range is also wider and wider (listening to the sound of each frequency). It takes time to improve the audibility, especially for children whose hearing loss exceeds 90dB. At least 6 months of continuous listening and practice are required to achieve better results. Therefore, it is unrealistic to hope that the hearing aid can be heard clearly and the corresponding response can be made.
Hearing impaired children enter intelligibility from the audible stage, not only need appropriate hearing aids, but more importantly, need systematic listening training and individual mental development, including training for various sounds, requiring a series of auditory development and improvement. The process, such as hearing the sound that can be distinguished from listening, the memory of the sound, the information accompanying the sound, is not a problem that can be solved by the hearing aid. Therefore, a correct understanding of the role of hearing aids, the objective and reasonable expectations of their own hearing rehabilitation should be an important condition for the success of hearing rehabilitation in children.
(3) Your baby ABR has 110 decibels, and you can’t hear the sound. You don’t need a hearing aid.
This misunderstanding comes not from parents or patients, but from doctors, due to the lack of basic knowledge of children’s hearing rehabilitation. There are two problems with this misunderstanding. One is the interpretation of the ABR test results, and the second is whether children with severe hearing loss need to use hearing aids. The validity and applicability of ABR in predicting children’s behavioral hearing threshold is not mentioned here. ABR tests the threshold of response to acoustic stimulation in the brainstem of patients, and predicts the hearing threshold of children through these reaction thresholds. Therefore, the child’s response to a certain stimulus intensity is regarded as the patient’s hearing threshold, which is slightly far-fetched and should be avoided.
Whether children with extremely severe hearing loss can also benefit from hearing aids is an indisputable fact in the world. The Children’s Hearing Aids Guidance Program issued by the American Academy of Audiology in 2004 is a very important document in the field of hearing rehabilitation for children. It was translated into Chinese by Jiang Tao and published in the Journal of Audiology. Among them, whether children with extremely severe hearing loss need to wear hearing aids, the article clearly stipulates: “Although the auditory brainstem evoked potential (ABR) can not lead to any response, children with very severe hearing loss must also be equipped with hearing aids.” Modern hearing aid technology height Developments, many hearing aids can provide more than 80dB gain and 140dB output, as well as a number of matching functions, the range of children’s hearing aid fitting has been increased from the past 90dB to 100-105dB. A large number of studies have also fully demonstrated that hearing aids can not only help children with extremely severe hearing loss to learn speech, but also train children’s perception and resolution of sound. This kind of amplified experience and effect is of great significance for the subsequent hearing rehabilitation of children, even Finally, it is necessary to choose a cochlear implant, which also helps early hearing training for infants with severe and severe hearing loss. Therefore, it is neither wise nor scientific to simply give up the choice of hearing aids because of excessive hearing loss.
(4) At present, the method of fitting children’s hearing aids in China to basically follow the adult is the fourth misunderstanding that needs to be pointed out.
Most hearing aid fitting centers lack the hardware and software foundation required for child hearing aid fitting. The hardware refers to the test of the real ear-coupled cavity difference (RECD) device, the accessories for debugging the child’s hearing aid, etc. The software refers to the software (DSL 5.0 or NAL-NL2) required for the fitting of the hearing aid for children, and the evaluation of the child hearing aid. Technical conditions for using effects, etc. If these important conditions are not met, it is strictly impossible to carry out the work of fitting children’s hearing aids effectively, and the effect is also affected. First of all, we know that the ears of infants and young children have been in the process of continuous development since birth, especially in the two years after birth. They are gradually formed after the age of seven, and they stop after ten years old. During the period, the size of the auricle, the size of the external auditory canal, the hardness, the direction, etc. are constantly changing. For example, the acoustic parameters of the ear canal commonly used in hearing aid fitting are based on the average data of adults, and the study shows the ear canal resonance curve of the newborn. The peak frequency is 2 ~ 3 times the average adult; the child’s true ear-coupled cavity difference is approaching the adult mean when it is five years old. Therefore, in reality, it is obviously wrong to use the average adult value to calculate the target gain and other important parameters for the child hearing aid fitting. In addition, we also need 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, adapting to the development of the external auditory canal, avoiding acoustic feedback or transition amplification.
Therefore, it is recommended that parents choose where to use their hearing aids for their children. In addition to the business reputation and qualifications of professional institutions, it is necessary to check whether the fittings have sufficient professional knowledge and experience in child fitting. It has the necessary technical means, such as the real ear test instrument, the true ear-coupled cavity difference module, and the sound field test conditions suitable for children. Only when the hospital or the fitting center has these conditions can we cooperate with the deaf children for a long time. 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 first conditions for success.
(5) Children with unilateral hearing loss do not need to use hearing aids, because good ears can be heard.
Before explaining why this is a misunderstanding, let us first look at whether unilateral hearing loss is a problem for individual children, or a more common fact. Epidemiological data show that the incidence of unilateral hearing loss in newborns is 0.083%, less than one in a thousand, and the incidence of neonatal intensive care areas is much higher, about 0.32%. Obviously, unilateral hearing loss occurs. The rate is not low and is close to the incidence of hearing loss in newborns, which has become one of the health care measures for children’s hearing health. Therefore, we cannot ignore the existence of unilateral hearing loss. From the perspective of the impact of unilateral hearing loss on pediatric development, if they do not use hearing aids, although their good ears can hear normal people, they face many hearing impairment problems in daily life, and understand the difficulty and direction of speech under noise. Sexual discrimination ability is reduced, binaural effect cannot be utilized. The data show that 35% children with unilateral hearing loss have stayed at least once in their learning career, 13.3% of children need special help to continue their studies, and 20% of children with unilateral hearing loss are rated as having serious disciplinary problems by their teachers, 50 It is difficult for % of children to learn to make great progress.
Similarly, the Children’s Hearing Aids Guidance Program clearly requires that “such children should use hearing aids”. In addition to helping children to listen to speech and learn speech more effectively, hearing aids maintain a constant auditory signal stimulation of the bad ear, which can avoid the phenomenon of so-called auditory deprivation, that is, the poor ear not only loses the hearing sensitivity, but also loses the The ear cannot use the ability of auditory magnification even under ideal listening conditions. In short, suppose that children do not continue to receive sound stimulation, even the latest bone-anchor hearing aids will not have a good effect. The ability to lose perception of sound intensity is not the same as the ability to lose sound resolution and decoding. The latter’s ability to use sound is to end any possibility of future recovery. Therefore, we should not easily negate the need to use hearing aids for unilateral hearing loss.
In summary, the child hearing aid fitting is a systematic project and a long-term project. Currently, there are different problems in China. However, this article selects the above five representative misunderstandings for explanation and explanation. The purpose is to let parents Teachers, doctors and hearing experts pay more attention to the status quo and development of hearing rehabilitation in children. We must face the reality that child hearing aid fitting is an important part of newborn hearing screening. Screening newborns are generally less than one year old. It is always a huge choice for this group to select, debug and evaluate hearing aids. The challenge, rushing out of the above misunderstandings will greatly improve the quality of the child’s hearing aid fitting, which in turn will increase the number of hearing aids used.
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Link：Five misunderstandings of children's hearing aidsREF: Hearing Aids Supplier , Hearing amplifier, Hearing Loss
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