Basic situation: Liu, male, 4 years old, ABR 100 decibels in both ears did not elicit V wave, in 2009, Binaural U+BTE675 hearing aids were selected for both ears, and one year of language training. Parents reported that the effect was obvious, but the pronunciation was always inaccurate. And “pronounced very sharp, many false sounds”, suspected hearing aid quality problems and poor debugging, I sent the hearing aid to the headquarters for testing, the results were normal, and told the parents that the child is very hard of hearing, and language training takes time, so be patient.I once doubted whether there was a problem with the quality of the language training, but every time my parents saw me, they asked what to do. As a result, other parents also doubted the effect of hearing aids.
Pure tone audiometry (game audiometry PA)
Frequency (Hz) 250 500 1000 2000 4000
Left ear hearing (dB) 90 95 110 / /
Right ear hearing (dB) 90 95 115 / /
deal with：Adjusted according to the pure tone listening situation and the situation reflected by the parents, mainly by re-entering the HTL under the sound field evaluation (see Table 1 and Table 2):
Table 1: Table 2:
HTL（Hz）500 1000 2000 HTL（Hz）500 1000 2000
Left ear (dB) 95 98 93 Left ear (dB) 85 102 98
Right ear (dB) 88 90 89 Right ear (dB) 86 101 99
result:Parents’ feedback is better than the original. It’s better to speak slowly and to speak more familiar words. As long as you speak quickly or loudly, it will be the same. I explained that this may be because the child is too nervous to speak, which causes incorrect vocal cords. It is caused by vibration, and tells the parents to try to make the child speak slowly and clearly, and communicate with the child frequently, but after a period of time, the parent is still not satisfied with it.
analysis:1.助听器的各个频率的增益对言语理解率的影响是不同的，中频（1000 Hz）对言语的可听度占30%，可懂度占40%，低频（500 Hz）对言语的可听度占60%，可懂度占10%。低频增益过多可产生向上掩蔽，只增加可听度，对可懂度无益；通过增加中频，在可听度、可懂度方面均有提高。
2. The situation of “pronounced very sharp, many false sounds” is still related to the language training (breath), and the psychological factors of the parents also need to be considered.