Children’s hearing aid fittings need to be cautious, please pay attention to these five misunderstandings

Fitting hearing aids for children is not the same as fitting for adults. Adults can often express their feelings well during the fitting process, telling the audiologist whether the sound of the hearing aid is too loud or too small, what sounds can be heard clearly, and what sounds are I can not hear you.For children, they are often unable to express their feelings, so real ear analysis is a very critical part of the fitting process.Real ear analysis can calculate the degree to which the hearing aid should amplify the sound in each frequency band according to the size of each person’s external auditory canal and hearing. It plays a very important reference role when audiologists help children adjust their hearing aids.However, the current situation of domestic child hearing aid fittings is worrying.Especially the following five typical misunderstandings:

Misunderstanding XNUMX: Ignore the importance of listening

Pediatric examinations are obviously different from adults. Children do not have good cooperation 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, when we do hearing aid fittings, we must have a comprehensive understanding of the child’s hearing. Only objective examination is not enough. The combination of subjective and objective examinations can be more realistic and close to the child’s hearing.Pediatric behavior test is the “gold standard” to understand the degree of hearing loss in children. Children 6 years of age and below can use pediatric behavioral audiometry, including behavioral observation, visual enhancement audiometry, and game audiometry.According to the different age characteristics of hearing-impaired children, different testing methods and testing frequencies are used.

Misunderstanding XNUMX: Wearing a hearing aid can understand speech

Many parents’ first reaction after their children wear hearing aids is to call their children “Mom and Dad”.If the child cannot do it, or even does not understand it at all, the parents are often very disappointed, and later think that the hearing aid does not work well.This eagerness for success is understandable.However, the main function of hearing aids is to help children with hearing loss improve their perception of sound, that is, audibility.It is not medicine or surgery, and it is impossible to have an immediate effect.You must “hear” before you can “understand”.The two cannot be equal. “Hearing” is a psychoacoustic process that can be qualitatively and quantitatively: on the basis of meeting other conditions, as the gain of the hearing aid increases, the hearing impaired children can hear more and more sounds (loudness) and clearer ( The signal-to-noise ratio is improved), and the sound range is getting wider (listen to the sound of each frequency). The improvement of “understanding” requires a certain amount of time and requires long-term listening and rehabilitation training to have better results.Therefore, it is unrealistic to hope that children can hear clearly and respond accordingly as soon as they put on a hearing aid.

Misunderstanding XNUMX: Does the “banana map” show that the hearing threshold is well compensated?

“Banana chart” refers to the range of normal people’s language frequency distribution and intensity distribution on the audiogram. It is the “gold standard” for hearing aid fitting. The hearing threshold in the “banana chart” shows that you can hear the most in daily life Part of the speech (the closer you are to the upper edge, the better you can hear it).But it is not absolute.
The hearing aid threshold for children under two years old should be under the banana chart, because the measured results are often inaccurate, and the actual hearing must be about 15 decibels above the threshold.The principle of equipping children with hearing aids is safety, comfort, and audibility, so small compensation should not be large when fitting.
The evaluation of children’s hearing compensation also needs to add real ear analysis and speech assessment to comprehensively evaluate the situation of children’s hearing compensation.

Misunderstanding XNUMX: Follow the adult fitting method

It is worth noting that, at present, the fitting of hearing aids for children in my country basically follows the adult method.Most hearing aid fitting centers lack the hardware and software foundation required for child hearing aid fitting.Hardware refers to testing real ear-coupled cavity difference (RECD) equipment, debugging accessories for children’s hearing aids, etc.; software refers to formula software (DSL 5.0 or NAL-NL2) required for fitting children’s hearing aids, and evaluating children’s hearing aids Technical conditions for the use effect, etc.If these important conditions are not met, strictly speaking, it is impossible to effectively carry out the fitting work of children’s hearing aids, and the effect will be affected.
It takes ten years or more for pediatric hearing rehabilitation to achieve better results. Strict selection of qualified hearing aid fitting and service centers is one of the prerequisites for successful rehabilitation.

Misunderstanding XNUMX: One-time fitting, ignoring long-term listening ability management

The ears of infants and young children are in the process of continuous development after birth, especially in the first two years after birth, and gradually form after the age of 7, and then stop after the age of 10.During this period, the size of the auricle, the size of the external ear canal, the hardness, the direction, etc. will continue to change.However, the current acoustic parameters of the ear canal commonly used in hearing aid fittings are based on average adult data.Studies have shown that the peak frequency of the neonatal ear canal resonance curve is 2 to 3 times that of adults; the difference between the real ear-coupling cavity of children does not gradually approach the adult average value until 5 years old.Therefore, in reality, it is obviously wrong to use the adult average value to calculate the target gain and other important parameters for the fitting of children’s hearing aids.In addition, the fitting needs to consider the characteristics of children’s external ears. Softer ear molds are better for children and need to be replaced constantly to adapt to the development of the external auditory canal and avoid problems such as acoustic feedback or excessive amplification.Therefore, regular review, evaluation and debugging are essential

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