What Level of Hearing-Aid Technology is Best for Children? – guest post by Ryan McCreery

free-double-diamond-slotsAudiologists who dispense hearing aids know and recognize “the levels”.  Entry-level, Premium, Ultra-Premium, Double-Diamond Platinum.  Maybe I went a little overboard with that last one, but most audiologists have a hierarchy of hearing-aid technology that they present to patients to help find the right features for their needs.  Naturally, audiologists will often ask about the appropriate level of technology for their pediatric patients.  Do we provide the highest level of technology that the family or funding program can provide? Are basic, entry-level hearing aids sufficient to give children what they need to develop speech and language?  Is the right answer somewhere in the middle?

BalanceThese are important questions.  First, we have evidence that providing amplification early and consistently can help to minimize communication delays in children.  The decisions we make about early amplification could have long-term developmental implications.  No pressure.   Audiologists also bear the responsibility of being fiscally responsible to either the child’s family or to the funding organization that is paying for the child’s hearing aids. Either way, our goal is to balance the developmental needs of the child with the financial realities of the family or funding agency.

technology-wallpaperWhat evidence do we have to guide these clinical decisions?  Unfortunately, research does not tell us which level of technology will give kids the best outcomes.  In fact, such evidence does not exist even for adults.  The absence of such a study is at least due in part to the fact that the technology levels that we know and love are primarily marketing strategies.  Thus, the actual differences between the categories of technology are subtle and vary widely across manufacturers.  That is not to suggest that the distinctions between technology levels in hearing aids are arbitrary. Differences in hearing-aid technology could impact developmental outcomes.  Rather, it is important to recognize that the lack of a consistent definition about what constitutes entry-level versus Double-Diamond Platinum (there I go again) would make such a study difficult to perform.  We also know that these categories change every year with the introduction of new and improved hearing-aid signal processing.

child-listening__largeFortunately, there are a few things we do know about what children need from their hearing aids that can provide guidance. Children need consistent audibility of speech to give them the experience they need to develop language.  How much audibility is enough?  The amount of audibility that can be provided varies as a function of degree and configuration of hearing loss, but the experts at the University of Western – Ontario have developed a protocol to assist audiologists in knowing how much audibility to expect based on the degree of hearing loss (for more information, click here).  In our multicenter, longitudinal study of children with hearing loss who wear hearing aids (for more information, click here), the amount of audibility provided by the hearing aid is an important predictor of developmental outcomes.  For the most part, audibility can be achieved for a large range of hearing losses using entry-level technology.

infant-baby-using-laptop--007Audiologists should also consider connectivity to hearing assistance technology (like FM systems) and other devices, such as tablets and smart phones, when making decisions about the level of hearing-aid technology.  Even young children are using these technologies to interact with friends and relatives from a distance.  With some manufacturers, connectivity requires a higher level of technology, whereas in other cases connectivity can be achieved with a basic level of technology and the purchase of additional accessories.  Selecting a more basic level of technology to allow families or funding agencies to purchase listenthe accessories needed to promote communication access in a wide range of situations is often more important than selecting the highest level of hearing-aid technology. Decisions about the level of hearing-aid technology for children should be based on an assessment of the child’s listening needs, verifying that the device provides sufficient audibility, and ensuring that the child can use their hearing aid to access a wide range of communication opportunities.  In the meantime, research will continue to attempt to identify hearing-aid features that can provide the best acoustic signal to support communication development.

ryan mcCreeryRyan McCreery, Ph.D. is the Associate Director of Audiology and a Staff Scientist at Boys Town National Research Hospital in Omaha, Nebraska.  His research involves identifying factors that influence speech recognition in children and optimizing hearing-aid signal processing for children.  Ryan is a co-investigator on the Outcomes for Children with Hearing Loss (OCHL) multi-center research study.  You can contact Ryan at ryan.mccreery@boystown.org.


About AU Bankaitis

A.U. Bankaitis, PhD is a clinical Audiologist with extensive clinical, research, and business experience within the hearing industry. Dr. Bankaitis created this blog to educate her colleagues on viable product solutions for their patients and/or clinical practice.
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4 Responses to What Level of Hearing-Aid Technology is Best for Children? – guest post by Ryan McCreery

  1. discpad says:

    Ryan, I see no barrier to using the ReSound Mini Mic with kids (I have an Alera 987TS system & am testing a Verso 787 as I sit here). The only issue I see is one of battery drain, as when digital reception is switched on it jumps from about 2.2-2.4 mA to 5.0 mA (but that happens with all wireless hearing aids: For more, please see this article and footnote.

    And Yes, the Alera & Verso have DAI boots, with the drain actually dropping to about 2.0mA because the anti-feedback processing can be shut down. 😉

    Dan Schwartz,
    Editor, The Hearing Blog
    All incoming Facebook friend requests are welcome

  2. Hi Dan,

    I like Resound’s Unite Mini Mic as a companion microphone and have heard from several of our adult patients that this solution is not only affordable, but works very well. We have not fit children with Alera or Verso hearing aids, although we have adults patients happily using these products. Thus, I cannot really speak to using either of these products with young children. To expand on the connectivity point that I was making above, I would want a product that not only had compatibility with the manufacturer’s companion microphone solution, but also allowed for DAI, had a telecoil and also general FM compatibility using a universal receiver for Comfort Audio DM, and Phonak and/or Oticon FM systems. If these devices meet all of those requirements, I’d consider them an option.

    Hope this helps,

  3. discpad says:

    Ryan, what is your opinion of using the ReSound Unite Mini Mic (“spouse mic”) fir young kids with their Alera or Verso wireless platform hearing aids?

  4. Reblogged this on Accurate Hearing Centers and commented:
    Thanks for sharing!

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