Nine principles of hearing aid matching

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Nine principles of hearing aid matching

Here we provide “nine principles of hearing aid fitting for children” for your reference: (data source: early diagnosis, assessment and intervention of hearing loss in infants (8), Journal of Huang Zhiwu, audiology and speech diseases, Vol. 22, No. 3, 2014, p337-338)

1. Accurate diagnosis: the diagnosis of children’s hearing needs to include otoscope, tympanogram, acoustic immittance and other electrophysiological examinations (ABR of auditory brainstem response, ASSR of multifrequency steady-state evoked potential, OAE of otoacoustic emission, etc.), in addition, special attention should be paid to LVAS, hearing retardation, auditory neuropathy, high-frequency hearing loss and secretory otitis media. Communicate with you the idea that we “can’t judge a child’s hearing just by the results of a test!”

2. Early matching of hearing aids: within one month when the child is diagnosed as “permanent hearing loss”, the baby shall be matched with hearing aids.

3. Bilateral matching:

– can delay the age of hearing

To prevent the hearing loss of one side and avoid the decline of auditory nerve function; (the hearing loss of one side refers to the hearing loss of both sides, but only one side hearing aid is equipped, then the hearing loss of the side not equipped will gradually increase, and the ability to distinguish and understand speech will also decline. )

– you can also be a pleasant ear

Realize 360 degree sound source positioning: the sound source positioning ability refers to the ability to know which direction the sound comes from and how far the specific distance is. This ability will affect the safety (for example, if the car honks from the back, which side will be dangerous if it is unclear).

– suppress tinnitus

Reduce the interference of tinnitus and the pain caused by it, that is, reduce the discomfort of tinnitus.

4. Appropriate intervention:

For the children whose ABR was not elicited by the maximum acoustic output stimulation, hearing aids should not be abandoned, especially when the age of the children is less than 1 year old, the situation of non intervention should be avoided.

In fact, the results of “auditory brainstem response not elicited” are common in the following three situations:

(1) test errors caused by test instruments and testers;

(2) very severe high frequency hearing loss;

(3) auditory neuropathy.

Avoid over intervention: for some infants within 6 months who have hearing retardation, especially those diagnosed as mild to moderate hearing loss, it is recommended to reexamine hearing after 3 months, and then decide whether to install hearing aids to avoid over interference.

5. Choose hearing aids with good performance:

The difference between amplification technology and multichannel vs. single channel is to “ensure the continuous audibility of children”.

6. Obtain full band hearing compensation:

There must be a referential hearing threshold test result (at least 5, 1, 2, 4K results are required)

Methods of children’s behavioral audiometry:

– behavioral observation and listening (BOA) 0-6 months;

– visual reinforcement audiometry (VRA) from June to 2.5 years old;

– play audiometry (PA) 2.5-5 years old;

– objective audiometry, including ABR, ASSR, OAE and 40Hz.

Listening assessment is a gradual and accurate process, so it is usually after the age of 7 that we can get more accurate results of behavioral audiometry!

7. Professional hearing aid adjustment:

The types of hearing aids can be divided into six types: otodorsum, ITe, ITC, CIC, IIC, CRT.

Ear back hearing aid should be the first choice for children, for three reasons: (1) the ear canal is still growing; (2) the earwax does not contact directly with the hearing aid; (3) the ear back hearing aid has more functions, including telecoil, wireless function, FM, etc.

Who has conducted a number of surveys and studies and does not recommend that children wear it before the age of 14.

8. Verify the effect evaluation of hearing aids:

Including Lin’s six tone test, hearing threshold after hearing aid, speech test and real ear analysis (example: the gap between recd real ear and coupling cavity).

The true ear analysis is more accurate, because each person’s ear canal size, physiological structure is different. It can be more objective evaluation: it can objectively test the gain or output of the hearing aid in the whole frequency range, and show whether the gain or output of the hearing aid matches the target curve of the prescription formula in real time, so that users can get more benefits.

9. Correct use of hearing aids:

(1) use soft ear mold as much as possible;

(2) parents need to observe whether there is feedback screaming;

(3) signs to be replaced:

The fit between the ear mold and the related parts of the outer ear decreased, and the hearing aid began to howl outside;

Damage of ear mold or dislocation of acoustic tube;

The ear mold feels bloated, stuffy and painful after wearing correctly.

(3) replacement rule:

Children’s ear canal no longer grows up obviously after 12-15 years old;

It is recommended to replace the ear model once every 3-6 months.