Five misunderstandings of hearing aids for children

According to age, the number of people who use hearing aids is dumbbell type, that is, patients under 16 years old and patients over 60 years old are the most used group of hearing aids, while the age of about 30 is relatively less. The correct use of hearing aids is a crucial step in children’s hearing rehabilitation. However, in real life, compared with the elderly, children face more problems. This is because children are young, unable to clearly express their needs, and unable to give feedback on the good or bad use of hearing aids. What’s more, children’s hearing aids test involves more artificial links, including children’s parents The opinions of children’s hearing aids, teachers of school age, doctors of infants and other experts, technicians, relatives and friends can influence the success of the use of children’s hearing aids. Of course, in the whole process, the biggest problem is that the hearing condition of children can’t be obtained in time, so that the hearing aid tester can only touch the elephant blind, see the flowers in the fog, rely on intuition and experience to test the hearing aid, so it is inevitable to have problems.

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From the theory and practice of hearing aid matching, it is a common understanding that children are not “small adults”. The former is different from adults because of its own characteristics: for example, the development of the auditory system, psychological state, vision, intelligence, response ability and other aspects are different from adults. As a special rehabilitation technology, hearing aid can’t be different from each other. We must rely on the cooperation of hearing aid examiner and parents to achieve the best effect.

In view of this, according to the reality and specific characteristics of children’s hearing aid fitting in China and referring to the regulations of children’s hearing aid fitting in foreign countries, this paper analyzes the problems and puzzles in children’s hearing aid fitting at present, and sums up the following five influential phenomena, which are called misunderstandings because, if these problems can not be solved in time, they will certainly give parents and relevant professionals a chance to make Misunderstanding, confusion and even misleading.

(1) the most expensive hearing aid is the best one for children.

This view represents the standard adopted by some parents when choosing hearing aids, which is a common misunderstanding. In fact, the price of the product is mainly reflected in the technology and market positioning of the product itself. There is no direct relationship between the price and the effect. In short, the more expensive the hearing aid, the better the effect. This rule is true 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 hearing aids, which directly reflects the amount of investment in the research and development of the product. For example, most of the high-end hearing aids launched in the market now have wireless technology and information transmission capacity. Because these technologies need special technical support and processing, which is impossible for the general hearing aids, these technical investment Large, relatively expensive to understand; but whether this technology is the first choice for 6-month-old infants to choose hearing aids? It is worth considering and belongs to the decision-making of matching.

The second factor determining the price of hearing aids is the market positioning of the product. Usually, according to the market position of each hearing aid, the manufacturer divides it into the entry-level economy type, the medium price business type and the expensive high-end type according to the price. This classification has no corresponding relationship with the age range suitable for hearing aid fitting. Obviously, only considering the price of hearing aids, we may choose one with all the advanced technologies, but it is not necessarily suitable for children to use, which is wasteful and has no obvious effect.

Therefore, we suggest that when choosing hearing aids, we should not use the price as the standard, but purchase the required hearing aids according to the specific hearing status of children and the purpose of hearing rehabilitation that we hope to achieve. In fact, most powerful manufacturers have other methods besides classifying hearing aids according to prices and market strategies. For example, according to the characteristics of children, the manufacturers generally have specially designed hearing aids for children. The shape of the hearing aid is specially designed for children, such as children’s ear hook, 13 battery hearing aid with extra large power but small volume, hearing aid with battery door lock, inductor and audio input suitable for connection with wireless FM equipment, etc.

(2) after wearing the hearing aid, my baby still can’t be called “Mom and Dad”.

Many parents’ first reaction after their children just put on the hearing aid is to let the children call their parents. If the children can’t do it, or even can’t understand it at all, the parents are often very disappointed, and then think that the effect of the hearing aid is not good. This eagerness for success is understandable and reflects our high expectations for hearing aids. Hearing aids are not drugs or surgery, and can’t be achieved immediately after a single injection. Hearing rehabilitation is a long and orderly process, and any fluke psychology is bound to affect the systematic rehabilitation training for children. The main function of hearing aids is to help children with hearing loss to improve their perception of sound, which we call audibility. You can hear it first, then you can understand it later. You can’t draw an equal sign. Hearing is a psychoacoustic process that can be qualitative and quantitative: on the basis of satisfying other conditions, with the increase of the hearing aid gain, children with hearing impairment can hear more and more sounds (loudness), more and more clear (signal-to-noise ratio improved), and the sound range is more and more wide (listening to sounds of various frequencies). It will take a certain time to improve the audibility, especially for children whose hearing loss is more than 90dB. It will take at least 6 months of continuous listening and practice to have a better effect. Therefore, it is unrealistic to hope that you can hear and speak clearly and respond accordingly just after you put on the hearing aid.

Children with hearing impairment need not only appropriate hearing aids, but also systematic hearing training and individual mental development, including the training of various sounds. They need a series of processes of hearing development and improvement, such as distinguishing the sounds they hear from the sight they hear, associating the memory of sounds with the information attached to the sounds Miscellaneous auditory process is not a problem that can be solved by hearing aids. Therefore, a correct understanding of the role of hearing aids and an objective and reasonable expectation of their own children’s hearing rehabilitation are important conditions for the success of children’s hearing rehabilitation.

(3) your baby’s ABR has reached 110 decibels, and he can’t hear any sound, so he doesn’t need a hearing aid.

This misunderstanding is not from parents or patients, but from doctors, due to the lack of basic knowledge of children’s hearing rehabilitation. There are two problems in this misunderstanding, one is the interpretation of ABR test results, the other 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 are not mentioned here. ABR tests the response threshold of brain stem to acoustic stimulation, and then predicts children’s hearing threshold through these response thresholds. Therefore, it is a little too far fetched to regard children’s response to a certain stimulus sound intensity as the patient’s hearing threshold, which should be avoided.

Whether children with very severe hearing loss can also benefit from hearing aids is an indisputable fact in the world. In 2004, the American Society of Audiology issued a very important document in the field of children’s hearing rehabilitation, which was translated into Chinese by Jiang Tao and published in the Journal of audiology. As for whether children with extremely severe hearing loss need to wear hearing aids or not, it is clearly stipulated in the article: “although ABR can not lead to any response, children with extremely severe hearing loss must also be equipped with hearing aids.” With the development of modern hearing aid technology, many hearing aids can provide more than 80 dB gain and 140 dB output, and many supporting functions. The application range of children’s hearing aid matching has increased from 90 dB in the past to 100-105 dB. A large number of studies have also fully shown that hearing aids can not only help children with severe hearing loss learn speech, but also train children’s perception and resolution of sound. This experience and effect of amplification is of great significance for hearing rehabilitation of children later. Even if human cochlea is selected finally, it is also helpful for early hearing training of children with severe and very severe hearing loss. Therefore, it is neither wise nor scientific to give up using hearing aids simply because of the excessive hearing loss.

(4) at present, the method of matching hearing aids for children in China basically follows that of adults is the fourth mistake that needs to be pointed out.

Most hearing aid fitting centers lack the hardware and software foundation for children’s hearing aid fitting. Hardware refers to the equipment for testing the real ear coupling cavity difference (recd), accessories for debugging children’s hearing aids, etc. software refers to the software (DSL 5.0 or nal-nl2) required for children’s hearing aids, technical conditions for evaluating the use effect of children’s hearing aids, etc. If these important conditions are not met, strictly speaking, children’s hearing aid matching cannot be carried out effectively, and the effect is also affected. First of all, we know that infants’ ears have been in the process of continuous development since birth, especially in the two years after birth, the fastest development, gradually shaped after the age of seven, and stopped after the age of ten. During this period, the size of auricle, the size, hardness and direction of external auditory canal are constantly changing. For example, the acoustic parameters commonly used in hearing aid fitting are based on the average data of adults, while the research shows that the peak frequency of the ear canal resonance curve of newborns is 2-3 times of the average of adults; the real ear coupling cavity difference of children will gradually approach the average value of adults only when they are five years old. Therefore, in reality, it is obviously wrong to use the adult mean to calculate the target gain and other important parameters for children’s hearing aid matching. In addition, we also need to consider the characteristics of children’s external ear. The soft ear mold is better for children, and it needs to be changed constantly to adapt to the development of the external ear canal, and avoid problems such as acoustic feedback or excessive amplification.

Therefore, it is suggested that parents should choose where to install hearing aids for their children