Abstract

The purpose of this study was to identify common clinical practice patterns for providing advanced noise management features in children with cochlear implants (CIs) and evaluate trends in consideration of clinician experience and comfort with CI manufacturer-specific technology. A mixed-model survey including quantitative and qualitative questions regarding providing advanced noise management features in the pediatric CI population was collected electronically via research electronic data capture. Survey questions spanned approach/philosophy toward provision of features, age of provision, and demographics of respondents. Descriptive statistics were completed to define common clinical practice patterns and demographic information. A total of 160 pediatric audiologists from 35 U.S. States and five Canadian provinces completed the survey. Most audiologists (73.8%) reported enabling automatic directional microphones, and a vast majority (91%) reported enabling advanced noise processing features such as automatic noise cancellers, wind noise cancellers, and impulse noise cancellers in recipients' main programs. Audiologists ranked features in terms of importance for a school-age child with the top three ranked as automatic noise reduction, automatic directional microphones, and concha-level microphones. Importance of child-specific factors varied depending upon the specific feature of interest. Variability exists among providers in enabling advanced noise management features for pediatric CI recipients. Multiple factors, including patient characteristics, provider characteristics, and limited evidence-based guidance, could account for much of the variation. Overall, there is a trend toward automaticity for noise management. Additional studies are warranted to provide the evidence base for confidently programming advanced features for children using CIs.

Highlights

  • The purpose of this study was to identify common clinical practice patterns for providing advanced noise management features in children with cochlear implants (CIs) and evaluate trends in consideration of clinician experience and comfort with CI manufacturer-specific technology

  • Variability exists among providers in enabling advanced noise management features for pediatric CI recipients

  • There is a trend toward automaticity for noise management

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Summary

Introduction

The purpose of this study was to identify common clinical practice patterns for providing advanced noise management features in children with cochlear implants (CIs) and evaluate trends in consideration of clinician experience and comfort with CI manufacturer-specific technology. Additional studies are warranted to provide the evidence base for confidently programming advanced features for children using CIs. Difficulty with understanding speech in noisy environments among school-age children with hearing loss has been a well-documented concern for decades (Crandell & Smaldino, 2000; Finitzo-Hieber & Tillman, 1978; Schafer & Thibodeau, 2006; Walker et al, 2019). Use of bilateral devices like two CIs (Litovsky et al, 2012) or use of a contralateral routing of signal device with a contralateral hearing aid (Oosthuizen et al, 2020) or with a contralateral CI (Dorman et al, 2018) improves hearing in noise primarily by allowing access to summation and overcoming the head shadow effect.

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