Goals and expectations of the hearing aid fitting.

Abstract

For the child, meeting communication needs is an ongoing process. The DIAL, the Pediatric Hearing Demand, Ability, and Need Profile, and the Family Expectation Worksheet should streamline this process and provide the information needed to create functional auditory goals considering what normally hearing children accomplish while accounting for the specific needs and abilities of the individual child. In addition, this protocol should provide the tools to create ongoing evaluation, treatment, and documentation of accomplishments through the use of assistive technology and communication strategies. These tools are meant to empower both the clinician and family in order to work as partners in the process of functional auditory development that leads to secure, self-reliant, socially active children who happen to have hearing loss. This set of tools provides the information needed for the clinician to identify what auditory situations demand solutions. Creating the solutions is another topic all together. It is only meaningful to define these situations if the clinician is prepared to create auditory and nonauditory solutions. These solutions may involve hearing aid technology (hearing aid features, telecoils, direct audio input, behind-the-ear/FM combinations), clever communication strategies, or advanced assistive technology (alerting systems, telephone amplifiers, etc.). If not in a position to provide the total package of these intervention services, begin with the hearing aid fitting and refer the patient to a cooperating facility to complete the package. It is essential that both facilities discuss the needed hearing aid options in order to allow coupling to recommended assistive technology (Palmer, 1996). The clinician will find that keeping up with the solutions demands a large time commitment. Valuable information can be found in scientific and trade journals as well as in the exhibit halls of major audiology conferences. The Interactive Assistive Device Product Locator computer program provides a comprehensive database of current assistive technology which can help familiarize the clinician with the range of technological solutions available (Palmer and Garstecki, 1990; Palmer and Rauterkus, 1992). Perhaps, most importantly, the clinician should be ready to ask hearing aid manufacturers for specific information regarding the coupling abilities of their hearing aids to various assistive devices. If a satisfactory answer is not forthcoming, work with a manufacturer who appreciates the need for hearing aids that couple successfully with assistive technology.