Paediatric amplification protocol, based on individualization of the hearing aids’ fitting parameters

Abstract

Background. There are no paediatric amplification clinical practice guidelines in Russia at the moment. At the same time the technological progress of hearing aids (HA), new algorithms and functions requires the objective evidence of safety and effectiveness for the hearing impaired children. For these reasons paediatric amplification algorithm was developed by the authors. Besides the standard procedures the algorithm includes an objective electroacoustic verification of the output parameters and separate HA functions. The research is devoted to the investigation of the protocols advantages. 
 Aim development and evaluation the paediatric amplification protocol, based on objective electroacoustic verification of the output and functions of hearing aid. 
 Materials and Methods. Prospective, randomized, controlled clinical trial was performed. Two protocols effectiveness were compared. Standard protocol (control group) is based on the subjective verification. Experimental protocol suggests an electroacoustic verification of the output and different HA functions: feedback cancellation, amplitude and frequency compression, microphone directionality, digital noise reduction (experimental group). Each group included 56 children (317 years old) with permanent hearing loss from moderate to moderately-severe degree. Initial amplification was performed for each child; the results were estimated in 1, 3 and 6 months using PEACH and LIFE questionnaires, speech audiometry and phoneme testing. DataLogging and first fitting appointment time were also estimated. 
 Results. In preschool-age children of the experimental group post-amplification PEACH results were 6% better than in controls. In school-age children (LIFE questionnaire) results were 11% better comparing with control group. Speech intelligibility in quiet was 3.1% (p 0.05) higher for pre-schoolers in the experimental group and 9.3% (p 0.01) higher for school-age children comparing with control group. Speech intelligibility in noise was higher in experimental group than in control: 7.8% (p 0.05) in pre-schoolers and 13% (p 0.01) for school-age children. Phoneme recognition was better in experimental group as well: 4.5% (p 0.05) in pre-schoolers and 9.8% (p 0.01) in school-agers than in control group. After HA fitting following an experimental protocol DataLogging time was 1112% longer in comparison with standard procedure. On the other hand, experimental protocol took in average 1.5 hours for the first fitting and standard protocol 53 minutes. 
 Conclusions. Protocol of paediatric amplification based on objective electroacoustic verification of HA output and functions allows to significantly increase the effectiveness of hearing rehabilitation in children.