Early Identification Of Hearing Loss Research Articles

Changing the time intervals between cisplatin cycles alter its ototoxic side effect

Various methods have been tested and deployed clinically to identify and minimize cisplatin ototoxicity. Upon early identification of hearing loss, one of the possible approaches to reducing future ototoxicity is to increase the gaps or breaks between cycles or doses of cisplatin. However, recent findings about the retention of cisplatin in the cochlea and the potential for its long-term ototoxic effects call into question whether such an approach is effective in reducing hearing loss. The current study was undertaken to determine whether increasing the rest intervals between cycles of cisplatin altered the resulting ototoxicity. CBA/CaJ mice were exposed to a cumulative dose of 48 mg/kg cisplatin delivered in three cycles of 16 mg/kg (4 mg/kg per day for 4 consecutive days). The cycles were separated by either 10, 17, or 87 days to determine if the inter-cycle rest intervals affected resulting ototoxicity. Ototoxicity was measured using auditory brainstem response threshold shifts and hair cell losses. Results indicated that longer intervals between cycles of cisplatin led to lower threshold shifts and outer hair cell lesions. The results support the principle that ‘slowing down’ cisplatin dosing by increasing rest intervals between doses can reduce the ototoxic side effect. Further testing is needed to optimize the timing and to determine the impact of longer inter-cycle intervals on cisplatin's anti-tumor efficacy.

Development and validation of a digits-in-noise hearing test in Persian

Objective The prevalence of unrecognised and late-diagnosed hearing loss is higher in low- and middle-income than in high-income countries, due in part to lack of access to hearing services. Because hearing screening is important for early identification of hearing loss, development of an accessible, self-screening test that can detect hearing loss reliably and quickly would provide significant benefits, especially for underserved populations. This study aimed to develop and validate a new version of the digits-in-noise (DIN) test for Persian speaking countries. Design Recordings of Persian digits 0–9 were binaurally presented in broadband speech-shaped noise. Using fitted speech intelligibility functions, digits were homogenised to achieve equal perceptual difficulty across stimuli. The evaluation was established by reference to existing English DIN tests. Study sample Thirty Persian speaking young adults with normal hearing thresholds (≤20 dB HL, 0.25–8 kHz). Results Speech intelligibility functions produced a mean speech reception threshold (SRT) of −7.7 dB, corresponding closely to previously developed DIN tests. There was no significant difference between test and retest SRTs, indicating high reliability of the test. Our findings suggest that language-specific factors need to be considered for cross-language comparison of DIN-SRTs. Conclusion This study introduces a convenient tool for future hearing screening in Persian speaking countries with limited access to audiology services.

Perspectives of newborn hearing screening in resource constrained settings

Newborn hearing screening is an effective strategy for early identification of hearing loss in the newborn which result in early intervention and best outcome. However implementing universal screening strategy is a challenge in many resource constrained settings. There are various limitations towards successful implementation of hearing screening program in the developing countries. The cost effectiveness of the screening program also needs to be considered in a resource constrained settings. We attempt to provide a viewpoint that can be potentially helpful for the successful implementation of hearing screening in a resource constrained settings of the developing countries.

Hearing Loss

Key Points A child who has passed a newborn hearing screening may still have hearing loss. Early identification of hearing loss is of little value without timely intervention. Even mild hearing loss can have serious consequences, with affected children 10 times likelier than their peers to fail a grade in school. Of children with hearing loss, 30% to 40% have additional disabilities.

Algorithm of hearing monitoring of children with congenital heart disease

Congenital heart disease (CHD) is one of the most common types of birth defect. Often newborn hearing screening is not performed for infants with congenital heart disease because of serious health problems at birth. Hearing loss in children with CHD may have late onset due to different stages of CHD treatment. The monitoring of the auditory function is required for early identification of hearing loss in children with CHD, however algorithm of follow-up assessment is not currently defined.
 Objective – estimation of prevalence, types and time of hearing loss onset in children with congenital heart disease and development a follow-up assessment for CHD children.
 Results. 148 children with congenital heart disease have been evaluated with auditory brainstem response testing, otoacoustic emissions, impedancemetry, behavioral hearing tests. The patients ranged in age from 7 days to 6 years. 55 children had hearing loss: 28 children with conductive hearing loss and 27 children with sensorineural hearing loss, 2 of them with auditory neuropathy. 6 children had late onset sensorineural hearing loss. The age of delayed hearing loss identification ranged from 4 months to 5 years.
 Conclusion. Children with CHD require long-term monitoring of the auditory function; an algorithm of follow-up assessment for children with congenital heart disease is proposed. Audiological assessment in children with CHD should include auditory brainstem response registration for auditory neuropathy identification.

Prevalence and risk factors for hearing loss in high-risk neonates in Germany.

Hearing loss in infants is often diagnosed late, despite universal screening programmes. Risk factors of hearing impairment in high-risk neonates, identified from population-based studies, can inform policy around targeted screening. Our aim was to determine the prevalence and the risk factors of hearing loss in a high-risk neonatal population. This was a retrospective cohort study of neonates hospitalised at the University Hospital Cologne, Germany from January 2009 to December 2014 and were part of the newborn hearing screening programme. Multivariable regression analyses using the lasso approach was performed. Data were available for 4512 (43% female) neonates with a mean gestational age at birth of 35.5weeks. The prevalence of hearing loss was 1.6%, and 42 (0.9%) neonates had permanent hearing loss. Craniofacial anomalies, hyperbilirubinaemia requiring exchange transfusion, oxygen supplementation after 36weeks of gestation and hydrops fetalis showed associations with permanent hearing loss. Our findings of risk factors for hearing loss were consistent with other studies. However, some commonly demonstrated risk factors such as perinatal infections, meningitis, sepsis and ototoxic drugs did not show significant associations in our cohort. Targeted screening based on risk factors may help early identification of hearing loss in neonates.

Screening of high-risk newborns for hearing in MRMC using OAE and BERA

<p class="abstract"><strong>Background:</strong> Hearing is necessary to learn languages and speech and to develop cognitive skills. As hearing is important for normal educational and social development, hearing loss can be disastrous and for the family it can be very distressing. With early detection of hearing loss using OAE and BERA, we can ensure normal language development and help the growing child to lead a near normal life.</p><p class="abstract"><strong>Methods:</strong> 500 cases- out of which 400 normal babies and 100 high risk babies are taken for the study who attend Pediatric OPD and IPD of Basaweshwara Teaching and General Hospital (BTGH) and Sangameshwar hospital attached to MRMC. </p><p class="abstract"><strong>Results:</strong> Out of 400 cases 2 cases have impaired hearing and out of 100 cases with high risk 6 cases have hearing loss.</p><p class="abstract"><strong>Conclusions:</strong> This study highlights the need for OAE and BERA for early identification of hearing loss and that although universal hearing screening programs are warranted but most of the cases with hearing loss can be identified based on the risk factors and High-risk Screening can suffice in areas with limited resources.</p>

Hearing Loss in Pediatric Septo-Optic Dysplasia.

To identify and characterize hearing loss (HL) in children with septo-optic dysplasia (SOD). Otologic and audiometric data for patients less than 18 years of age identified as having SOD who were seen in the Children's Healthcare of Atlanta-Scottish Rite Hospital clinic between 2013 and 2017 were collected and reviewed through a HIPAA-compliant medical record search. Relevant literature was also reviewed with the assistance of Medline. Sixty-four patients with SOD were identified, and 7 of those patients (10.9%) were diagnosed with hearing loss. Type of hearing loss was sensorineural (SNHL) in 5 patients (63%), mixed (MHL) in 1(14%), and conductive (CHL) in 1(14%). Bilateral loss presented in 60% (3/5) of SNHL patients, while the rest demonstrated unilateral loss. Unilateral findings included cochlear nerve deficiency (1) and atresia/microtia (1). Tympanostomy tubes were required in 57% (4/7) of SOD children with hearing loss. Amplification was successfully implemented in 86% (6/7). Hearing loss was found in nearly 11% of SOD children, and SNHL was identified as (63%) the predominant form of loss. To our knowledge, this is the first retrospective review of hearing loss in a pediatric SOD cohort and the first to report of cochlear nerve deficiency and atresia/microtia in this population. Based on these findings, early identification of hearing loss with imaging when appropriate and treatment of otitis in this population is recommended.

Comparison of hearing thresholds using audiometric versus android-based application

Background: Hearing loss is a highly widespread problem worldwide and early identification of hearing loss through screening is important to overcome the negative effects of untreated hearing impairment. Screening can be done using handheld device app technologies for the hearing assessments that would be easy to be used by any individual. Aims and Objectives: The aim of the present study was to compare the hearing thresholds with smartphone application and conventional audiometer. Materials and Methods: A total of 52 participants were included in the study. They were divided into two groups. Group 1 included 36 participants (72 ears) in the age range of 7 to 35 years with normal hearing sensitivity. Group 2 included 16 participants (32 ears) in the age range of 18-68 years with varying degree of hearing loss ranging from minimal hearing loss to severe hearing loss. Thus, a total of 104 ears were tested. Air Conduction thresholds were obtained at octave frequencies from 250 Hz to 4000 Hz using conventional audiometer in a sound treated room and through the android application (Hearing test version 1.1.) using a smart phone (Micromax Xpress Canvas) in a quiet room. The noise levels for hearing assessment through smart phone app ranged between 70-75 dB A, which was measured prior to the testing session. The thresholds were obtained for both right and left ear of the participants. The hearing thresholds obtained from both the measures was subjected to appropriate statistical analysis. Results: The results showed that there was a significant difference in the thresholds across the procedures for all the frequencies in Group 1. However, there was no significant difference in thresholds across the procedures for all the frequencies in Group 2. Conclusion: It can be concluded that hearing screening through mobile application is user-friendly and cost-effective, but it might lead into under referrals.

Terrible Twos or Early Signs of Psychopathology? Developmental Patterns in Early Identified Preschoolers With Cochlear Implants Compared With Hearing Controls.

Cochlear implants (CIs) have dramatically improved the lives of children who are deaf or hard of hearing; however, little is known about its implications for preventing the development of psychiatric symptoms in this at-risk population. This is the first longitudinal study to examine the early manifestation of emotional and behavioral disorders and associated risk and protective factors in early identified preschoolers with CIs compared with hearing peers. Participants were 74 children with CIs and 190 hearing controls between ages 1 and 5 years (mean age, 3.8 years). Hearing loss was detected using the Newborn Hearing Screening in The Netherlands and Flanders. Parents completed the Early Childhood Inventory-4, a well-validated measure, to evaluate the symptoms of DSM-IV-defined psychiatric disorders, during three consecutive years. Language scores were derived from each child's medical notes. Children with CIs and hearing controls evidenced comparable levels of disruptive behavior and anxiety/depression (which increased with age in both groups). Greater proficiency in language skills was associated with lower levels of psychopathology. Early CI and longer duration of CI use resulted in better language development. In turn, higher early language skills served as a protective factor against the development of disruptive behavior symptoms. This longitudinal study uniquely shows that improvement in language skills mitigates the development of early signs of psychopathology. Early identification of hearing loss and CIs help children improve their language skills.

Cochlear Proteins Associated with Noise-induced Hearing Loss: An Update.

Noise-induced hearing loss (NIHL) is one of the major occupational disease that has influence on the quality of life of mining workers. Several reports suggest NIHL is attributed to noise exposure at workplace and approximately 16% of hearing loss is due to it. NIHL occurs as a result of exposure to high-level noise (>85 dB) in the workplace. Noise disrupts proteins present in the micromachinery of the ear that is required for mechano-electric transduction of sound waves. High-level noise exposure can lead to hearing impairment owing to mechanical and metabolic exhaustion in cochlea, the major organ responsible for resilience of sound. Several key proteins of cochlea include tectorial membrane, inner hair cells, outer hair cells, and stereocilia are damaged due to high-level noise exposure. Numerous studies conducted in animals have shown cochlear proteins involvement in NIHL, but the pertinent literature remains limited in humans. Detection of proteins and pathways perturbed within the micromachinery of the ear after excessive sound induction leads toward the early identification of hearing loss. The situation insisted to present this review as an update on cochlear proteins associated with NIHL after an extensive literature search using several electronic databases which help to understand the pathophysiology of NIHL.

ROZWÓJ SŁUCHU U DZIECI Z ODDZIAŁÓW INTENSYWNEJ TERAPII I POŚREDNIEJ OPIEKI ZDROWOTNEJ W BRAZYLII

BackgroundUnidentified hearing loss at birth can badly affect the linguistic, social, and educational development of children. National and international committees on infant hearing emphasize the importance of early identification of hearing loss, with follow-up and early intervention. The aim of this study was to analyze data on hearing development from a program following up exits from the Neonatal Intensive Care Unit (NICU) and from neonatal intermediate care wards in Prof. Dr. Jose Aristodemo Pinotti Women’s Hospital in the Brazilian State of Sao Paulo.Material and MethodsThis was a retrospective study based on records from a follow-up program. Data came from records collected from 2012 to 2015 on 88 subjects, and included the results of behavioral hearing tests, visual reinforcement audiometry and tympanometry. The data were descriptively and statistically analyzed.ResultsChanges in the development of hearing abilities over the first two years of life in children that stayed at the NICU or the intermediate care ward for more than 48 hours were significant. However, late-onset or progressive hearing losses were not observed. There was no correlation between hearing development and specific risk indicators or with tympanometry.ConclusionsFor the analyzed program, progressive or late-onset losses were not found, but there were major delays in the development of hearing abilities in the first two years of life for children from NICU and neonatal intermediate care wards.

Prelingual Deafness: An Overview of Treatment Outcome.

Prelingually deaf child is one who is either born deaf or who lost his or her hearing early in childhood, before acquiring language. A child with subnormal hearing acuity suffers from consequences of hearing loss compounded by impaired speech development. The period from birth to 3years of life is critical for the development of speech and language, therefore, there is need for early identification and assessment of hearing loss and early rehabilitation in children. 40 patients were evaluated clinically, radiologically and audiologically to assess the degree of patient's handicap. The modes of treatment included use of hearing aid in patients with moderate, moderately-severe, severe or profound HL and cochlear implantation in patients with profound HL. Each patient was followed for 18months and results were calculated in terms of speech perception (CAP) and language (REELS) development of the patient. Out of the 40 patients, 60% (n=24) were females and 40% (16) were males. 50% (n=20) patients had PSNHL, 32.5% (n=13) had SSNHL, 10% (n=4) had MSSNHL and 7.5% (n=3) had MSNHL. 30% (n=12) of patients had significant radiological findings. Among the hearing aid users patients with PSNHL got no benefit at the end of 18months whereas the patients with cochlear implantation had significant improvement. Also the patients managed at a younger age (<3years) had a significantly better outcome then those managed later. Early identification of hearing loss, that is followed by immediate and appropriate intervention results in better language, speech, and social-emotional development when compared to children treated at a later age.

Initial Results of the Early Auditory Referral-Primary Care (EAR-PC) Study

Hearing loss (HL) is the second most common disability in the U.S., yet is clinically underdiagnosed. To manage its common adverse psychosocial and cognitive outcomes, early identification of HL must be improved. A feasibility study conducted to increase screening for HL and referral of patients aged ≥55 years arriving at two family medicine clinics. Eligible patients were asked to complete a self-administered consent form and the Hearing Handicap Inventory (HHI). Independently, clinicians received a brief educational program after which an electronic clinical prompt (intervention) alerted them (blinded to HHI results) to screen for HL during applicable patient visits. Pre- and post-intervention differences were analyzed to assess the proportion of patients referred to audiology and those diagnosed with HL (primary outcomes) and the audiology referral appropriateness (secondary outcome). Referral rates for those who screened positive for HL on the HHI were compared with those who scored negatively. There were 5,520 eligible patients during the study period, of which 1,236 (22.4%) consented. After the intervention's implementation, audiology referral rates increased from 1.2% to 7.1% (p<0.001). Overall, 293 consented patients (24%) completed the HHI and scored >10, indicating probable HL. Of these 293 patients, 28.0% were referred to audiology versus only 7.4% with scores <10 (p<0.001). Forty-two of the 54 referred patients seen by audiology were diagnosed with HL (78%). Overall, the diagnosis of HL on problem lists increased from 90 of 4,815 patients (1.9%) at baseline to 163 of 5,520 patients (3.0%, p<0.001) over only 8 months. The electronic clinical prompt significantly increased audiology referrals for at-risk patients for HL in two family medicine clinics. Larger-scale studies are needed to address the U.S. Preventive Services Task Force call to assess the long-term impact of HL screening in community populations.

Profil Penerima Implan Koklea Kebangsaan bagi Kanak-Kanak Bermasalah Pendengaran Pralingual di Malaysia

The Ministry of Health (MoH) commenced the National Cochlear Implant (CI) Program in 2008. As of November 2014, the program has implanted 205 individuals with hearing losses, many of whom are pediatric recipients (71%) with prelingual deafness. This study aimed to profile the prelingually deafened pediatric cochlear implant recipients under the MoH CI program. The data reported here were from a total of 121 recipients (82.8%) from all the nine satellite hospitals in the program. There were 58 males and the majority of the cases were Malay (66.9%). From the cases reviewed 39 (32.2%) were high risk for permanent hearing loss and the majority (46%) had multiple risk factors. In this cohort, only 12 children (9.9%) were identified through the newborn hearing screening (NHS) program. The age of diagnosis of hearing loss ranged from 1 to 46 months with a mean age of 24.3 ± 10.2 months. Hearing aids were fitted at the age of 4 to 46 months with a mean of 27.5 ± 9.9 months. The average age of implantation was 41.5 ± 10.3 months. The mean overall waiting period from the first visit to the audiologist to the time when the cochlear implant was activated was 18.5 ± 9.1 months. Descriptive findings indicate that the children received their implants at a relatively late age for speech and language development. The existing national NHS program needs to be tighten and strengthen so that it can be the main feeder for the pediatric CI program under the MoH. Subsequently, it is hoped that early identification of hearing loss will lead to earlier age of implantation among the pediatric patients in the future. DOI : http://dx.doi.org./10.17576/JSKM-2017-1502-21

The Importance of Early Identification and Intervention for Children with Hearing Loss. Part 1: Human Development

Hearing loss is invisible and therefore historically has not been given the attention needed. If hearing loss is undetected and/or “rehabilitative” efforts are not begun as soon after birth as possible, then a child’s language, emotional and cognitive development will be affected. This will then contribute to later literacy difficulties and other academic difficulties. This is the first article of a two-part series that discusses the importance of early identification of hearing loss and its implications, discussed in the context of human development. In this first article, hearing loss in general will be discussed including the terms “Deaf”, ‘hard of hearing” and “deaf” and how early identification is important for all three groups. Tests that are available for testing the hearing of infants will also be discussed. In Part 2 further discussion of differentiating “deaf” and “hard of hearing” will occur and more information about the relationship between early identification and child development will be presented. This article presents the case that early identification of hearing loss is critical, not just for communication purposes, but for a child to reach their maximum human development and self-actualization.

Hearing and Auditory Working Memory in Women with Polycystic Ovarian Syndrome (PCOS)

Objectives: The present study assessed the hearing and auditory working memory in women with polycystic ovarian syndrome (PCOS). Study Design: Standard group comparison. Materials and Methods: A total of 20 female participants were included in the study and were divided into two groups. Group-1 included ten women diagnosed with PCOS, under ultrasound examination and hyperandrogenism was confirmed through hormonal analysis. Group-2 included ten healthy women, with no evidence of hyperandrogenism and normal menstrual cycles. Routine pure tone audiometry was done in the frequency range of 250 Hz to 8000 Hz and extended high frequency hearing thresholds from 9000 Hz to 16,000 Hz, was also obtained. Auditory working memory was assessed through digit span and digit sequencing tasks. Results: The results revealed that the extended high frequency audiometry threshold was significantly poorer for PCOS group compared to the normal group for 9000 Hz (F1, 34=9.444, p<0.05), 10000 Hz (F1, 34=6.120, p<0.05), 11200 Hz (F1, 34=9.211, p<0.05), 12500 Hz (F1, 34=12.651, p<0.05), 14000 Hz (F1, 34=41.342, p<0.05), 16000 Hz (F1, 34=12.230, p<0.05). Comparison across various auditory working memory tasks showed that the PCOS group performed significantly poorer on backward digit task (Z=-1.996, p<0.05), ascending digit task (Z=-1.989, p<0.05) and descending digit task (Z=-3.198, p<0.01). Conclusion: These findings suggest that the high frequency sensitivity and working memory is affected in subjects with PCOS compared to the normal group. The study highlights the importance of early identification of hearing loss in PCOS group and the importance of auditory working memory screening in women with PCOS.

Auditory Brain Development in Children With Hearing Loss – Part One

Auditory Brain Development in Children With Hearing Loss – Part One

Progressive Hearing Loss in Early Childhood.

Deterioration in hearing thresholds in children is of concern due to the effect on language development. Before universal newborn hearing screening (UNHS), accurate information on the progression of hearing loss was difficult to obtain due to limited information on hearing loss onset. The objective of this population-based study was to document the proportion of children who experienced progressive loss in a cohort followed through a UNHS program in one region of Canada. We explored risk factors for progression including risk indicators, audiologic, and clinical characteristics of children. We also investigated deterioration in hearing as a function of age. For this study, two working definitions of progressive hearing loss were adopted: (1) a change of ≥20 dB in the 3 frequencies (500, 1000, and 2000 Hz) pure-tone average, and (2) a decrease of ≥10 dB at two or more adjacent frequencies between 500 and 4000 Hz or a decrease in 15 dB at one octave frequency in the same frequency range. Population-based data were collected prospectively on a cohort of children identified from 2003 to 2013 after the implementation of UNHS. Clinical characteristics including risk indicators (as per Joint Committee on Infant Hearing), age at diagnosis, type and severity of hearing loss, and initial audiologic information were recorded when children were first identified with hearing loss. Serial audiometric results were extracted from the medical charts for this study. Differences between children with progressive and stable hearing loss were explored using χ tests. Association between risk indicators and progressive hearing loss was assessed through logistic regression. The cumulative amount of deterioration in hearing from 1 to 4 years of age was also examined. Our analysis of 330 children (251 exposed to screening) with detailed audiologic records showed that 158 (47.9%) children had some deterioration (at least ≥10 dB and) in hearing thresholds in at least one ear. The 158 children included 76 (48.1%) with ≥20 dB loss in pure-tone average in at least one ear and 82 (51.9%) with less deterioration in hearing levels (≥10 but <20 dB). In the children with progressive hearing loss, of 131 children initially diagnosed with bilateral loss, 75 (57.3%) experienced deterioration in 1 ear and 56 (112 ears; 42.7%) in both ears (total of 187 ears). Of 27 children with an initial diagnosis of unilateral loss, 25 experienced deterioration in the impaired ear and 5 in the normal-hearing ear, progressing to bilateral hearing loss. Within 4 years after diagnosis, the mean decrease in hearing for children with progressive loss was 25.9 dB (SD: 16.4) in the right ear and 28.3 dB (SD: 12.9) in the left ear. We explored the risk factors for hearing loss identified by Joint Committee on Infant Hearing where there were sufficient numbers in our sample. On multivariate analysis, there was no statistically significant relationship between most risk indicators examined (neonatal intensive care unit admission, family history, syndromes, and postnatal infections) and the likelihood of progressive loss. However, the presence of craniofacial anomalies was inversely associated with risk of progressive hearing loss (odds ratio = 0.27; 95% confidence interval: 0.10, 0.71; p = 0.01), that is, these children were more likely to have stable hearing. Given that almost half of the children in this cohort experienced deterioration in hearing, close postneonatal monitoring of hearing following early hearing loss identification is essential to ensure optimal amplification and therapy.

Audiologist Practices: Parent Hearing Aid Education and Support.

Early identification of hearing loss has led to routine fitting of hearing aids in infants and young children. Amplification provides opportunities to optimize child development, although it also introduces challenges for parents to navigate. Audiologists have a central role in providing parents with support to achieve effective management strategies and habits. The purpose of this study was to explore current practices of pediatric audiologists who work with children birth to 5 yr of age, regarding their support of parent learning in achieving effective hearing aid management, identify existing gaps in service delivery, and to determine if audiologists were receptive to receiving training related to effective approaches to provide counseling and support to parents. A cross-sectional, population-based survey was used. Three hundred and forty-nine surveys were analyzed from pediatric audiologists who provided services to children birth to 5 yr of age. Responses were received from 22 states in the United States. Responses were collected through the mail and online. Descriptive statistics were used to analyze the information. More than half (61%) of the audiologists in the study had been providing pediatric hearing aid services to children birth to 5 yr of age for >10 yr. Of the audiologists who reported monitoring hours of hearing aid use, the majority reported that they used data logging (90%). More than half of the audiologists (57%) who shared data logging with parents reported that they encountered defensiveness from parents when addressing hearing aid use. Information and skills that were not routinely provided by one-third to one-half of the audiologists included the following: how to get access to loaner hearing aids (30%), available hearing aid options/accessories (33%), available financial assistance (36%), how to teach hearing aid management to other caregivers (38%), how to do hearing aid maintenance (44%), and how to do a Ling 6 sound check (52%). Many audiologists reported they did not frequently collaborate with speech-language pathologists (48%), early interventionists (47%), or physicians (68%). More than half of the audiologists indicated a desire for more training in counseling skills, for all 14 items queried, to support parents with hearing aid management (53-79%), regardless of their previous training experience. For young children with hearing loss to achieve optimal benefit from auditory experiences for speech and language development, they need evidence-based, comprehensive, and coordinated hearing aid management. Audiologists have an important role for teaching information and skills related to hearing aids, supporting parent learning, and collaborating with other providers. Pediatric audiologists in this study recognized and desired the need for further training in counseling skills that can better prepare them to meet the emotional needs of parents in the hearing aid management process.