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. 2003;7(1):29-40.
doi: 10.1177/108471380300700104.

An approach for ensuring accuracy in pediatric hearing instrument fitting

Richard C Seewald  1 , Susan D Scollie
Affiliations

An approach for ensuring accuracy in pediatric hearing instrument fitting

Richard C Seewald et al. Trends Amplif. 2003.

Abstract

Hearing instrument fitting with infants and young children differs in several important ways relative to the fitting process with adults. In developing the Desired Sensation Level method, we have attempted to account for those factors that are uniquely associated with pediatric hearing instrument fitting. Within this article we describe how the external ear acoustics of infants and young children have been systematically accounted for in developing the Desired Sensation Level method. Specific evidence-based procedures that can be applied with infants and young children for the purposes of audiometric assessment, electroacoustic selection, and verification of hearing instrument performance are described.

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Figures

Figure 1.
Figure 1.
Illustration of how audiometric thresholds, measured in dB HL, are transformed in the DSL®[i/o] v4.1 software system to predict the ear canal level in dB SPL. When possible, infant-specific RECD values are applied in the transformation process.
Figure 2.
Figure 2.
Pull-down menu from the DSL®[i/o] v4.1 software system for selecting the transducer type used in audiometric testing.
Figure 3.
Figure 3.
Pull-down menu from the DSL®[i/o] v4.1 software system for selecting the HL to SPL transform to be applied to the audiometric data.
Figure 4.
Figure 4.
Assessment data entry window from the DSL®[i/o] v4.1 software system.
Figure 5.
Figure 5.
The Auditory Area window from the DSL®[i/o] v4.1 software system. Values are shown for the predicted HL (HLp) thresholds in addition to the predicted ear canal SPL values.
Figure 6.
Figure 6.
SPLogram from the DSL®[i/o] v4.1 software system showing (from bottom to top) average normal hearing sensitivity (MAP) [▿-▿], the child's thresholds [□-□] and the predicted upper limit of comfort [▪-▪] in dB SPL (ear canal level) as a function of frequency.
Figure 7.
Figure 7.
Illustration showing the general application of acoustic transforms in the hearing instrument selection and fitting process.
Figure 8.
Figure 8.
SPLogram from the DSL®[i/o] v4.1 software system showing (from bottom to top) average normal hearing sensitivity (MAP) [▿- ▿], the child's thresholds [□-□], the targets for the amplified long term average speech spectrum (LTASS) [+-+], and the predicted upper limit of comfort [▪-▪] in dB SPL (ear canal level) as a function of frequency.
Figure 9.
Figure 9.
Illustration of the process of transforming the desired real-ear hearing instrument performance characteristics from the real-ear to the 2 cc coupler.
Figure 10.
Figure 10.
The Hearing Instrument Specification window from the DSL®[i/o] v4.1 software system. Values are shown for the prescribed 2 cc coupler saturation sound pressure levels, full-on gain, user gain, and compression ratios across frequencies.
Figure 11.
Figure 11.
Illustration of the process of transforming the measured 2 cc coupler performance of a hearing instrument to predict how the instrument will perform when fitted to the ear of an infant or young child.
Figure 12.
Figure 12.
SPLogram from the DSL®[i/o] v4.1 software system showing (from bottom to top) average normal hearing sensitivity (MAP) [▿-▿], the child's thresholds [□-□], the targets [+-+] and hearing aid responses [•-•] for the amplified long term average speech spectrum (LTASS), and the predicted upper limit of comfort [▪-▪] and the predicted corresponding Real-Ear Aided Response for a 90 dB input [▪-▪] in dB SPL (ear canal level) as a function of frequency.
Figure 13.
Figure 13.
Speech intelligibility index values for five hearing aid prescriptions, as a function of input level. All hearing aids were programmed assuming a flat 50 dB HL audiogram and using wide-dynamic range compression circuitry.
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References

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