Permanent Childhood Hearing Loss
Hearing Assistive Technology Systems (HATS) Treatment

External Scientific Evidence

Evidence-Based Practice Guidelines

New York State Department of Health, Early Intervention Program; U.S. Department of Education Clinical Practice Guideline: Report of the Recommendations. Hearing Loss, Assessment and Intervention for Young Children (Age 0-3 Years) New York State Department of Health, Early Intervention Program. (2007). Albany (NY): NYS Department of Health, Publication No. 4967, 354 pages. Added: July 2012

Description
This evidence-based and consensus-based guideline provides recommendations for the assessment and intervention of hearing loss for young children ages birth to three. The guideline targets parents and professionals. Recommendations of interest to audiologists and speech-language pathologists include screening, assessment, and management of hearing and assessment of communication. Each recommendation is provided with a strength of evidence rating defined as Level A (strong evidence), Level B (moderate evidence), Level C (limited evidence), Level D1 (consensus panel opinion based on topics where a systematic review has been conducted), and Level D2 (consensus panel opinion not based on findings from a systematic review).

Recommendations

• Children not demonstrating development in communication or auditory skills should undergo a reassessment of the amplification device fitting. Alternative assistive devices (e.g., FM systems, cochlear implant) may need to be considered (Level D2 Evidence).
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Children who are candidates for a cochlear implant should also “receive sufficient experience with well-fitting amplification and enroll in a program focused on the development of listening skills (auditory training) to determine whether or not the child will benefit from amplification or other assistive technology. The trial period with amplification may vary depending on a number of factors such as: age of identification, etiology of hearing loss, amount of residual hearing, progress or lack of progress, recurrent otitis media, the amount of time the child actually wears the hearing aid” (Level D1 Evidence) (p. 161).


Loaner amplification devices may be provided at the beginning of the amplification acquisition process until a final recommendation is made to the family regarding specific hearing aids. The availability of these devices can facilitate the initiation of hearing aid use and provide opportunities for ongoing hearing aid evaluation or experimentation with various assistive listening device technologies (Level D2 Evidence).


The combination of FM technology and a hearing aid can increase access to speech in different listening situations (particularly those with increased noise levels). “For some children with severe and profound hearing loss, a combination hearing aid with FM system may be recommended as the primary form of amplification” (Level D2 Evidence) (p. 153).


Because conventional click evoked ABR typically does not detect low-frequency auditory sensitivity and the intensity of the clicks to elicit the ABR is limited; “Children with no ABR may have residual hearing and may benefit from hearing aids or FM systems” (Level D2 Evidence) (p. 150).


For children with a profound hearing loss, a tactile aid (an assistive device that converts sound to vibration on the skin) may be beneficial and should be used in conjunction with a hearing aid when possible. Tactile aid candidates include those with no cochleae, potential cochlear implant candidates during pre-implantation evaluation, and those who are not receiving a cochlear implant due to family choice or medically fragility (Level D2 Evidence).

» See full summary and quality ratings

Evidence-Based Systematic Reviews

No evidence-based systematic reviews were found.

Clinical Expertise/Expert Opinion

Consensus Guidelines

No consensus guidelines were found.

Client/Patient/Caregiver Perspectives

No information was found pertaining to client/patient/caregiver perspectives.

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