Stability of audiometric thresholds for children with hearing AIDS applying the American Academy of audiology pediatric amplification guideline

Implications for safety

Ryan W McCreery, Elizabeth Walker, Meredith Spratford, Benjamin Kirby, Jacob Oleson, Marc A Brennan

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Children who wear hearing AIDS may be at risk for further damage to their hearing from overamplification. Previous research on amplification-induced hearing loss has included children using linear amplification or simulations of predicted threshold shifts based on nonlinear amplification formulae. A relationship between threshold shifts and the use of nonlinear hearing AIDS in children has not been empirically verified. Purpose: The purpose of the study was to compare predicted threshold shifts from amplification to longitudinal behavioral thresholds in a large group of children who wear hearing AIDS to determine the likelihood of amplification-induced hearing loss. Research Design: An accelerated longitudinal design was used to collect behavioral threshold and amplification data prospectively. Study Sample: Two-hundred and thirteen children with mild-to-profound hearing loss who wore hearing AIDS were included in the analysis. Data Collection and Analysis: Behavioral audiometric thresholds, hearing aid outputs, and hearing aid use data were collected for each participant across four study visits. Individual ear- and frequencyspecific safety limits were derived based on the Modified Power Law to determine the level at which increased amplification could result in permanent threshold shifts. Behavioral thresholds were used to estimate which children would be above the safety limit at 500, 1000, 2000, and 4000 Hz using thresholds in dB HL and then in dB SPL in the ear canal. Changes in thresholds across visits were compared for children who were above and below the safety limits. Results: Behavioral thresholds decreased across study visits for all children, regardless of whether their amplification was above the safety limits. The magnitude of threshold change across time corresponded with changes in ear canal acoustics as measured by the real-ear-to-coupler difference. Conclusions: Predictions of threshold changes due to amplification for children with hearing loss did not correspond with observed changes in threshold over across 2-4 yr of monitoring amplification. Use of dB HL thresholds and predictions of hearing aid output to set the safety limit resulted in a larger number of children being classified as above the safety limit than when safety limits were based on dB SPL thresholds and measured hearing aid output. Children above the safety limit for the dB SPL criteria tended to be fit above prescriptive targets. Additional research should seek to explain how the Modified Power Law predictions of threshold shift overestimated risk for children who wear hearing AIDS.

Original languageEnglish (US)
Pages (from-to)252-263
Number of pages12
JournalJournal of the American Academy of Audiology
Volume27
Issue number3
DOIs
StatePublished - Mar 1 2016

Fingerprint

Audiology
Hearing
Acquired Immunodeficiency Syndrome
Guidelines
Pediatrics
Safety
Hearing Aids
Hearing Loss
Ear Canal
Ear
Research
Acoustics

Keywords

  • Amplification
  • Audiogram
  • Children
  • Hearing AIDS
  • Hearing loss
  • Modified Power Law
  • Pediatrics
  • Safety limits
  • Temporary threshold shifts

ASJC Scopus subject areas

  • Speech and Hearing

Cite this

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title = "Stability of audiometric thresholds for children with hearing AIDS applying the American Academy of audiology pediatric amplification guideline: Implications for safety",
abstract = "Background: Children who wear hearing AIDS may be at risk for further damage to their hearing from overamplification. Previous research on amplification-induced hearing loss has included children using linear amplification or simulations of predicted threshold shifts based on nonlinear amplification formulae. A relationship between threshold shifts and the use of nonlinear hearing AIDS in children has not been empirically verified. Purpose: The purpose of the study was to compare predicted threshold shifts from amplification to longitudinal behavioral thresholds in a large group of children who wear hearing AIDS to determine the likelihood of amplification-induced hearing loss. Research Design: An accelerated longitudinal design was used to collect behavioral threshold and amplification data prospectively. Study Sample: Two-hundred and thirteen children with mild-to-profound hearing loss who wore hearing AIDS were included in the analysis. Data Collection and Analysis: Behavioral audiometric thresholds, hearing aid outputs, and hearing aid use data were collected for each participant across four study visits. Individual ear- and frequencyspecific safety limits were derived based on the Modified Power Law to determine the level at which increased amplification could result in permanent threshold shifts. Behavioral thresholds were used to estimate which children would be above the safety limit at 500, 1000, 2000, and 4000 Hz using thresholds in dB HL and then in dB SPL in the ear canal. Changes in thresholds across visits were compared for children who were above and below the safety limits. Results: Behavioral thresholds decreased across study visits for all children, regardless of whether their amplification was above the safety limits. The magnitude of threshold change across time corresponded with changes in ear canal acoustics as measured by the real-ear-to-coupler difference. Conclusions: Predictions of threshold changes due to amplification for children with hearing loss did not correspond with observed changes in threshold over across 2-4 yr of monitoring amplification. Use of dB HL thresholds and predictions of hearing aid output to set the safety limit resulted in a larger number of children being classified as above the safety limit than when safety limits were based on dB SPL thresholds and measured hearing aid output. Children above the safety limit for the dB SPL criteria tended to be fit above prescriptive targets. Additional research should seek to explain how the Modified Power Law predictions of threshold shift overestimated risk for children who wear hearing AIDS.",
keywords = "Amplification, Audiogram, Children, Hearing AIDS, Hearing loss, Modified Power Law, Pediatrics, Safety limits, Temporary threshold shifts",
author = "McCreery, {Ryan W} and Elizabeth Walker and Meredith Spratford and Benjamin Kirby and Jacob Oleson and Brennan, {Marc A}",
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T1 - Stability of audiometric thresholds for children with hearing AIDS applying the American Academy of audiology pediatric amplification guideline

T2 - Implications for safety

AU - McCreery, Ryan W

AU - Walker, Elizabeth

AU - Spratford, Meredith

AU - Kirby, Benjamin

AU - Oleson, Jacob

AU - Brennan, Marc A

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N2 - Background: Children who wear hearing AIDS may be at risk for further damage to their hearing from overamplification. Previous research on amplification-induced hearing loss has included children using linear amplification or simulations of predicted threshold shifts based on nonlinear amplification formulae. A relationship between threshold shifts and the use of nonlinear hearing AIDS in children has not been empirically verified. Purpose: The purpose of the study was to compare predicted threshold shifts from amplification to longitudinal behavioral thresholds in a large group of children who wear hearing AIDS to determine the likelihood of amplification-induced hearing loss. Research Design: An accelerated longitudinal design was used to collect behavioral threshold and amplification data prospectively. Study Sample: Two-hundred and thirteen children with mild-to-profound hearing loss who wore hearing AIDS were included in the analysis. Data Collection and Analysis: Behavioral audiometric thresholds, hearing aid outputs, and hearing aid use data were collected for each participant across four study visits. Individual ear- and frequencyspecific safety limits were derived based on the Modified Power Law to determine the level at which increased amplification could result in permanent threshold shifts. Behavioral thresholds were used to estimate which children would be above the safety limit at 500, 1000, 2000, and 4000 Hz using thresholds in dB HL and then in dB SPL in the ear canal. Changes in thresholds across visits were compared for children who were above and below the safety limits. Results: Behavioral thresholds decreased across study visits for all children, regardless of whether their amplification was above the safety limits. The magnitude of threshold change across time corresponded with changes in ear canal acoustics as measured by the real-ear-to-coupler difference. Conclusions: Predictions of threshold changes due to amplification for children with hearing loss did not correspond with observed changes in threshold over across 2-4 yr of monitoring amplification. Use of dB HL thresholds and predictions of hearing aid output to set the safety limit resulted in a larger number of children being classified as above the safety limit than when safety limits were based on dB SPL thresholds and measured hearing aid output. Children above the safety limit for the dB SPL criteria tended to be fit above prescriptive targets. Additional research should seek to explain how the Modified Power Law predictions of threshold shift overestimated risk for children who wear hearing AIDS.

AB - Background: Children who wear hearing AIDS may be at risk for further damage to their hearing from overamplification. Previous research on amplification-induced hearing loss has included children using linear amplification or simulations of predicted threshold shifts based on nonlinear amplification formulae. A relationship between threshold shifts and the use of nonlinear hearing AIDS in children has not been empirically verified. Purpose: The purpose of the study was to compare predicted threshold shifts from amplification to longitudinal behavioral thresholds in a large group of children who wear hearing AIDS to determine the likelihood of amplification-induced hearing loss. Research Design: An accelerated longitudinal design was used to collect behavioral threshold and amplification data prospectively. Study Sample: Two-hundred and thirteen children with mild-to-profound hearing loss who wore hearing AIDS were included in the analysis. Data Collection and Analysis: Behavioral audiometric thresholds, hearing aid outputs, and hearing aid use data were collected for each participant across four study visits. Individual ear- and frequencyspecific safety limits were derived based on the Modified Power Law to determine the level at which increased amplification could result in permanent threshold shifts. Behavioral thresholds were used to estimate which children would be above the safety limit at 500, 1000, 2000, and 4000 Hz using thresholds in dB HL and then in dB SPL in the ear canal. Changes in thresholds across visits were compared for children who were above and below the safety limits. Results: Behavioral thresholds decreased across study visits for all children, regardless of whether their amplification was above the safety limits. The magnitude of threshold change across time corresponded with changes in ear canal acoustics as measured by the real-ear-to-coupler difference. Conclusions: Predictions of threshold changes due to amplification for children with hearing loss did not correspond with observed changes in threshold over across 2-4 yr of monitoring amplification. Use of dB HL thresholds and predictions of hearing aid output to set the safety limit resulted in a larger number of children being classified as above the safety limit than when safety limits were based on dB SPL thresholds and measured hearing aid output. Children above the safety limit for the dB SPL criteria tended to be fit above prescriptive targets. Additional research should seek to explain how the Modified Power Law predictions of threshold shift overestimated risk for children who wear hearing AIDS.

KW - Amplification

KW - Audiogram

KW - Children

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KW - Hearing loss

KW - Modified Power Law

KW - Pediatrics

KW - Safety limits

KW - Temporary threshold shifts

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