Major findings of the LOCHI study on children at 3 years of age and implications for audiological management

Objective: This article describes the major findings of the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study. Design: A population-based prospective cohort study; with randomized controlled trials of hearing aid prescription and non-linear frequency compression. Sample: 451 children in New South Wales, Victoria and Southern Queensland. Results: Significant predictors of language outcomes at 3 years of age included severity of hearing loss, gender, presence of additional disabilities, maternal education, and age at cochlear implantation. Although prescription did not have a significant effect on outcomes, its influence on loudness and hearing aid safety has implications for management. After controlling for a range of predictor variables, nonlinear frequency compression did not have a significant effect on outcomes. For the same hearing sensitivity, the presence of auditory neuropathy did not have a significant effect on outcomes. Conclusions: These findings form the basis for evidence-based guidelines for management of children with hearing loss.4 page(s

A comparison of NAL and DSL prescriptive methods for paediatric hearing-aid fitting

OBJECTIVE: To examine the impact of prescription on predicted speech intelligibility and loudness for children. DESIGN: A between-group comparison of Speech Intelligibility Index (SII) and loudness, based on hearing aids fitted according to NAL-NL1, DSL v4.1, or DSL m[i/o] prescriptions. A within-group comparison of gains prescribed by DSL m[i/o] and NAL-NL2 for children in terms of SII and loudness. STUDY SAMPLE: Participants were 200 children , who were randomly assigned to first hearing-aid fitting with either NAL-NL1, DSL v4.1, or DSL m[i/o]. Audiometric data and hearing aid data at 3 years of age were used. RESULTS: On average, SII calculated on the basis of hearing-aid gains were higher for DSL than for NAL-NL1 at low input level, equivalent at medium input level, and higher for NAL-NL1 than DSL at high input level. Greater loudness was associated with DSL than with NAL-NL1, across a range of input levels. Comparing NAL-NL2 and DSL m[i/o] target gains revealed higher SII for the latter at low input level. SII was higher for NAL-NL2 than for DSL m[i/o] at medium- and high-input levels despite greater loudness for gains prescribed by DSL m[i/o] than by NAL-NL2. CONCLUSION: The choice of prescription has minimal effects on speech intelligibility predictions but marked effects on loudness predictions

A randomized controlled comparison of NAL and DSL prescriptions for young children

OBJECTIVE: To determine the influence of choice of prescription and other child-, family- and intervention-related factors on speech, language, and functional performance of hearing-impaired children by three years of age. DESIGN AND STUDY SAMPLE: A randomized controlled design was implemented as part of a population-based, longitudinal study on outcomes of children with hearing impairment (LOCHI) in Australia. Two hundred and eighteen children were randomly assigned to either the NAL or the DSL prescription for first fitting of hearing aids. Their performance outcomes were evaluated. RESULTS: Prescriptive targets were closely matched in children's hearing aids. There were not significant differences in children's language, speech production, or functional performance between prescriptions. Parents' ratings of children's device usage and loudness discomfort were not significantly different between prescription groups. Functional performance within the first year of fitting together with degree of hearing loss, presence of additional disabilities, and maternal education explained 44% of variation in language ability of children by three years of age. CONCLUSIONS: There was no significant association between choice of hearing-aid prescription and variance in children's outcomes at three years of age. In contrast, additional disability, maternal educational level, and early functional performance were significant predictive factors of children's outcomes