Pediatric Hearing Loss

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Help is needed beyond the classroom

Classroom environments present many challenges to children with hearing loss. They require improved signal-to-noise ratios, shorter reverberation times and less distance from a speaker in order to achieve speech recognition scores comparable to their normal hearing peers.1

Hearing aids alone cannot overcome the deleterious effects of classroom environments. An FM system is one of the most common and effective solutions for helping students understand speech in noisy and reverberant situations, and over long distances. It uses wireless FM radio frequencies to transmit desired audio, like a teacher’s voice, directly into hearing aids, allowing kids with hearing loss to maximize their hearing and learning abilities and improve their overall performance in school.

The child can sit anywhere in the classroom and still be able to hear the teacher’s voice clearly and directly in their ears regardless of other sounds in the classroom.

FM systems are highly effective, but it’s important to remember that children are learning not only academics in the classroom, but also social and life skills. They learn from teachers and everyone with whom they come into contact. This means that learning takes place in and outside the classroom ? everywhere they go.

Learning Outside the Classroom

Besides classrooms, kids spend their school day in all types of listening environments filled with noise or reverberation, such as hallways, cafeterias, school buses and gymnasiums. A student’s ability to hear and understand what is being said becomes challenging in these environments.

Reverberation is caused by sounds bouncing off of hard, reflective surfaces. Sounds blur together, making it increasingly difficult for kids with hearing loss to understand speech. A good example of a room where reverberation occurs is the gymnasium. Besides the coach or teacher, kids need to be able to hear other students and teammates who could be anywhere. Since FM systems work best when there’s only one or two designated speakers, (e.g., a coach or teacher), it’s not practical in such situations when the speaker could be anybody positioned anywhere in the room. That’s when a student has to rely on their hearing aids alone to hear.

In addition to academics, kids are also developing their social skills in school. As they grow, social relationships with peers become increasingly important. Conversations with friends and classmates oftentimes take place outside of the traditional classroom, such as in hallways and the cafeteria. These tend to be busy, noisy settings with significant background noise and multiple conversations occurring at the same time.

To make matters worse, these spaces are filled by hard, reflective surfaces. The resulting reverberation makes listening to speech even more challenging. While an FM system may be an ideal solution in such listening situations, it’s not always practical to have friends speak into a FM transmitter microphone. Plus, these are often fluid conversational situations with multiple participants who leave or join the conversation at will. This is another instance in which FM might not help, and the performance of the child’s hearing aids becomes critical in helping them follow the conversation.

Advanced Hearing Aid Features Can Help

Unlike adults with acquired hearing loss, very young children need to hear everything ? not only speech sounds, but all sounds in the environment, including noise. This means advanced digital hearing aid features like directional microphones and digital noise reduction may actually take away important auditory information that young children need in order to promote the development of auditory skills. As a result, “advanced features” are sometimes considered less relevant when choosing hearing aids for kids.

Hearing aid technology has dramatically improved in recent years, and more research is available suggesting that older children (around 8-years-old and above) can benefit from directional microphones and digital noise reduction ? the same features that have consistently proven helpful to.2 So for these older kids, it is important to ensure that the chosen hearing aids offer options to facilitate better speech understanding at all times. Beyond FM compatibility, parents should also make sure their child’s hearing aids include features that can effectively reduce reverberation, minimize background noise and still be able to handle the rough-and-tumble of an active child or teen’s lifestyle.

Today’s most advanced hearing aids feature a variety of automatic directional microphone and digital noise reduction features that highlight the target speech source, reduce background noise and suppress reverberation. As the student goes through their day the hearing aids adapt continuously and automatically, optimizing features with the goal of enhancing speech understanding. In addition to FM compatibility, they offer audio streaming, so kids can also hear their favorite music or phone calls directly in their hearing aids. They are robust and many are rated IP67 or IP68 for resistance against sweat and water to withstand the lifestyles of active kids and teens. They can even be remotely controlled via smartphone apps. Some convenient and eco-friendly models are even rechargeable.

An additional feature that can be very helpful is the “speech in noise only” optional setting. The hearing care professional who fits your child’s hearing aids can set them so that digital noise reduction and directional microphones only activate when the hearing aids detect both speech and noise. This means that in the absence of speech sounds, these features will not engage automatically, so the child can still hear all sounds coming from every direction without any additional attenuation. But when speech sounds are present, these advanced features will engage to reduce background noise and ensure optimal speech understanding. This option is a great way to transition from settings appropriate for toddlers and younger children to the point where an adolescent can use full advanced signal processing.
Summary

When choosing amplification options for a child, it’s important to also consider their hearing needs outside of the traditional classrooms. More recent research has shown that older kids may do better with more advanced hearing aid features, such as directional microphones and digital noise reduction. These automated hearing aid features could be helpful in listening situations outside of the traditional classroom where FM systems are impractical. They help kids and teens grow not only academically, but also socially and emotionally.


References:

  1. Crandell, C. & Smaldino, J. (2000). Classroom acoustics for children with normal hearing and with
    hearing impairment. Language Speech and Hearing Services in Schools, 31, 362-370.
  2. Crukley, J. & Scollie, S. D. (2014). The effects of digital signal processing features on children’s speech recognition and loudness perception. American Journal of Audiology, 23(1), 99-115.
  3. Pittman, A. L. & Hiipakka, M. M. (2013). Hearing impaired children’s preference for, and performance with, four combinations of directional microphone and digital noise reduction technology. Journal of American Academy of Audiology, 24(9), 832-844.
  4. Ricketts, T. A. & Picou, E. M. (2013). Speech recognition for bilaterally asymmetric and symmetric hearing aid microphone modes in simulated classroom environments. Ear and Hearing, 34(5), 601-609.
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About Author

Lisa Klop, AuD

Lisa Klop is an educational specialist for Sivantos, Inc.

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