Why is Pedi Amp an issue as compared to Adult amp?
Adults don't have growing ears. Fitting will continually change for children. Kids don't also have a base for language.
Is there a minimum age for fitting HAs?
No! Youngest is 3 months, dependent on how quickly services go.
Can you base binaural HA fitting on sound field MRL?
No because it's not ear specific; only getting one ear. Could potentially get too much lows or highs.
If the child's developmental age is < 6 months, ____
Confirm behavioral responses with electrophysiology (ABR)
List the advantages of Click ABR?
-The only thing that checks for auditory neuropathy.
- Clean waveform and easy to interpret.
List disadvantages of Click ABR
- Doesn't give you any lows
- Clicks are based on the best threshold in 2000-4000 Hz.
If you fit based on Click ABR...
Minimum Click at 500 Hz, and then try to get 2000 and 4000 Hz to continue to work on the fitting.
ABR Tone Burst
โข Confirming behavioral responses if child's developmental age is <6 months
500 Hz; more freq. specific
โข Argument for slope of click-evoked wave V latency-intensity function tells configuration of the loss
difference in output of HA between the real ear and 2-cc coupler. Comparison of exact same signal of the 2cc coupler and the signal measured in the canal
What is the GOAL for DSL?
To provide children with amplified speech that is consistently audible, comfortable, and undistorted across the frequency spectrum. Flexible in what intensity reference is used.
List the cons for aided sound field measures.
- The HAs will think the tones are noise.
- Never use Behavioral thresholds to fit HAs
- Not taking ear canal acoustics into account
- If testing at loud levels, compression could kick in
Probe mic measures
โข Do not require behavioral (voluntary) responses
โข Directly measures real-ear output levels across freqs.
โข Can make predictions based on ear canal levels for amplified speech across freqs.
โข Takes less time than behavioral measures
โข Tests at more "real-life" intensities
โข Realize the kid must still be calm; have several things to distract
What type of HA is used most on kids?
BTE because compatibility for FM systems, they having growing ears (easier to switch out the ear molds), durable, and better retention.
What type of options would you want to include on the HA?
- FM compatible battery door (HA is FM compatible or DAI)
- Tamper proof (age dependent)
- Pedi earhook
- Water-resistant HAs
- Flexibility of having on omni/directional
- Turn off volume control buttons
List the HA characteristics for Kids.
- Binaural fittings unless contraindicated
- Programmable aids
- Minimum of 2 year warranty
- Soft ear mold materials (silicone)
Validation measures can include...
-Aided SF speech
โข Age-appropriate material
-Functional measurements, such as:
โข SIFTER, Pre-school SIFTER
โข Listening Inventory for Listening Difficulties
โข Parent's APHAB
โข Functional Auditory Performance Inventory
โข Meaningful Auditory Performance Integration Scale; Infant-Todder Meaningful Auditory Performance Integration Scale
โข PEACH, LittlEears
Aided SII (speech intelligibility index)
SII of <0.65 correlates w/ greater delays in vocabulary development for losses up to moderately severe
Children <12 months show largest what?
RECD, the bigger the RECD, the greater chance of oversimplification
Differences in RECD
Ear canal length
-Ear canal occluded volume
-Head & body diffraction effects