Research & Scholarly Achievement
at Gallaudet University

Project R3: Validation of hearing aid fitting for infants and toddlers

ID: 2644
Status: Ongoing
Start date: October 2015
End Date: September 2019


Current assessment protocols cannot be used to evaluate hearing aid settings in infants younger than 2.5 years of age, which poses a significant challenge when fitting amplification at such an early age. The inherent variability of unconditioned behavioral responses in infants older than 6 months adds difficulty when making a clinical judgment of appropriate amplification. Identification of hearing in the newborn period requires a physiological protocol because reliable conditioned behavioral responses cannot be obtained in the first 6 to 7 months of life. In the newborn period, a physiological protocol is also needed to validate hearing aid fitting of children with a speech discrimination procedure because obtaining a behavioral response for speech discrimination is not possible at this age. Likewise, there is a critical need to develop an objective behavioral measure of speech discrimination that can be reliable and valid for children between 7 and 9 months of age and 2.5 years of age, when auditory discrimination, the current standard for validation of hearing aid fitting, can be used. The project aims to fill in the current gaps in validating amplification fitting for infants and toddlers below the age of 3 years, demonstrating that physiological measures can be used immediately after the first hearing aid fitting, followed by a behavioral validation beginning at 7 to 9 months of age. Coupled with improvements to parent report instruments, the project also aims to provide a procedure for assessing auditory development after the fitting of amplification that is developmentally sensitive, and these instruments will be used for progress monitoring rather than as an inadequate validation of hearing aid fitting in infants.


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Gilley, P. M., & Uhler, K (2017). Assessing speech perception in infancy: A comparison of two electrophysiological measures. The Annual Ultimate Midwinter Meeting for Otolaryngology and Otology-Audiology. Vail, CO.

Gilley, P. M., & Uhler, K (2017). Developing a tool to assess speech perception in infancy. American Academy of Audiology. Indianapolis, IN.

Gilley, P. M., Uhler, K., Watson, K., & Yoshinaga-Itano, C (2017). Spectral-temporal EEG dynamics of speech discrimination processing in infants during sleep. BMC Neuroscience, 18(1):34.

Uhler, K., Gilley, P. M., Watson, K., & Ross, R. G. (2017). Three-month-old speech contrast MMRTF predicts performance on behavioral measures of speech discrimination at 7 months. Presented at the Biennial Meeting of the Society for Research in Child Development. Austin, TX.

Yoshinaga-Itano, C. (2017). CAEP, VRISD, Parent Questionnaires, Ling sounds: Validating hearing aid fitting in young children. Listen and Chat, Denver, CO.

Yoshinaga-Itano, C. (2017). Technology advances transforming the future of pediatric audiology. CDC workshop, Atlanta, GA.

Yoshinaga-Itano, C. (2017).  EHDI in the 21st century.  Early Hearing Loss Detection: Protocols for Diagnostic Audiological Assessment Follow-up to Newborn Hearing Screening, Presentation at NCHAM. Cincinnati Children’s Hospital, Cincinnati, OH.

Yoshinaga-Itano, C. (2017, February). Recommended practices for family-centered early intervention with families who have infants and toddlers who are deaf or hard of hearing. Presented at the OSUMC Eye and Ear Institute Open House Conference. Columbus, OH.

Yoshinaga-Itano, C. (2017, July). Impact of EHDI in the 21st Century. Presented at Frontiers in Hearing: Auditory Development and Disorders Symposium. Estes Park, CO.

Yoshinaga-Itano, C. (2017, October). The infant brain and children who are deaf or hard of hearing. Presented to the Association of State and Territorial Health Officials. Washington, DC.

Yoshinaga-Itano, C. (2017, October). Transforming what we do in early intervention with technological advances. Presented to Getting it Right 0-5:  Together we make a difference, Ear Foundation and AG Bell Association, London, England. 

Yoshinaga-Itano, C. (2017, September). Technology advances transforming the future of audiology. Presented at the 50th Anniversary of the British Society of Audiology, e-learning conference, taped.

Yoshinaga-Itano, C. (2017, September). Validating hearing aid fitting and cochlear implant maps of very young children. Presented at the 10th Asia Pacific Conference on Speech, Language and Hearing (APCSLH2017), Narita, Japan.

Yoshinaga-Itano, C., Sedey, A. L., Wiggin, M., & Chung, W. (2017).  Early hearing detection and vocabulary of children with hearing loss.  Pediatrics. 140(2):e20162964, DOI: https:// doi. org/ 10. 1542.

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