Clinical and sociodemographic predictors of hearing aid use in infants aged 0-2 with permanent childhood hearing loss: a retrospective cohort single-site pilot study
Authors: Gosnell Emilee , Rajasingam Saima , Mahon Merle , Vickers Deborah 
Published: June 2023

Objectives

The aim of this study was to identify differences in hearing aid use among infants aged 0-2 years with respect to clinical and sociodemographic factors in an attempt to better predict which patients and families may benefit from extra support in the early stages of hearing aid fitting to encourage optimum usage. The secondary aim was to investigate how hearing aid use changed over the first two years post-fitting.

Methods

A retrospective review of records was performed on 252 patients, aged 0-2 years with permanent childhood hearing loss from a single-site hospital who were fitted with hearing aids between 2005-2022. Ninety-six patients met the inclusion criteria. Datalogging values were collected for six different time points post fitting that coincided with their routine clinical follow-up appointments: 2 weeks, 6 weeks, 6 months, 12 months, 18 months and 24 months. Clinical and sociodemographic information was also collected for each participant. This included sex, average pure tone threshold, unilateral vs bilateral use, speech intelligibility score, additional disabilities, Index of Multiple Deprivation, Income Decile, Education and Skills Decile, Income Deprivation Affecting Children Index (IDACI), ethnicity and home language.

Results

The datalogging results indicated a median average of 4.67 hours (3.0-7.3) hours per day use across patients and across the first two years post-fitting. Differences in datalogging according to IDACI Decile was significant (p=0.01), suggesting that infants from the more deprived groups (1-5) used their devices less. All other predictors did not reach statistical significance. There was insufficient data to investigate change in hearing aid use over the first two years post-fitting.

Discussion

There were significant amounts of missing datalogging information. Some of the missing data was attributed by the clinical teams to lost hearing aids or unattended appointments. It is also believed that time restraints in clinic are the primary barrier. The datalogging values are lower than expected. It is considered that up to 12 hours per day use is necessary for good speech and language development. The findings highlighted that many families struggle to achieve optimal hearing aid usage in their infants. There was an association between daily device use and one socioeconomic status predictor.

Conclusions

Average datalogging values for daily hearing device use were lower than considered optimal for 0-2 year olds with permanent childhood deafness. The only factor related to these findings was IDACI Decile indicating that infants from more deprived backgrounds may achieve lower hearing aid usage than those from the lesser deprived regions. This finding needs to be verified on a larger scale and better understood to explore potential approaches to overcome the problems. The role of multiple factors also needs to be explored with a larger sample size. This would require a multi-centre study to be conducted.