Vol. 12 • Issue 1 • Page 24
The industry has made great strides in hearing aid technology in recent years. The range and the quality of the devices available are changing the way we treat hearing loss-ultimately improving the lives of wearers. Pediatrics in particular has evolved into a specialized segment deserving a unique approach and technologies specific to younger patients.
The traditional approach to hearing aid design was to first address the needs of the older, more mature patient. Manufacturers focused technologies and solutions on the larger hearing loss audience with the intent of later adapting these devices for use with pediatric patients. This lack of detailed attention to the needs of children left many of the unique issues specific to children without a viable solution.
Children with hearing loss have very different needs than adults. They need to hear all types of sounds in order to properly develop speech and language skills, and they have changing needs in classroom settings and new social environments. Children also need hearing instruments that are durable and safe in design that can withstand the daily rigors of even the most active lifestyles.
Today, manufacturers design hearing instruments that are truly pediatric in size, shape and feature set. Manufacturers begin by focusing on what children need and how lifestyle activities differ from those of adult wearers. Through this process, pediatric devices are developed with very specific feature sets including appearance and specific attention to details that engage a child's interest to create a positive experience.
Flexibility
It is critical that children can grow with their hearing aids. As pediatric patients mature, so too will the features they require. Many of the top pediatric devices have features that children won't use right away, like a directional microphone. As we know, the directional microphone suppresses sound from behind a child. For very young wearers, it is vital to their development that they be able to hear each unique sound around them. In this listening situation, most audiologists recommend that the device remain in omnidirectional mode.
However, as a child develops and is introduced into a classroom setting, possibly around the age of 3 or 4, the child's device will need to be adjusted to accommodate this new environment. In this situation, the flexibility of the device's feature set is critical to each patient's development.
Several of the advanced features offered in today's pediatric devices include the following. These features can be disabled or modified depending on a child's listening and educational needs:
• True binaural listening by synchronizing advanced signal procession, controlling both instruments simultaneously and providing better left-to-right sound localization;
• Sound dampening that softens startling impulse sounds;
• Speech and noise management that automatically reduces distracting background noise for greater comfort in noisy environments;
• Reduction of wind noise for better outdoor use;
• Automatic detection and reduction of feedback whistling;
• Data logging to retain relevant usage data, allowing for quicker and more efficient visits with the audiologist.
Safety and Reliability
Device safety and reliability also must be addressed in pediatric device design. Simple features, such as a locking battery door, rounded push buttons, durable parts that cannot be broken off and swallowed, and ear hooks that can't be taken off resulting in bodily harm, are just some of the key safety features that differentiate a top-quality pediatric device from the standard adult device. More complex features that must be integrated into the casing design include indicator lights for parents and caregivers. Indicator lights give parents the reassurance that their child's device is working correctly or signal that an adjustment, such as a battery change, needs to be made.
These devices also are designed to withstand the daily activities of even the most active child. To protect against day-to-day wear and tear, special nano-coatings are directly integrated into the device casings to shield against outside elements like dirt and moisture. In the case of pediatric patients, it is important to avoid having the device off of the child if at all possible. The additional layer of protection offered by this integrated nano-coating gives these devices greater durability and higher reliability.
There are also a number of protective covers that can be worn over the hearing device; offering maximum protection. These covers also add an additional safety feature in the form of a clip that attaches to the child's clothing so that the hearing aid can't accidentally be knocked off and become damaged.
Tools for the Professional
Just as changes in the device design process have advanced the solutions we offer children, so too has the pediatric fitting software available to audiologists. The process of fitting a pediatric patient must be approached differently than that of an adult to account for unique fitting workflow and basic physical differences. For example, standard adult fitting software may not correctly prescribe the correct sound pressure in a child's ear due to the reduced ear canal volume of young children.
Manufacturers are recognizing that audiologists need additional tools to address these differences. To ensure that none of the specific requirements of these unique patients is overlooked, pediatric fitting software should incorporate a detailed "workflow" different from that of adult patients. Several components of pediatric fitting software include real-ear-to-coupler difference (RECD), DSL and NAL fitting algorithms.
Regardless of the software used, the key to a successful fit is in the specialized approach and attention to unique pediatric fitting requirements.
Learning Devices for Success
Hearing instruments are the first step for children with hearing loss, but there are a number of peripheral devices that address educational and social situations a child is set to encounter. As a child is introduced to the classroom environment, direct audio input (DAI) becomes critical to a child's ability to interact with their teacher. The most common approach in the classroom is to have the teacher wear a microphone that provides direct input to the device worn by the hearing impaired child.
In the evolution of new classroom technology, device design may trend toward Bluetooth® integration and the merging of Bluetooth and FM platforms. There will most likely remain the need for a transmission device that connects directly to a child's hearing instrument, but Bluetooth and other wireless technologies may offer students increased levels of connectivity in coming years.
There are several products on the market today that connect hearing instruments with devices such as Mp3 players, game consoles, cell phones, and televisions. This same technology needs to be integrated into the learning environment so children are hearing more than just what the teacher is saying, but also capturing the responses of their classmates.
The benefits of Bluetooth-enabled devices go far beyond the classroom setting. Wireless connectivity provides children with true normalcy among their peers and improved social acceptance. Whether a child is playing video games with their friends or listening to music on their own, Bluetooth and other wireless devices help children with hearing loss develop naturally and avoid awkward social situations. The industry is currently challenged to educate children and parents about the devices available. While complete connectivity is the tangible benefit, social acceptance for each pediatric patient is the ultimate goal.
Wireless remote technology will see Bluetooth integration in future devices and possibly a shift toward a "communication device." The idea behind a "communication device" is to create a device smaller than today's Bluetooth headsets. This device will offer the benefits of both amplification and wireless connectivity to everyday devices. Either way, the goal is to eliminate the need for a streaming device all together. Until then, there are several wireless remote products that can make a true impact on a child's life.
Beyond the Device
The advanced technologies in pediatric devices are giving children with hearing loss the tools they need to develop speech and language skills from a very early age. Hearing loss is being detected much earlier now and children are being fit at a much younger age. Not long ago, it was common to see an 18- to 24-month-old child come in for their first hearing test. Now we are testing children in the newborn unit in the hospital, with approximately 95 percent being tested just after birth.
With nearly one out of 10 American children having a hearing loss termed "educationally significant," parents and caregivers need to be well informed about pediatric hearing loss and the special support that is needed in terms of speech and language development. Advanced digital technology coupled with comprehensive parent education can help them adjust to wearing hearing instruments and reach their full potentials.
This parental education needs to be ongoing and promoted within the industry. Parents and caregivers must be made aware of the challenges that their children will face throughout their developmental process. The most effective way to address this is for the audiologist to provide consistent counseling and a thorough course-of-treatment plan through the child's adolescence. While this plan is not set in stone and will be adapted to fit the child's changing needs, this approach produces an informed caregiver that understands the necessary steps to protect their child's critical development process. Children with hearing loss face a more difficult road through adolescence, but through counseling and preparation, caregivers can help mitigate some of these issues and provide the most normal childhood possible.
There are resources available for those families in need of additional assistance. Programs like Quota International understand the importance of identifying hearing loss in children and helping them develop their potential both socially and academically. Through partnerships with hearing aid manufacturers, the Quota International program provides hearing instruments for children who are financially disadvantaged. Quota handles the evaluation process of each child and works directly with hearing care providers to ensure complete treatment.
Manufacturers also are dedicating resources to helping pediatric patients adjust to their hearing impairment. Innovative and interesting peripheral materials make learning to care for and use hearing aids a more positive experience.
The technologies and feature sets offered in today's devices give pediatric patients and their families the resources necessary to enjoy normal childhood development. Feature-rich devices and wireless accessories provide safety, but these devices only go so far in treating a patient's hearing loss. As an industry, it is critical to remember that normal development and social acceptance are end goals that can only be achieved through comprehensive treatment. This begins with the device manufacturers are designing for the individual patient and the hearing professional taking the time to treat each patient and family on an individual basis. Children with hearing loss deserve the best start possible, and they are fortunate to have manufacturers and audiologists alike dedicated to their cause.
Thomas Powers, PhD, is vice president, Audiology & Compliance, at Siemens Hearing Instruments.
The ADVANCE Guide to Pediatric Aids And Accessories
Ear Gear
Ear Gear Baha
Ear Gear announces Ear Gear Baha. Designed to easily fit most models of Baha produced by Cochlear, Ear Gear Baha is available in beige, in both corded and cordless models. Like all Ear Gear models, Ear Gear Baha protects the processor from sweat, moisture, dirt, and loss. Ear Gear Baha can be purchased on the Ear Gear Web site at $28.95 for the cordless model and $32.95 for the corded model: wholesale prices are available from lead distributors Westone, Oaktree and Warner Tech-care.
For more information about Ear Gear products: 888-766-1838, www.gearforears.com, mark@gearforears.com
Oticon
Oticon Safari
Oticon Safari is a family of hearing instruments designed exclusively for children ages 0 to 18. With three attractive price points and six models in total, Safari delivers highly desirable features, including: extended bandwidth to support language development; binaural processing to improve spatial awareness and localization; and wireless connectivity for easy access to phones, TVs and communication/entertainment devices. Safari's intelligent LED indicator lets parents, teachers and caregivers know with certainty that the hearing instrument is functioning properly.
New Pediatric Support Materials
In connection with the introduction of the new Safari family of pediatric hearing instruments, Oticon Pediatrics now offers a catalog of current and new support materials. The catalog, which includes an order form, is divided into three sections: materials for professionals, for parents and teachers, and for children and teens. A number of new brochures are geared specifically to school-age children and teens, including the Connectivity Guide and Plugged In, a new comic series. Spanish language brochures are also available for parents and other caregivers.
National Loaner Bank
Oticon's National Loaner Bank Program provides hearing instruments for a 3-month period to children under age 3 while third-party reimbursement is secured or while cochlear implant evaluation is underway. The latest Oticon pediatric hearing solutions-the Safari family-are offered, as well as Amigo FM transmitters. To utilize the Loaner Bank, hearing care professionals must have an Oticon account and complete a one-time application. There is no fee to participate in the Loaner Bank program.
For more information about Oticon Pediatrics products: www.pediatrics@oticonusa.com
Phonak
Nios micro
Nios was specially designed to provide children with the audibility and clarity needed to optimize speech and language outcomes. Nios features high-level feedback elimination,
frequency compression and FM technology. The Sound
Recover technology has been proven in independent labs around the world to improve the recognition of high frequency speech sounds and plurals. Nios offers the dependability, confidence and safety that is essential for children to live life without limits.
Naida SP/UP
With its unique performance and features, Naida delivers the promise of digital technology to children with moderate to profound hearing loss. Naida is offered in two power levels and can be coupled with design-integrated or universal dynamic FM for unprecedented performance in noise. With its water-resistant housing and Phonak's unique SoundRecover technology, Naida wearers have access to speech and the freedom to live life without limits.
Audeo Yes
Audeo Yes answers the challenges of the teenage years. With its award-winning design and appealing colors, Audeo Yes meets the cosmetic needs of older children without compromising performance. The features of the CORE portfolio, including SoundRecover, maximize understanding, and the two receiver options extend the fitting range from mild through moderately-severe. With full wireless functionality, teens can have seamless access to cell phones, MP3 players, FM and other gadgets important in teen life.
For more information about Phonak products: www.phonak.com
SeboTek
Sebo HD
SeboTek has long been an industry leader for providing wide bandwidth hearing instruments where high fidelity sound is given top priority. Sebo HD hearing instruments provide unmatched sound quality with up to 111 channels of processing, 14 kHz bandwidth, Bluetooth® connectivity, and many other new advanced features in a newly-designed smaller case.
For more information about SeboTek products: 800-388-9041, www.sebotek.com, info@sebotek.com
Siemens Hearing Instruments, Inc.
Explorer
Siemens Explorer is specially designed for children from birth to adolescence with moderate through severe hearing loss. Explorer can withstand the everyday activities of childhood, while it is small enough to fit perfectly behind the ears of younger wearers. It has been developed with particular attention to safety. Explorer can be used in a classroom setting using trusted FM technology, enabling the child to more clearly hear the teacher's voice. Explorer also can be enhanced with the Tek.
Disney Pediatric Kit
Siemens Hearing Instruments Inc., in partnership with The Walt Disney Company, offers the Disney Pediatric kit to young wearers and their parents. Inside the kit's colorfully-illustrated Disney lunchbox are the items needed to care for hearing instruments and help children and parents understand and adjust to hearing loss in a positive way, including a Mickey Mouse plush and an exclusive book, Three Cheers for Bunny's Ears!
For more information about Siemens Hearing Instruments products: www.siemens.com/healthcare. For more information on Siemens' Disney Pediatric kit: www.hearitforthefirsttime.us/us
Unitron
360
360™ provides children with innovative technology that helps them to communicate, learn and thrive in their daily lives. 360 is purpose-built with technologies specifically tailored for severe to profound hearing loss. Many of 360's features can be customized, as required, to adapt to a growing child's needs. Engineered for durability and reliability, 360 is Enviro-Tough™ and comes with the benefits of the Kids Club program.
For more information about Unitron products: www.unitron.com
VanB Enterprises LLC
Hearing Aid Sweat Band
The Hearing Aid Sweat Band is made from specially-
designed, all-natural fabric that sheds moisture, protecting the hearing aid from the damaging effects of moisture. This enables the wearer to leave a hearing aid in place during high-perspiration sport activities or any time protection from moisture, dust and dirt is needed. Nine sizes in 17
colors are available for all makes and models of BTE devices. The Hearing Aid Sweat Band is made in USA.
For more information about VanB Enterprises products: 866-644-2500, www.hearingaidsweatband.com, info@vanbenterprises.com
Widex
Mind 440
Widex hearing aids are designed with children in Mind™! Mind hearing aid features will help you achieve your pediatric fitting goals, including: audibility of the softest sounds with a compression threshold as low as 0 dB HL, a high quality signal and comfortable output with dual integrated signal processing and 'Trusound' AOC. Additional features include: HA RECD measurement capability, self-test, automatic FM activation, programmable LED, extended bandwidth, and frequency transposition.
Mind 330
Achieve audibility of the softest sounds with a compression threshold as low as 0 dB HL, a high-quality signal and comfortable output with dual integrated signal processing and 'Trusound' broadband and narrowband AOC. Additional features include: self-test, automatic FM activation, programmable LED, extended bandwidth, and frequency transposition.
Inteo, Aikia and Flash
The focus is audibility in all levels of Widex hearing aids. All levels are available in moderate gain and mini-power, and in standard-, mini- and micro-sized cases.
Features include integrated signal processing, in-situ threshold measurement, compression threshold as low as 0 dB HL, active Fb cancellation, automatic FM activation with adjustable direct audio input, and self-test.
For more information about Widex products: 800-221-0188, www.widexPro.com
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