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Enregistrement W2329642437 · doi:10.1097/01.hj.0000369574.59915.19

A pediatric hearing aid fitting Bill of Rights

2010· article· en· W2329642437 sur OpenAlexaboutno aff
George A. Lindley

Notice bibliographique

RevueThe Hearing Journal · 2010
Typearticle
Langueen
DomaineMedicine
ThématiqueEthics and Legal Issues in Pediatric Healthcare
Établissements canadiensnon disponible
Organismes subventionnairesnon disponible
Mots-clésHearing aidHearing lossAudiologyDigital subscriber lineMedical prescriptionMedicinePsychologyTelecommunicationsComputer scienceNursing

Résumé

récupéré en direct d'OpenAlex

The 21st century has seen a rapid evolution in technology designed for children with hearing loss. To maximize the potential for a child to benefit from 21st-century technology, it becomes critical to use a 21st-century fitting approach. To that end, I would like to propose the following “Pediatric Hearing Aid Fitting Bill of Rights.” In my opinion, every child with a hearing loss has a right to these fundamental aspects of a hearing instrument or FM fitting. (1) Early and accurate diagnosis and treatment The rapid decrease in the age at which hearing loss is first diagnosed is perhaps the greatest audiologic success story of the 21st century. To what extent this success leads to better outcomes is highly dependent on how quickly amplification is provided. Fortunately, today's diagnostic technology allows for frequency-specific audiometric data to be obtained early in a child's life. Audiologists can be more confident in the initial settings of instruments fitted at a very young age. (2) Appropriate, verified HA settings While Canada (DSL) and Australia (NAL) may debate which fitting rationale is better for children, the use of an empirically derived, audibility-friendly prescription is critical. Pediatric hearing aid settings are generally more aggressive since speech and language are still developing. Independent strategies such as DSL 5.0 and NAL-NL2 provide different prescriptions for infants and young children versus adults who acquire hearing loss later in life. Manufacturers' device-specific rationales are generally not developed with the needs of a child in mind and tend to be less audibility-driven. Once an appropriate fitting strategy is chosen, verification of the settings is critical. This is best achieved using a speech stimulus at multiple presentation levels. Using aided sound-field threshold data to evaluate the fitting gives an incomplete picture and can lead to inaccurate conclusions. Documenting real-ear output via in situ measures or by using a test box while incorporating child-specific real-ear-to-coupler-difference (RECD) values represents the best-case scenarios. If reliable measures cannot be made via probe microphone, use of appropriate, age-based average RECD values is critical. (3)Access to high-frequency speech cues With increases in hearing aid bandwidth, improvements in feedback-cancellation algorithms, and the advent of frequency-lowering technologies, the days of being satisfied with audibility out to 4000 Hz are numbered. For children with mild to moderately severe hearing loss, a wide bandwidth is generally indicated to maximize speech understanding. Fortunately, entry-level hearing aids with a wide bandwidth and phase-cancellation feedback algorithms are increasingly available. Bandwidth need not be sacrificed to cost considerations. In determining if a child is benefiting from aided high-frequency information, appropriate speech-testing materials are necessary. Word recognition in quiet using traditional pediatric speech measures may not be sensitive enough to capture the benefit obtained by a wider bandwidth. For children with greater degree of high-frequency loss for whom audibility cannot be provided or for those who are unable to extract information from the aided high-frequency signal, frequency-lowering technologies are a viable option. (4) Access to the teacher's voice Classrooms are often noisy and reverberant. The distance between the teacher and child varies. FM is a proven technology for overcoming these obstacles. “Right” #2 applies here as well, though. The combination of FM system with hearing instruments presents some unique challenges. Therefore, verification of the FM fitting is important. The same equipment used to verify the hearing aid fitting can be used to verify an FM fitting. The AAA has an excellent DVD on this. For rights #5-#10, see Hearing and Children in the May Hearing Journal!

Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.

Comment cette classification a été obtenuedéplier

Prédiction distillée sur la base complète

Imitation des enseignants

Ni prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.

score de la tête « metaresearch » (Codex)0,002
score de la tête « metaresearch » (Gemma)0,001
Version: codex-gemma-dda1882f352aStatut de validation: machine_predicted_unvalidated
Catégories candidatesIntégrité de la recherche
Catégories consensuellesaucune
DomaineSignal candidat: aucune · Signal consensuel: aucune
Devis d'étudeSignal candidat: Observationnel · Signal consensuel: Observationnel
GenreSignal candidat: Empirique · Signal consensuel: Empirique
Score de désaccord entre enseignants0,240
Score d'incertitude au seuil0,999

Scores Codex et Gemma par catégorie

CatégorieCodexGemma
Métarecherche0,0020,001
Méta-épidémiologie (sens strict)0,0000,000
Méta-épidémiologie (sens large)0,0000,000
Bibliométrie0,0000,000
Études des sciences et des technologies0,0000,000
Communication savante0,0000,000
Science ouverte0,0000,000
Intégrité de la recherche0,0000,003
Charge utile insuffisante (le modèle a refusé de juger)0,0000,000

Scores machine (provisoires)

Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.

Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.

Tête enseignante Opus0,048
Tête enseignante GPT0,354
Écart entre enseignants0,306 · la distance entre les deux têtes enseignantes sur ce seul travail
Statut de validationscore_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle

Classification

machine, non validée

Prédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.

Devis d'étudeObservationnel
Domainenon disponible
GenreEmpirique

Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».

En bref

Citations0
Publié2010
Routes d'admission1
Résumé présentoui

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