Small Talk: 11 in ’11: Top highlights in pediatric audiology

Figure: iStockphoto.com/CarmenMartínezBanúsBetween extreme weather and worldwide economic troubles, 2011 was not exactly a stellar year. Sports fans suffered through labor disputes and lockouts while politicians elevated finger-pointing to a new art. But thanks to amazing researchers and clinicians, 2011 was a great year for pediatric audiologists and children with hearing loss. For your consideration, our top 11 list for 2011. (Pediatric hearing health care couldn't be contained in a mere 10 highlights!)Figure: Jace Wolfe11. Pediatrics got a best seller!The Comprehensive Handbook of Pediatric Audiology: Leave it to Richard Seewald, PhD, to step up yet again and give us an authoritative, comprehensive text for managing children with hearing loss. With the help of his co-editor, Anne Marie Tharpe, PhD, and inspired by the late Dr. Judy Gravel, this book is a must-have resource for any clinician who has children walking through his clinic door. 10. So that's why a cochlear implant works: In a recent supplemental issue of Ear and Hearing, Ann Geers, PhD, and colleagues describe the most recent results of their longitudinal study of children with cochlear implants. (2011;32[1]:2S-12S.) Jam-packed with quality information describing myriad factors that influence outcomes, these are important data for any researcher working with pediatric implant recipients. 9. Get it wet! Hearing aid and cochlear implant manufacturers are making solid attempts at developing devices that can be worn when kids dive head first into the pool. Kids just want to be kids, and shouldn't have to forego water play because of their hearing aids. Let's hope that this waterproofing trend continues. 8. Fancy is good: This was the year that research provided information necessary to determine if all the fancy technology we have is really good for kids. Todd Ricketts, PhD, shed light on the application of directional technology for children while Pat Stelmachowicz, PhD; Ryan McCreery; and Andrea Pittman, PhD, all published on digital noise reduction for children. Susan Scollie, PhD; Daniel Glista; Andrew John, PhD; and others continued to demonstrate the benefits of nonlinear frequency compression for children. Good job, guys. Please keep it coming. 7. Probe mic vs. real life. The UWO Pediatric Amplification Validation Battery: Pediatric audiologists have been impressed with our ability to turn amplification fittings into a scientific battery of protocols designed to claim an evidence-based, scientifically grounded strategy for hitting targets. We've put so much emphasis on it yet we've ignored the more important validation: outcomes. Marlene Bagatto, AuD, and colleagues at the University of Western Ontario have raced to the rescue by developing a battery of measures to validate the efficacy of our fittings on the littlest ears. Be on the lookout for these measures to make their way into your clinic. Probe mic measures are great, but we must also make certain we see a positive change in the life of the child. 6. Plural Test makes it to the clinic: Hearing aid manufacturers responded to Pat Stelmachowicz's research supporting adequate audibility beyond 8000 Hz by developing hearing aids with frequency-lowering technology and wideband frequency responses. Unfortunately, clinicians have not been equipped with a tool to evaluate a fitting beyond 8000 Hz. Efforts are underway to develop electroacoustic tools to evaluate the efficacy of high-frequency fittings. In the meantime, Scollie, Glista, and colleagues at UWO developed the Plural Test to assess a child's ability to discern high-frequency speech sounds. The test is simple to administer, appears to be sensitive to a child's access to high-frequency speech, and is now commercially available. Check it out. 5. Therapy on the go: There's a plethora of new applications that can be downloaded onto phones, tablets, and computers. These apps make therapy portable, and give a wide variety of options for parents and teachers to use. Most importantly, kids don't know it's therapy—thanks to young entrepreneurs like the one that started Smarty Ears (smartyearsapps.com). 4. Children riding on a hybrid: Researchers at the University of Iowa led by Bruce Gantz, MD, and Sick Kids Hospital in Toronto led by Blake Papsin, MD, are conducting trials to evaluate hybrid cochlear implants for children who have severe-to-profound high-frequency hearing loss and usable low-frequency hearing. Implant manufacturers are also working on developing long electrode arrays and insertion techniques that minimize damage to residual hearing and delicate cochlear structures. These efforts should improve the listening abilities of children with cochlear implants, and may also maintain children's candidacy for inner therapies developed in the future. 3. Kids and corticals: The year 2011 will be remembered as one in which major steps were made in the transition of cortical auditory evoked potential (CAEP) assessment from the lab to the clinic. Harvey Dillon, PhD, and colleagues at the National Acoustic Laboratories in Australia published findings on CAEP with infants. They showed that statistical analysis can reliably be used to detect CAEP responses. They also demonstrated that the presence of a CAEP response is often related to functional outcomes and between-subject differences exist in response presence as a function of sensation level. Anu Sharma, PhD, and colleagues showed CAEP assessment could be used to improve management of children with auditory neuropathy spectrum disorder, and Papsin and colleagues showed important differences in the CAEP response for children who received bilateral cochlear implants in simultaneous procedures compared with children for whom a long period of time elapsed between the receipt of their first and second implants. Most importantly, equipment is being developed to allow this test to be completed in a clinically friendly manner. Over the next few years, CAEP testing will most definitely play an increasingly larger role in managing children with hearing loss. 2. iTech for the ears: As audiologists, it's tough to admit that our elementary-aged children know just as much about technology as we do. In response, manufacturers are designing hearing technology to resemble consumer electronics. Remote controls are beginning to look like products produced by Apple. We have seen children go from being lukewarm about hearing technology to being totally pumped to receive a slick MP3-looking remote. Taking things a step further, hearing aid companies are producing apps that allow wearers to use a smartphone to control and troubleshoot hearing technology. (Hearing Journal, November 2011.) Kids will love this, and it gives parents an easy way to adjust hearing technology, and confirm that it is working appropriately. 1. Datalogging on steroids! LENA Software: Psychologists Betty Hart and Todd Risley in 1995 showed that the variation in children's spoken language ability is directly related to the amount parents speak to their children. They estimated that children with good language abilities had heard 48 million words by the time they were 4. As professionals, we know that our technology and therapies are worth little if the children we serve are not exposed to an enriching auditory lifestyle. The LENA pro is a small device that analyzes up to 16 hours of audio data, and classifies the amount of exposure to meaningful speech a child needs to develop spoken language. Maybe we're dorks, but we think this a really awesome idea. We encourage you to research this product and its application for your patients. Essentially, it's a huge tool that has been missing from our toolbox. Hearing aid and cochlear implant manufacturers should strive to incorporate this technology within their devices.

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