Background: Most children with hearing loss have hearing thresholds in the mild-to-severe range in one or both ears. The majority of these children (approximately 80 percent) are candidates for hearing aids. When fitted adequately for individual hearing thresholds and ear canal acoustics, hearing aids can minimize developmental delays; however, evidence suggests that children have a wide range of outcomes in terms of the quality of the hearing aid fitting. Purpose: This study explored the effects of sociodemographic variables on the quality of pediatric hearing aid fitting outcomes. Research Design: Hearing aid verification data were gathered using a prospective, longitudinal design. Study Sample: The sample consisted of 297 children with permanent bilateral hearing loss who wore air conduction hearing aids. Data were collected between 2009 and 2018. All children were participants in a multicenter collaborative project focused on characterizing service delivery and developmental outcomes of children with mild-to-severe hearing loss. Data Collection and Analysis: Children participated in a comprehensive audiological evaluation and hearing aid verification. To quantify deviation from prescriptive hearing aid targets, we calculated the root mean square error (RMSE) at 500, 1000, 2000, and 4000 Hz. We used an ordinal logistic regression to model the probability of a child having a well-fitted hearing aid based on sociodemographic variables. Results: Our analysis indicated that the geographic location of the participants was significantly associated with the quality of pediatric hearing aid fittings. Children from metropolitan and micropolitan areas had a higher probability of having a well-fitted hearing aid than that of children from rural areas. We also found a significant effect of race. Non-White children had a higher probability of having a well-fitted hearing aid compared with that of White children. We did not find any effects of sex, age, or maternal educational level. Conclusions: Children who live in rural areas are at higher risk for disparities in the early hearing detection and intervention process compared with children who live in more urban settings. These delays in service delivery may extend to the intervention process. Children who live in rural areas are more likely to experience suboptimal hearing aid fittings than children from more urban areas. Audiologists must actively promote accessibility to hearing-health care for underserved pediatric clients.
Walker et al. (Thu,) studied this question.