Purpose: The aim of this study was to determine the influence of early fitting of hearing devices to children with congenital unilateral hearing loss (UHL) on language, speech production, functional auditory performance, and social skills at age 3 years. Method: This is a randomized controlled trial (RCT) of hearing device fitting versus no fitting with two parallel groups. Assessments at age 3 years included directly administered standardized tests of speech production and language as well as parent reports on functional performance and social interactions in real life. Analyses were done according to the intention-to-treat principle. A subgroup analysis examined the influence of early language environment. This trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12615000651583). Results: A total of 109 children who were randomly assigned ( n = 57 in the intervention group and n = 52 in the control group) were included. On average, the cohort achieved language outcomes similar to normative populations at the same age but underperformed on measures of speech production and functional performance in noise. The main analyses showed no significant differences in outcomes between groups. The effect of device fitting was not significant. The subgroup analyses revealed that conversational turns at ages 12–15 months had a stronger effect than device fitting on language and vocabulary. Conclusions: This RCT showed that device fitting had no significant impact on outcomes at age 3 years, but early language input has a strong positive effect on language outcomes. This information will be valuable to parents and clinicians considering whether to provide hearing devices to infants with UHL. Interventions to enhance nurturing talk and improve listening in noise should be explored further.
Ching et al. (2026) studied this question.