Audiometric Configurations in Children

Recent studies suggest that the amplification needs of children and adults differ due to differences in perceptual ability. For example, several studies have confirmed that children realize greater benefit from a more audible speech signal (Stelmachowicz, Hoover, Lewis, Kortekaas and Pittman 2000; Stelmachowicz, Pittman, Hoover, Lewis and Moeller 2004), a higher signal-to-noise ratio (Hall and Grose 1991; Veloso, Hall and Grose 1990), and an extended frequency response (Kortekaas and Stelmachowicz 2000; Stelmachowicz, Pittman, Hoover and Lewis 2001) compared to adults. In addition to these aspects, a comparison of the audiometric configurations of these two groups also may be appropriate. The hearing losses of children have been observed in clinical practice to be unlike those of adults in that they are not typically sloping in configuration. Because pure-tone thresholds are used to prescribe amplification characteristics (e.g., gain, output, compression), it seemed reasonable to compare the audiometric configurations of children and adults to determine whether or not differences that are fundamental to amplification exist. For that reason, Pittman and Stelmachowicz (2003) compared the audiometric configurations, bilateral symmetry, and progression of hearing loss over time in children and adults with hearing loss. The purpose of this chapter is to describe the results of that study as well as several additional analyses that highlight interesting aspects of amplification in children.