A significant portion of hearing-impaired children have additional disabilities, but data about the maturation of their auditory cortex are scarce. In these children, behavioral tests are often unreliable, and objective tests are needed for diagnostics and follow-up. This study aimed to explore auditory cortical maturation and language development, and the usability of an objective electroencephalogram-based biomarker in children with multiple disabilities. In 65 hearing aid and cochlear implant users (36 females; 36 with multiple disabilities; 44.3 ± 18.5 months of age, mean ± SD), auditory processing was examined using the P1 cortical auditory evoked response biomarker, and language development with the Preschool Language Scales 5th edition (PLS-5). During the study, all of the children received intensive extra language therapy for six months. No significant differences were found between the groups in P1 latency development, the proportion of abnormal P1 latencies, or the number of children whose P1 latencies changed from abnormal to normal during the study. The PLS-5 total language scores, auditory comprehension scores, or expressive communication scores did not differ between groups either. The P1 latencies showed meaningful negative correlations with the language scores. The results suggest that auditory cortex development is similar in hearing-impaired children with/without additional disabilities, and the P1 biomarker is a feasible tool to evaluate central auditory maturation in children with multiple disabilities.

The aim of this study was to examine the relationship between an American English Digits in Noise (DIN) test and commonly used audiological measures to evaluate the DIN test’s ability to detect hearing loss and validate hearing aid fitting. QuickSIN and DIN tests were completed by participants with untreated hearing loss (n = 46), prescription hearing aids (n = 15), and over-the-counter (OTC) hearing aids (n = 12). Performance on the QuickSIN showed moderate positive correlations with DIN for untreated hearing loss participants and prescription hearing aid users, but not for OTC hearing aid users. For untreated hearing loss participants, both QuickSIN and DIN tests showed positive moderate to strong correlations with high frequency puretone averages. In OTC users, DIN scores did not significantly change over a 6-month time period and were better when conducted remotely compared to in-person testing. Our results suggest that the DIN test may be a feasible monitoring option for individuals with hearing loss and those fitted with hearing aids. However, due to small sample size in this pilot study, future research is needed to examine DIN test’s utility for fitting and validating OTC hearing aids.

Objectives: To investigate the gain provided by self-fitting over-the-counter (SF-OTC) hearing aids compared to clinical NAL-NL2 targets, the differences between various FDA-approved SF-OTC devices, and potential changes in gain over time. Methods: Two experiments were conducted: (1) a cross-sectional comparison of six SF-OTC hearing aids (n = 43) and (2) a longitudinal evaluation of gain within five days of self-fitting and four additional time points (n = 15). Real-ear measurements (REMs) were used to measure gain. Results: SF-OTC hearing aid gain corresponded with 10 dB SPL but not 5 dB SPL criteria from NAL-NL2 targets. Differences between NAL-NL2 targets and gain did not differ significantly between devices. There were no significant changes in gain over time for any input level. Conclusions: SF-OTC hearing aids generally provide user-selected gain levels lower than clinical targets, particularly at higher frequencies. The gain remains stable over time, indicating limited user adjustment after initial fitting. OTC hearing aid manufacturers should consider implementing fitting algorithms that allow for gradual user acclimatization.

Background/Objectives: The cortical auditory evoked potential P1 response is a biomarker of cortical auditory maturation for tracking longitudinal cortical maturation in children with hearing loss after treatment with hearing aids and/or cochlear implants. In conjunction with hearing treatments, children with hearing loss commonly receive language therapy services. However, the effect of language therapy on cortical maturation in hearing loss is less well studied. Methods: This study explored auditory cortical maturation changes, using the P1 response, with coinciding language changes, utilizing the Preschool Language Scales test, following approximately six months of supplemental listening and spoken language therapy services in 39 children with hearing aids or cochlear implants. Results: Following supplemental language therapy, P1 latencies significantly decreased in all children, at a rate found to be significantly faster than expected for typical maturation. Language scores also significantly improved beyond expected maturation effects and were correlated with P1 latencies following supplemental therapy. Overall, with approximately six months of therapy, the children in this study made significantly greater gains of 9 to 10 months in total language and expressive communication. A subgroup analysis revealed that children with cochlear implants showed significantly lower language scores than their chronological age following supplemental therapy, while children with hearing aids obtained language scores that were not significantly different to their chronological age at follow-up. Conclusions: Overall, the results from this study showed that supplemental language therapy resulted in more typical auditory cortical maturation and improved language abilities and that the P1 CAEP response can objectively track neuroplastic changes in children as a function of language therapy provided in conjunction with hearing aids and CIs.