Children who are deaf or hard of hearing (DHH) are likely to exhibit difficulties in development of psychosocial skills, pragmatic language skills, and use of hearing for social communication in real-world environments. Some evidence suggests that pragmatic language use affects peer-relationships and school engagement in these children. However, no studies have investigated the influence of functional auditory performance and use of language and speech in real-world environments on children’s behavior and emotion, and on their health-related quality of life. This study explored the relationship in DHH children at 9 years of age. Data from 144 participants of the Longitudinal Outcomes of Children with Hearing Impairment study were analyzed. Parent reports were obtained on quality of life, behavior and emotion, pragmatic language skills, and auditory functional performance of children in real life. Children’s spoken language abilities and speech intelligibility were assessed by research speech pathologists. On average, performance of children in all domains was within the range of typically developing peers. There were significant associations among functional auditory performance, use of speech and language skills, psychosocial skills, and quality of life. Multiple linear regression analyses revealed that better auditory functional performance and pragmatic language skills, rather than structural language abilities, were associated with better psychosocial abilities and quality of life. The novel findings highlight the importance of targeted intervention for improving functional hearing skills and social communication abilities in DHH children, and emphasize the importance of collaborative approaches among medical, audiology, allied health, and educational professionals to identify those at risk so that timely referral and intervention can be implemented for improving psychosocial health and well-being in DHH children.

To describe the development and evaluation of the NAL-NL3 Comfort in Noise Module; a new algorithm for determining hearing-aid gain that is part of the NAL-NL3 fitting system. Single-site multi-study design with each study and subsequent perceptual modelling informing refinements to module gain targets. Participants completed laboratory studies to investigate gain preferences and to evaluate the effect of the module on speech understanding in noise. Participants also completed real-world evaluations using a smartphone-based Ecological Momentary Assessment app with different brands of hearing aids. 83 adult hearing aid users with mild to severe hearing loss. The new module selectively reduced gain (compared with the NAL-NL3 Prescription) by imposing a limit on the total loudness. Iterative refinements led to progressive increases in user preferences favouring the new module over the NAL-NL3 Prescription in noise with respect to listening comfort. Laboratory-based testing identified no detrimental impact on speech perception in noise. Reducing the level of prescribed gain for hearing aid users in noise compared to in quiet improves comfort without significantly degrading speech understanding. This work supports the broader philosophy of the NAL-NL3 fitting system to provide specialised targets for different populations, situations and device technologies.

Lack of standardised information about hearing aid technologies presents a barrier to individuals seeking to understand and make informed choices about the hearing aid features they may benefit from. (1) To identify features in contemporary hearing aids as described in publicly available materials. (2) To develop a lexicon of hearing aid features that informs consumers about available technologies. A synthesis of published information on the features of contemporary hearing aids from six major manufacturers was conducted by a multidisciplinary research team. The analysis and categorisation of these findings was an iterative, agile process involving five distinct phases, Scoping, Extracting/Decoding, Mapping, Synthesising and Consulting. 119 documents/publications were included in this review. These materials comprised 14 product guides and specification data sheets, and 105 white papers and technical articles. We identified 253 unique features (e.g. Feedback Management) across 12 hearing aid devices (including both premium and entry-level models). This resulted in the development of a lexicon describing the core capabilities of modern hearing aids. Data synthesis identified key features of contemporary hearing aids across device models and manufacturers to inform the design of a lexicon for use by consumers.