Abstract:
Prescribing hearing technology (HT) to children with hearing loss is based on the expectation that it will improve auditory-based communication outcomes, literacy, occupational prospects, and psycho-social wellbeing. The desired effect, however, can only be achieved if appropriate HT is used optimally to foster consistent, cumulative auditory experiences comparable to peers with normal hearing. Therefore, a better understanding of the factors that influence HT use in children with hearing loss is necessary to guide hearing healthcare services and facilitate auditory-based outcomes. This study aimed to identify and describe predictors of daily HT use in children with hearing loss. A retrospective review of clinical records collected data, including demographic, family, intervention, socio-economic, audiology-related, and HT information. The study sample included 505 children (<11 years of age), fitted with hearing aids (HAs), cochlear implants (CIs), and bone conduction hearing devices (BCHDs), and enrolled in a South African auditory-oral intervention program between 2010 and 2018. Results demonstrated an average HT use of 9.4 hours a day for the entire sample. Multiple regression analyses were performed to identify predictor variables that influenced HT use. From the 42 variables included in the retrospective dataset, the bivariate analyses yielded 31 potential predictor factors. The final general linear model (GLM; p <.01, R2= 0.605) identified 10 interacting factors that were significantly associated with increased HT use in children. Intrinsic predictors of increased HT use included a more severe degree of hearing loss, older ages at diagnosis and initial HA fitting, and older chronological age. Extrinsic predictors included the child’s ability to independently use HT, at least one CI as part of the HT fitting, coordinated onsite audiological management, self-procured batteries, auditory-oral communication mode, and regular caregiver intervention attendance. Six of the 10 predictors identified were novel and previously undescribed in the literature, including CI recipiency, independent HT use, caregiver intervention attendance, older ages at diagnosis and initial HA fitting, and self-procured batteries. In conclusion, the average HT use for this study sample was high but below recommended all-day HT use. Although HT use is a multi-factorial outcome measure, an extensive range of predictive factors was identified that could predict and increase HT use in children. Additionally, four of the predictors, both novel and extrinsic, are malleable, signifying that intervention can change the outcome, namely HT use. These newly described predictors of HT use can contribute to evidence-based intervention services that promote optimal auditory-based outcomes.
