Protocol for the provision of amplification within the Ontario Infant hearing program

Abstract

Abstract

This document describes the protocol for the provision of amplification to infants and preschool children registered with the Ontario infant hearing program (OIHP) in Canada. The provision of amplification includes the prescription and dispensing of hearing instruments to infants and preschool children identified with permanent childhood hearing impairment (PCHI) in the province of Ontario. The first section deals with the structure and processes of the program, while the second section specifies the clinical procedures that are applied in providing hearing instruments to infants and young children with hearing impairment.

Sumario

Este documento describe el protocolo para el suministro de amplificación a niños y preescolares registrados en el programa de audición infantil de Ontario (OIHP) en Canadá. El suministro de amplificación incluye la prescripción y entrega de instrumentos auditivos a niños y a preescolares identificados con discapacidad infantil auditiva permanente (PCHI) en la provincia de Ontario. La primera sección trata sobre la estructura y los procesos del programa, mientras que la segunda sección, especifica los procedimientos clínicos que se aplican para suministrar instrumentos auditivos a bebes y ninos pequeños con discapacidad auditiva.

Key Words:

• Congenital hearing loss
• Hearing instrument fitting
• Early hearing detection and intervention

Acknowledgements

The authors gratefully acknowledge the support of the Early Learning and Child Development Branch and the Children's Corporate Systems Branch of Ontario's Ministry of Children and Youth Services in Canada.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Note

[1]. The first fitting of a device is usually tracked in the OIHP database. Data for those infants who received a cochlear implant following the use of a hearing instrument have not been uniformly tracked within the program. This probably results in a lower number of reported cochlear implant users in the OIHP.

Appendix

No response ABR

For infants in whom no response is indicated on the ABR and ANSD is presumed absent, amplification should be provided cautiously.

The following procedure is recommended:

1. If no response (NR) was noted on the ABR during the assessment, the audiologist prescribing amplification must consult with the audiologist who conducted the assessment to determine the highest level (dB nHL) that was presented at each frequency in each ear during the ABR.

2. The frequency-specific correction must be applied to the indicated dB nHL level (see Bagatto, 2008) to obtain a corrected threshold in eHL.

3. Subtract 5 from the resulting eHL value if the threshold search was conducted using 10-dB step sizes. If 5-dB step sizes were used, skip Step 3.

In such cases, continued observation and assessment of the infant are especially important.