We would like to dedicate this column about the past year's most significant developments in pediatric audiology to Dr. Judy Gravel, who contributed enormously to enhancing hearing care for children for more than 30 years. Dr. Gravel, who left us a year ago, was a major inspiration for pediatric audiologists around the world.
Last year was one of great advances and innovations for children. Here are those we consider most important:
10. Bone conduction comes into vogue: Not so long ago the use of bone-conduction hearing aids required an unsightly and uncomfortable apparatus. In addition, unsophisticated procedures were used to fit these devices. Recent advances in surgically implanted devices have led to a plethora of research supporting the use of bone-anchored hearing aids for children with conductive or single-sided deafness. This year, the release of new digital bone-conduction devices that allow numerous clinician-adjustable parameters and an in situ fitting process should serve to further enhance the benefit of these devices for this select population of children.
9. Dedicated pediatric instruments: Last year saw the introduction of hearing aids specifically designed for children. Pediatric audiologists have spent years fabricating pediatric uses out of adult products. Manufacturers are starting to look at the pediatric market as one that deserves special attention.
8. Dynamic FM for cochlear implant users: Noise continues to lead the list of problems for hearing-impaired children. In her work, Dr. Linda Thibodeau showed the benefits of Dynamic FM for hearing aid wearers. Studies published in 2009 demonstrated substantial improvement in speech recognition in noise for cochlear implant users using this technology.
7. Stem cells from skin cells: When the distinguished otologist Dr. Richard Myamoto gave the Marion Downs Pediatric Audiology lecture at AudiologyNOW! 2009, he mentioned that stem cell research may hold significant potential as an inner ear therapy to ameliorate cochlear hearing loss. This research has been limited by the ethical dilemmas associated with the use of stem cells extracted from embryos and fetuses. A breakthrough occurred last year when researchers found they could use stem cells extracted from skin cells to create genetic duplicates of the parent. This makes it likely that today's young children will eventually benefit from research exploring molecular therapies for sensory hearing loss.
6. How low can we go for kids with moderate hearing loss? Frequency-lowering technology for children with severe-to-profound hearing loss has drawn attention for the past decade. Dr. Patricia Stelmachowicz and colleagues have showed that children with moderate hearing loss struggle with the same limitations in speech recognition and production for sounds above 4000 Hz as their severely hearing-impaired counterparts. Research published in 2009 found that frequency-lowering technology could reduce the deleterious effects of moderate hearing loss on the recognition and production of high-frequency sound.
5. Hearing technology built “kid tough”: Cheers to technology designed to defend against moisture, which is the leading cause of faulty circuits and down time for children's high-tech hearing devices. A new cochlear implant sound processor has even received a “water-proof” rating when used with a rechargeable battery! The industry's efforts at waterproofing are long overdue and greatly appreciated.
4. Troubleshooting made easy: Remote controls and lights that signal a properly functioning device are making troubleshooting easier for parents and caretakers. In addition, diagnostic checks can point to problems in a child's hearing technology. Peace of mind is now only a remote/light away.
3. Auditory Neuropathy Spectrum Disorder (ANSD): A recent gathering of great minds published a guideline describing a sound contemporary protocol for the assessment and management of children with ANSD.
2. Richard Seewald: One of the most prolific pediatric audiologists/hearing researchers of all time announced his retirement last year. Dr. Seewald leaves a profoundly positive imprint on our profession and the lives of children around the world. Thank you, Dr. Seewald, for all you've done for our profession and for leaving an outstanding team of researchers in your place.
1. Dollars for babies: For the second year in a row, funding for pediatric audiology programs tops our list of crucial issues. Despite the global economic downturn, Congress extended funding for Early Hearing Detection and Intervention programs through 2010. However, the Senate has yet to approve funding for EHDI beyond 2010. We urge readers to advocate for federal programs that support early intervention, newborn hearing screenings, and hearing technology for the home and school. Your voice does make a difference.