There is a lot of discussion in pediatric audiology about when to start using remote microphone systems for little ones with hearing loss. The opinions vary from shortly after we fit them with hearing aids (mine) to not until they start school. My view about early use of FM may come from the state of technology when I started in this field in the 1960’s. We did not have hearing aids with enough output to provide good auditory access to children with severe and profound hearing loss. And cochlear implants were not yet available. When FM first became available they were in body worn devices that had hearing aid and remote microphones in them. I fit children with these body worn devices and parents wore the microphones. The kids did well. Parents reported that wearing that microphone around their necks was a constant reminder that they needed to talk talk talk.
Children learn what they hear. Children with hearing loss, like their typical hearing peers, need a lot of language exposure if they are to learn. Research by Hart and Risley (1995) and others have made it clear that the more exposure a child has the better their language is and the higher their IQ is. Research shows that children who wear well fit hearing aids, even 10+ hours/day still have language delays. It is reasonable to conclude that compromised exposure to good linguistic output is a factor in delayed language skills for children with hearing loss. Listening in background noise is a well know problem for children and adults with hearing loss. Remote microphones certainly help reduce the negative effects of background noise.
The Journal of Speech, Language, Hearing Research just published an article which confirms the advantages of early home use of remote microphones. Benitez-Barrera et al (2018) did a study in which then evaluated home use of remote microphone systems on spoken language of caregivers of children with hearing loss. They demonstrates that children who’s parents used a remote microphone system at home had access to approximately 42% more language exposure than when a remote microphone system ways not used.
The reasons for this are multiple. First, even if the child is at distance from the caregiver, and even when there is background noise, she will be receiving a loud and clear signal. In addition, knowing that the child hears what they are saying will encourage caregivers to talk more.
So should all children with hearing loss have remote microphones?
I understand the concern that some audiologists make, that children should not be fit with remote microphones until they are capable of reporting problems with the equipment. I disagree. I understand the concern but the advantages of good language exposure are overwhelming. Certainly for children with hearing aids, the parents can listen to the hearing aid in their daily hearing aid check and can also listen to the remote microphone and will know if it is working. True, this is more difficult to do when children are using cochlear implants but we can observe responses and monitor performance.
The data that supports how much a child benefits from exposure to language is overwhelming. Babies should be fit with remote microphone when they are fit with technology!!! Parents need to demand it. Listening and spoken languages need to demand it. Audiologists need to provide them. Let’s make use of the data have and provide babies with the ability to be the best they can be.
*featured image courtesy hearingfirst