Children's amplification needs--same or different from adults?

Hearing aid fitting strategies for children have largely developed separately from those for adults. There has, however, been little consideration of whether children's amplification requirements are different, except for the physical effects of differences in ear canal size. This paper summarizes the fitting strategies for children, and examines whether children require more (or less) gain for high-, medium- or low-level sounds, or a different frequency response, compared with adults with similar hearing loss. Research relating to the above questions is reviewed. The gain that children require for high-level sounds is not different than for adults because loudness discomfort levels are similar. The gain children prefer for medium-level sounds is the same, or only slightly more, than is preferred by adults. Children may require greater gain for low-level sounds because they do require higher signal levels to achieve the same level of speech understanding as adults do. There are, however, arguments why more gain for low-level sounds may not be desirable. The frequency response children prefer is the same as that preferred by adults. New methods for evaluating individual fittings are briefly discussed.