1 Ear Institute, 4919 University College London , UK.
2 Department of Audiology, 156708 Whipps Cross University Hospital , London, UK.
Trends Hear. 2017 Jan-Dec;21:2331216517744094. doi: 10.1177/2331216517744094.
Recording of free-field cortical auditory evoked potential (CAEP) responses to speech tokens was introduced into the audiology management for infants with a permanent childhood hearing impairment (PCHI) during 2011-2015 at a U.K. service. Children with bilateral PCHI were studied from two sequential cohorts. Thirty-four children had followed an audiology pathway prior to CAEP introduction, and 44 children followed a pathway after the introduction of CAEP and were tested with unaided and aided CAEP responses. Data analysis explored the age of diagnosis, hearing aid fitting, and referral for cochlear implant (CI) assessment for each of these groups. CAEP offered a novel educative process for the parents and audiologists supporting decision-making for hearing aid fitting and CI referral. Delays in hearing aid fitting and CI referral were categorized as being due to the audiologist's recommendation or parental choice. Results showed that the median age of hearing aid fitting prior to CAEP introduction was 9.2 months. After the inclusion of CAEP recording in the infant pathways, it was 3.9 months. This reduction was attributable to earlier fitting of hearing aids for children with mild and moderate hearing losses, for which the median age fell from 19 to 5 months. Children with profound hearing loss were referred for CI assessment at a significantly earlier age following the introduction of CAEP. Although there has also been a national trend for earlier hearing aid fitting in children, the current study demonstrates that the inclusion of CAEP recording in the pathway facilitated earlier hearing aid fitting for milder impairments.
2011 年至 2015 年期间，英国的一项服务开始将自由场皮质听觉诱发电位（CAEP）对语音令牌的反应记录纳入永久性儿童听力障碍（PCHI）婴儿的听力学管理中。双侧 PCHI 的儿童从两个连续队列中进行了研究。34 名儿童在引入 CAEP 之前遵循了听力学途径，44 名儿童在引入 CAEP 后遵循了途径，并进行了未助听和助听 CAEP 反应测试。数据分析探讨了这些组的每个组的诊断年龄、助听器适配和人工耳蜗植入（CI）评估的转诊情况。CAEP 为支持助听器适配和 CI 转诊决策的父母和听力学家提供了一个新颖的教育过程。助听器适配和 CI 转诊的延迟被归类为由于听力学家的建议或父母的选择。结果表明，在引入 CAEP 之前，助听器适配的中位数年龄为 9.2 个月。在将 CAEP 记录纳入婴儿途径后，这一数字降至 3.9 个月。这一减少归因于轻度和中度听力损失儿童的助听器更早适配，其中中位数年龄从 19 个月降至 5 个月。引入 CAEP 后，极重度听力损失儿童更早地接受了 CI 评估的转诊。尽管儿童助听器适配的全国趋势也有所提前，但本研究表明，将 CAEP 记录纳入途径有助于轻度听力障碍的助听器更早适配。
