Clinical and sociodemographic predictors of hearing aid use in infants aged 0-2 with permanent childhood hearing loss: a retrospective cohort single-site pilot study

Abstract Objectives: The aim of this study was to identify differences in hearing aid use among infants aged 0-2 years with respect to clinical and sociodemographic factors in an attempt to better predict which patients and families may benefit from extra support in the early stages of hearing aid fitting to encourage optimum usage. The secondary aim was to investigate how hearing aid use changed over the first two years post-fitting. Methods: A retrospective review of records was performed on 252 patients, aged 0-2 years with permanent childhood hearing loss from a single-site hospital who were fitted with hearing aids between 2005-2022. Ninety-six patients met the inclusion criteria. Datalogging values were collected for six different time points post fitting that coincided with their routine clinical follow-up appointments: 2 weeks, 6 weeks, 6 months, 12 months, 18 months and 24 months. Clinical and sociodemographic information was also collected for each participant. This included sex, average pure tone threshold, unilateral vs bilateral use, speech intelligibility score, additional disabilities, Index of Multiple Deprivation, Income Decile, Education and Skills Decile, Income Deprivation Affecting Children Index (IDACI), ethnicity and home language. Results: The datalogging results indicated a median average of 4.67 hours (3.0-7.3) hours per day use across patients and across the first two years post-fitting. Differences in datalogging according to IDACI Decile was significant (p=0.01), suggesting that infants from the more deprived groups (1-5) used their devices less. All other predictors did not reach statistical significance. There was insufficient data to investigate change in hearing aid use over the first two years post-fitting. Discussion: There were significant amounts of missing datalogging information. Some of the missing data was attributed by the clinical teams to lost hearing aids or unattended appointments. It is also believed that time restraints in clinic are the primary barrier. The datalogging values are lower than expected. It is considered that up to 12 hours per day use is necessary for good speech and language development. The findings highlighted that many families struggle to achieve optimal hearing aid usage in their infants. There was an association between daily device use and one socioeconomic status predictor. Conclusions: Average datalogging values for daily hearing device use were lower than considered optimal for 0-2 year olds with permanent childhood deafness. The only factor related to these findings was IDACI Decile indicating that infants from more deprived backgrounds may achieve lower hearing aid usage than those from the lesser deprived regions. This finding needs to be verified on a larger scale and better understood to explore potential approaches to overcome the problems. The role of multiple factors also needs to be explored with a larger sample size. This would require a multi-centre study to be conducted. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement No external funding was directly provided for this study. E.G is undertaking a funded HEE/NIHR Predoctoral Clinical Academic Fellowship (NIHR302719). D.A.V is funded by an MRC Senior Fellowship in Hearing (MR/S002537/1) and NIHR programme grant for applied research (201608). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Health Research Authority and Health and Care Research Wales gave ethnical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors.