Five percent of children have disabling hearing loss, yet the most common form—mild-to-moderate hearing loss (MMHL)—is the least understood. Only 34% of these children achieve two A-levels, compared to 55% of their hearing peers. The problem is that auditory technology (AT) like hearing aids and classroom streaming devices is designed for how adults communicate—assuming the listener looks at the speaker and asks for repeats. But children with normal hearing do not look. It is unknown whether children with MMHL look at talkers while listening, so the algorithms may be mismatched to how children actually hear. Over 18 months, the iCAT project will test three possibilities: children are not wearing their AT; the devices are “too much of a good thing,” weakening natural listening skills; or the AT is simply inappropriate for children. The team will measure eye and head movements and brain activity in a lab classroom, and systematically review AT usage across UK schools. If the research succeeds, it could change how hearing aids and classroom devices are fitted for children—shifting from adult-based designs to child-appropriate algorithms. This would directly affect educational outcomes, closing the attainment gap for the 5% of children with disabling hearing loss.
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Five percent of children have disabling hearing loss. These children often experience delayed speech and language development. Although the majority of these children attend mainstream schools in the UK, only 34% achieve two A-levels (or the equivalent), compared to 55% of their hearing peers. Mild-to-moderate hearing loss (MMHL) is the most common hearing impairment in children. However, despite the effect of their hearing impairment on development it is the least understood form of hearing loss in children. This means there is an urgent need for research on this group in order to meet the goal set by the National Deaf Children's Society (the UK's biggest children's hearing charity and a partner on this project) of making sure that "by 2030, no deaf child will be left behind". Children with MMHL are prescribed auditory technology (AT) to assist them. Hearing aids are more advanced and accessible than ever, and assisted listening devices - where a talker's speech is streamed directly to the hearing aid to reduce the effects of a noisy background - are now common in classrooms. However, AT is designed based on how adults communicate: adults generally look at the person they are talking with and ask for information to be repeated when they do not hear clearly. On the other hand, children with normal hearing do not look. It is unknown if children with MMHL look at the talker while they listen. This has an impact on the effectiveness of the AT algorithms. PI Stewart has shown that children with MMHL do not have the same improvements in attention, memory and learning as adults do when using AT. This could be due to 1) the children are not wearing their AT; 2) the ATs are "too much of a good thing" and have short- or long-term effects on key hearing and listening skills (e.g. children have found that they can hear without turning to look at the talker); or 3) the ATs are not appropriate for children. To test these hypotheses, we will first systematically review children's AT usage across the UK. Second, we will gather data on the developmental impact of ATs over an 18-month period. Key hearing and listening skills including working out where a sound came from and combining audio with visual information will be assessed. Third, we will assess how children with MMHL communicate with adults and children. We will do this in a research lab in the form of a classroom where eye and head movements and brain activity can be measured. This will allow iCAT to evaluate if AT algorithms (e.g. designed for the listener to look at the talker) are appropriate for children. iCAT will work with industry, audiologists and teachers of the deaf throughout the project to ensure change towards providing child-appropriate ATs for the benefit of children with MMHL. Through the publication of white papers, iCAT will work with UK-based charities and professional bodies to create evidence-based recommendations for policy regarding the use and fitting of the AT in children with MMHL.
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