title: Trends and Predictors of Longitudinal Hearing Aid Use for Children Who Are Hard of Hearing.
abstract: OBJECTIVE
  Children who are hard of hearing (CHH) have restricted access to acoustic and linguistic information. Increased audibility provided by hearing aids (HAs) influences language outcomes, but the advantages of appropriately fit HAs can only be realized if children wear their devices on a consistent basis. The purpose of this article was to characterize long-term HA use in CHH, based on parent-report measures, and identify factors that influence longitudinal trends in HA use.
  
  
  METHODS
  Participants were parents of 290 children with mild to severe hearing loss. At every visit, parents estimated the average amount of time the child used HAs per day during the week and on the weekends. Parent reports of daily HA use were analyzed to determine if different patterns of HA use were observed longitudinally during the study. Independent predictor variables were then related to longitudinal trends in HA use within three age groups (infant, preschool, school age).
  
  
  RESULTS
  On average across multiple visits, parents reported that their children wore their HAs for 10.63 hr per day (SD = 3.29). Data logging values were lower than parent-report measures (M = 8.44, SD = 4.06), suggesting that parents overestimated daily HA use. The majority of children in each age group wore HAs at least 8 hr per day from their first research testing interval to their last, based on parent-report measures. Maternal education level predicted longitudinal trends in HA use for infants and school-age CHH. Degree of hearing loss was related to trends in school-age children only.
  
  
  CONCLUSIONS
  These results indicated that the majority of CHH increased HA use over time, but a sizable minority demonstrated a low level of use or decreased use in the time period studied. Maternal education level influenced longitudinal trends in daily HA use. Degree of hearing loss influenced trends in school-age children only. Audiologists and early intervention service providers might aid in improving HA use by providing regular hands-on training with the HAs and individualized problem-based strategies to address the challenges families experience with attaining a high level of use. Families may also benefit from practical demonstrations of the benefits of consistent HA use, such as hearing loss simulations, examples of listening in noise with and without HAs, or listening to malfunctioning HAs.
authors.affiliation: 1Department of Communication Sciences and Disorders, University of Iowa, Iowa City, Iowa, USA; 2Center for Childhood Deafness, Boys Town National Research Hospital, Omaha, Nebraska, USA; 3Department of Biostatistics, University of Iowa, Iowa City, Iowa, USA; and 4Department of Otolaryngology, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Walker
authors.forename: Ryan W
authors.initials: RW
authors.lastname: McCreery
authors.forename: Meredith
authors.initials: M
authors.lastname: Spratford
authors.forename: Jacob J
authors.initials: JJ
authors.lastname: Oleson
authors.forename: John
authors.initials: J
authors.lastname: Van Buren
authors.forename: Ruth
authors.initials: R
authors.lastname: Bentler
authors.forename: Patricia
authors.initials: P
authors.lastname: Roush
authors.forename: Mary Pat
authors.initials: MP
authors.lastname: Moeller
mesh_terms: D001301:Audiometry, Pure-Tone; D002648:Child; D002675:Child, Preschool; D004522:Educational Status; D005260:Female; D006310:Hearing Aids / Q000706:statistics & numerical data*; D006312:Hearing Loss, Bilateral / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012720:Severity of Illness Index