Evaluating the physical fit of receiver-in-the-ear hearing aids in infants

J Am Acad Audiol. 2013 Mar;24(3):174-91. doi: 10.3766/jaaa.24.3.4.


Background: In spite of early identification and intervention efforts achieved by Early Hearing Detection and Intervention (EHDI) programs, many infants with hearing loss experience delays in early vocabulary development in comparison to peers with normal hearing (Mayne, Yoshinaga-Itano, Sedey, 2000a; Mayne, Yoshinaga-Itano, Sedey, Carey, 2000b; Moeller et al, 2007a, 2007b). One of the several factors that may contribute to individual differences in outcomes is inconsistent hearing aid use in this age group. This may be associated with the physical fit when using traditional behind-the-ear (BTE) hearing aids, since they are relatively large in comparison with the small and soft ear of an infant. Receiver-in-the-ear (RITE) hearing aids may be advantageous for use in pediatric fittings, since they are very tiny and lightweight and therefore sit comfortably on a small soft ear.

Purpose: To evaluate the use of a RITE hearing aid with an instant ear-tip especially developed for infants in terms of physical fit, stability, safety, and security of the device, as well as the use of retention tools (remedies for keeping the hearing aid securely on the ear) with this age group.

Research design: A longitudinal study with hearing impaired infants fitted with RITE hearing aids was performed.

Study sample: Eighteen infants with mild to moderate/severe hearing loss participated in the study. The age range was 2-36 mo. Sixteen infants had worn hearing aids prior to their participation in the study.

Intervention: Each hearing impaired infant was fitted with the RITE hearing aid and an instant ear-tip, the size of which was chosen by the audiologist. The infants used the device for a period of 2-5 mo.

Data collection and analysis: Audiologists and parents completed questionnaires at every visit (5-7 visits in total). Responses were obtained using a category rating scale (Stevens, 1975) from 0 to 10. The data were analyzed using descriptive statistics and nonparametric statistics.

Results: Sixteen of the 18 children completed the study. At the end of the study, 11 of the 16 children were using the instant ear-tip, whereas five children were fitted with the receiver mounted in a custom earmold. The audiologists rated the RITE solution to provide a safe, stable, and secure fit. The general trend was that ratings improved over time. At the final follow-up session, all median ratings were between 8 and 10.

Conclusions: Based on the positive results obtained in the study, the use of an appropriately designed RITE hearing aid is recommended for infants.

MeSH terms

  • Audiometry, Pure-Tone
  • Child, Preschool
  • Ear, External / anatomy & histology*
  • Female
  • Follow-Up Studies
  • Hearing Aids*
  • Hearing Loss, Sensorineural / diagnosis
  • Hearing Loss, Sensorineural / rehabilitation*
  • Humans
  • Infant
  • Infant Behavior
  • Male
  • Organ Size
  • Parents
  • Prosthesis Design*
  • Prosthesis Fitting / methods*
  • Surveys and Questionnaires