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Hearing loss is an important health concern in Canada's Arctic. The objective of this research was to provide information on the prevalence of childhood hearing loss in Nunavut. This cross-sectional study involved comprehensive audiologic assessments of school-aged children in six communities to determine overall and community-specific prevalence of hearing loss. Data were collected about hearing aid use and factors affecting use through a parent questionnaire. Assessments were completed for 644 children in kindergarten to grade 6. 124 (19.3%) children had hearing loss of ≥ 30 dB HL at one or more frequencies in at least one ear (93.5% conductive loss). Applying a Canadian prevalence study definition, 148 (23.5%) children had hearing loss. Tympanic membrane perforations were present in 36.8% (n = 28) of children with unilateral and 45.8% (n = 22) with bilateral loss. The prevalence of hearing loss in Canada's North was almost three times that reported for non-indigenous children. One in five school-aged children was found to have hearing loss that is likely to affect classroom learning and social/emotional development. A hearing health strategy tailored to this population is critically needed. [ABSTRACT FROM AUTHOR]

Abstract The relative effectiveness of the NAL-NL1 and the DSL4.1 prescriptions for 48 children with mild to moderately severe hearing loss was studied using a double-blind, four-period, two-treatment cross-over design in Australia and in Canada. Evaluations included speech perception tests, loudness ratings, reports from parents and teachers on functional performance in real life, children's self-reports, paired-comparison judgements of intelligibility, and children's preferences in real-world environments. Electroacoustic measures of hearing aids revealed that gain differences dominated the comparison. Across trials and measures, individual Australian children consistently preferred either the NAL-NL1 or the DSL v.4.1 prescription. An overall figure of merit (FOM), calculated by averaging the standardized difference scores between prescriptions for all measures, revealed that the strongest prescription-related differences were found in Australia. On average, an advantage and preference for the NAL-NL1 prescription was associated with lesser degrees of hearing loss. This research provides evidence on the effectiveness of the NAL-NL1 and DSL v.4.1 prescriptions, and highlights the need for evaluating and fine-tuning amplification to meet the diverse needs of individual children in real life. Sumario Se estudió la relativa efectividad de las prescripciones NAL-NL1 y DSL 4.1 en 48 niños con pérdidas auditivas de leves a moderadamente severas, usando un estudio doble ciego, en cuatro períodos y con un diseño cruzado de dos tratamientos en Australia y en Canadá. Las evaluaciones incluyeron pruebas de percepción de la palabra, tasas de reclutamiento, auto-reportes de los niños, juicios de inteligibilidad comparados por pares y preferencias de los niños en ambientes de mundo real. Las mediciones electroacústicas de los auxiliares auditivos revelaron que las diferencias en ganancia dominaron la comparación. En todas las pruebas y mediciones, los niños Australianos individualmente prefirieron de manera consistente tanto la prescripción NAL-NL1 como la DSL v.4.1. Una figura global de mérito (FOM), calculada al promediar las puntuaciones de diferencias estandarizadas entre prescripciones de todas las medidas, revelaron que las diferencias más fuertemente relacionadas con la prescripción, se encontraron en Australia. En promedio, la ventaja y preferencias hacia la prescripción NAL-NL1 se asoció con grados menores de pérdida auditiva. Esta investigación proporciona evidencia de la efectividad de las prescripciones NAL-NL1 y DSL v.4.1 y pone de relieve la necesidad de evaluar y de afinar la amplificación para alcanzar las diversas necesi-dades individuales de los niños en la vida real. [ABSTRACT FROM AUTHOR]

Abstract This paper reports real world preferences of children in a double-blind, cross-over trial comparing NAL-NL1 and DSL v.4.1 prescriptions. Twenty-four children wore digital WDRC hearing aids at each site (Australia, Canada). Multi-memory hearing aids provided the NAL and DSL programs in each of two memories. Diaries were completed during two counterbalanced trials, providing overall preference, situational preference, and preference comments. Ratings were reliable, and situational preferences factored into quiet/low level situations versus noisy/reverberant/high level situations. Children at both sites used DSL v4.1 for hearing low level speech, or when they wanted to hear loudly and clearly. Children used NAL-NL1 when they wished to hear sounds at a lower level, or to reduce background noise. Children expressed strong preferences for having the choice of both programs. Canadian children were more likely to prefer DSL than were the Australian children. Factors such as listening environment and prior listening experience are discussed in interpreting these findings. Sumario Este trabajo reporta las preferencias de los niños en el mundo real, en un estudio cruzado, doble-ciego que compara las prescripciones NAL-NL1 y DSL v4.1. Veinticuatro niños de dos sitios (Australia, Canada) utilizaron auxiliares auditivos digitales con WDRC. Los auxiliares auditivos con multi-memoria contaban con los programas NAL y DSL en dos de sus memorias. Se completaron diarios durante dos ensayos balanceados que proporcionaban información sobre la prefer-encia general, la preferencia situacional y comentarios sobre la preferencia. Las puntuaciones fueron confiables y la preferencia situacional se clasificaron en situación silente/nivel bajo versus situación ruidosa/reverberante/nivel alto. Los niños de ambos lugares utilizaron DSL v4.1 para escuchar el habla a intensidad baja o cuando querían escuchar alto y claro. Los niños expresaron una fuerte preferencia por poder tener la opción de ambos programas. Los niños canadienses tendieron a preferir DSL más que los niños australianos. Factores como el ambiente sonoro y las experiencias auditivas previas se discuten y se interpretan los hallazgos. [ABSTRACT FROM AUTHOR]