Parent report of the development of auditory skills in infants and toddlers who use hearing aids

Drorit Ben-Itzhak*, Tally Greenstein, Liat Kishon-Rabin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objectives: This study investigated the use of the Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) as a measure of early auditory skill development in aided infants and toddlers with varying degrees of hearing loss. Specific goals were (1) to rate the change in IT-MAIS score as a function of change in hearing thresholds achieved through amplification; (2) to establish the hierarchy of early auditory skill development for infants who use hearing aids (HAs) relative to what is known in infants with normal hearing; and (3) to analyze background information variables that may account for differences in IT-MAIS performance, as age and duration of HAs use. Design: The study included 106 infants and toddlers (47 girls and 59 boys) aged 7 to 36 months (mean = 19.02, SD = 7.7) with various degrees of sensorineural hearing loss (mean = 86.42 dB, SD = 22.52). Infants used bilateral digital HAs with a mean experience of 8 months. All participants attended the same early intervention program. After at least 2 months of HA use, parents were interviewed with the IT-MAIS questionnaire regarding the auditory behavior of their infants in everyday situations. Results: The results of the present study support the following outcomes: (1) on average, every 10 dB gain in pure-tone average scores (PTA4) threshold improved the IT-MAIS score by 10%; (2) infants who were part of the same unaided hearing categories appeared to have derived different benefits from amplification; (3) when reaching the same aided category, those infants who were originally in a better unaided hearing category achieved higher IT-MAIS scores than those who belonged to a worse unaided hearing category; (4) the hierarchy of auditory development in young aided infants with hearing loss followed that of normal hearing peers; and (5) 62.9% of the variance of IT-MAIS performance was explained by aided hearing level (50.3%), unaided hearing level (6.4%), and duration of HA use (6.2)%. Conclusions: The present study provides important information to assist clinicians and parents in setting realistic expectations regarding the auditory behavior of infants as a function of aided and unaided thresholds. It emphasizes the need for assessing functional hearing in young infants and not relying on hearing thresholds alone. Such data can also contribute to the decision-making process when selecting a sensory device (e.g., HA versus cochlear implant) for infants with hearing loss.

Original languageEnglish
Pages (from-to)e262-e271
JournalEar and Hearing
Issue number6
StatePublished - 2014


  • Amplification
  • Early auditory skills
  • Hearing aids
  • Hearing loss
  • Parental assessment


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