Minimal Hearing Loss: From a Failure-Based Approach to Evidence-Based Practice

Allison M. Winiger

Committee:

Joshua Alexander, Ph.D. (co-Chair)

Lata Krishnan, Ph.D. (co-Chair)

Allan Diefendorf, Ph.D. (co-Chair)

Despite such advances to both identify and provide appropriate care for children with hearing loss, some children are still comparatively underrepresented in the literature and underserved in our community. These children include those with Minimal Hearing Loss (Minimal HL), a broad category that includes unilateral, mild bilateral, and high frequency hearing loss. There is no universal protocol for the care and management of children with Minimal Hearing Loss. In order to determine the risks associated with Minimal Hearing Loss and to establish appropriate evidence-based care for its affected population, an extensive review of the existing literature was conducted. Results indicated that children with Minimal Hearing Loss are at risk for deficits in multiple domains, including speech recognition, language skills, academic performance, psychosocial and emotional well-being, listening effort, and localization abilities. Although it was traditionally assumed that these children required little to no intervention, the majority of evidence supports the opposite notion. Not only are children with Minimal Hearing loss at a disadvantage in their young life, but these disadvantages also have the potential to continue into adulthood. Several methods of appropriate intervention have been supported by evidence, such as the use of classroom modifications, FM systems, and hearing aids among others. However, due to large variability among the affected population and limited research investigating the effects of intervention, good clinical judgment must be used to determine the most appropriate care for each child on an individual basis.