This article summarises the current evidence and a recent study examining the factors influencing language development in children fitted with hearing aids in order to aid clinical decision making. The aims were to examine amplification factors that could be targeted for intervention rather than unchangeable factors such as the degree of hearing loss or age of identification of the hearing impairment. The study presented relates to a comparison between 302 children with hearing loss and 112 children with normal hearing aged between two and six years. The degree of hearing loss, audibility of speech through the aids and the amount and duration of hearing aid use were evaluated through a series of audiograms, indexes and questionnaires. As expected, poorer language abilities were found in children with hearing loss and the language ability correlated with the severity of hearing loss within each age group. Language ability development was better for those children with better audibility of speech through their aids. Similarly, the children who wore their aids for more than 10 hours a day had better language development trajectories compared to those wearing aids for less amount of time.
Fitting children at earlier ages also appears to improve language ability, but despite this, by six years of age, children who are identified with hearing loss later had closed any discernible gap in progression with the earlier fitted group.
Together, this demonstrates that the amount of audibility provided by the hearing aid helps to predict language development over time and late identification of hearing loss does not necessarily determine a poor outcome. This is certainly encouraging evidence that is useful in the counselling of parents of young patients with hearing loss.