ASHA journals
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Pediatric bone-conduction hearing devices: Decisions and outcomes (Edwards et al., 2024)

online resource
posted on 2024-04-19, 17:26 authored by Lindsey Edwards, Laura Middleton-Curran, Gillian Wright, Natasha Rooney, Anita Wong, Rebecca Hill, Neil Bulstrode, Robert Nash

Purpose: The decision to proceed with bone-conduction hearing devices is not an easy one despite being the audiological management of choice for the majority of children with unilateral hearing loss secondary to microtia–atresia, and the outcome is not always as hoped for. This study aimed to explore parent and child views on decision making and outcomes.

Method: Qualitative methods (focus groups and individual interviews) were used to explore parent and child opinions on factors influencing the decision to try a bone-conduction device and their subsequent use or nonuse. Quantitative methods (questionnaires) investigated the impact of hearing loss on listening effort and fatigue, quality of life, and learning, including executive functions such as working memory, information processing, and attention. Twelve parent–child dyads participated in the study, with children aged 9–14 years.

Results: A thematic analysis of qualitative data highlighted the importance to parents of timely, consistent, and accessible device information as well as concerns regarding bullying, psychosocial well-being, and educational impacts. Children’s concerns included feeling different from their peers, bullying, device appearance, and sound quality, as well as the support they wanted and received. Questionnaire results provided useful confirmatory information on the impacts of unilateral hearing loss on learning for a substantial proportion of the children in this sample.

Conclusion: The findings provide insights into the wide range of issues that have implications for the provision of audiological services as well as educational and psychological support for children with unilateral microtia–atresia.

Supplemental Material S1. Parent and child focus group interview questions.

Supplemental Material S2. Additional quotes for each theme and subtheme.

Edwards, L., Middleton-Curran, L., Wright, G., Rooney, N., Wong, A., Hill, R., Bulstrode, N., & Nash, R. (2024). Parent and child experiences of bone-conduction hearing devices for unilateral microtia–atresia: Decisions and outcomes. Perspectives of the ASHA Special Interest Groups, 9(3), 582–598.


This work was funded by the National Institute for Health and Care Research (NIHR) Biomedical Research Centre at Great Ormond Street Hospital to Robert Nash. Robert Nash was also partially funded by the NIHR Biomedical Research Centre at University College London Hospitals.