Efficacy of advanced hearing aid technology for children with listening difficulties

This study will evaluate two types of TGA-approved hearing aids to address listening challenges in children: Deep neural network (DNN)-enabled hearing aids and traditional directional microphone hearing aids. DNN hearing aids use artificial intelligence to process and enhance speech signals in complex acoustic environments, such as classrooms, by effectively separating speech from background noise. In comparison, directional microphone hearing aids rely on beam-forming technology to focus on sound from a specific direction (usually in front of the listener) while reducing background noise. For all participants, these hearing aids will be used during two key contexts: (1) laboratory testing and a (2) four-week take-home trial. 1. In the laboratory-based assessment, children will take part in structured auditory tests, administered by a Research Audiologist, to measure their ability to attend to and understand speech in challenging listening environments. Participants will be asked to perform 3 tasks unaided (no device) and while wearing the devices (aided): 1. Speech perception in noise. For this task participants will need to listen to and repeat target sentences (City University of New York-like (CUNY-like) sentence list), which will be played sequentially from 3 loudspeakers positioned at 0, 90, and 180 degrees azimuth while competing background noise (4-talker babble) is played from 4 loudspeakers positioned in the corners of the room). The stimuli will be delivered at a signal to noise ratio of 0dB and the participant will be seated in the centre of the room. This will take approximately 40 mins for all conditions (unaided, with DNN-based hearing aids and with directional microphone hearing aids). 2. Ability to locate sounds. This will require the participants to sit in the middle of a 16-channel loudspeaker array and pinpoint which of the speakers are producing a sound. This will take approximately 30 mins for all conditions. 3. Visual and auditory attention. This will be assessed using a computer program called Integrated Visual and Auditory continuous performance test - Quick Screening (IVA-QS). For this assessment participants will need to click a mouse button whenever they hear or see a particular number. This assessment will also be administered in the presence of background noise and will take approximately 30 mins to complete for all conditions. 2. During the take-home hearing aid trial, children will use two types of hearing aids — traditional directional microphone devices and advanced DNN hearing aids — over a four-week period. The hearing aids will be fitted by a Research Audiologist using minimal amounts of gain (5dB across 250 Hz - 8kHz) and the maximum power output of the devices will be set to 85dB to ensure damaging levels of sounds cannot be produced by the devices. Participants will be encouraged to wear the devices as much as possible, especially in the classroom setting. Each device will be worn for two weeks, allowing children to experience its benefits in real-world environments such as school, home, or social settings. At baseline and at the end of each two-week trial, children will complete a short set of self-administered (with the assistance of a parent) questionnaires (including the Listening Inventory for Education - Revised and the Paediatric Quality of Life Inventory) that captures perceptions of the hearing devices in daily life. It will take approximately 20 mins to complete the questionnaires. No washout period will be used in the study. A washout period will not be used in this study because the interventions being tested, DNN-hearing aids and traditional directional microphone hearing aids are non-pharmacological and do not have lingering physiological effects that could influence subsequent testing. The devices function only when actively worn and are removed at the end of each testing session or daily use. Unlike pharmacological interventions, hearing aids do not leave residual effects that could interfere with participants’ performance in future testing or with the alternative device. Additionally, the study design ensures each device is tested over a two-week period during the take-home trial, which allows participants sufficient time to become familiar with each hearing aid type. During the laboratory-based testing sessions, a randomised testing order will ensure unbiased comparisons between the devices. Since there is no physiological carryover between conditions, a washout period is unnecessary and would only increase the burden on participants without adding scientific value to the study. These interventions aim to identify which hearing aid technology offers superior outcomes for children with normal hearing thresholds but have significant listening difficulties (especially in background noise).