Pediatric Amplification: Past, Present and Future

Over the past three and half decades, tremendous gains have been achieved in the speech and hearing sciences. These conceptual and technological advances have improved the lives of children with hearing loss in ways that would have seemed inconceivable three or four decades ago. The goal of this paper is to provide an overview of the field of pediatric amplification in the 1970s, a review of progress over the last 35 years, a summary of the current status, and a discussion of research needs for the future. In the early 1970s there were no universal newborn hearing screening programs. The average age of identification of children with hearing loss was 3–3 1⁄2 years. Early efforts to improve this situation were a registry to identify newborns who are at high risk for hearing loss and development of the Crib-o-Gram (Simmons and Russ 1974; Simmons, McFarland and Jones 1979). While both procedures improved the early identification of children with severe-toprofound hearing loss, lesser degrees of hearing loss continued to go undetected. Diagnostic procedures to quantify the degree and configuration of hearing loss in infants were limited to behavioral observation audiometry, which is now known to be unreliable and prone to tester bias. Body-worn hearing aids and FM systems were the devices of choice for the pediatric population, but FM systems were used only in academic settings. Most hearing-aid circuits were linear peak clippers, fitting algorithms were based on adult data, and functional gain was used to verify aided performance. At that time, audiologists