Clinical Practice Patterns With Pediatric Loudness Perception Measures

Purpose: Obtaining a patient's loudness discomfort level (LDL) can assist the audiologist in defining their dynamic range so that the hearing device fitting can ensure that low-level sounds are audible, average-level sounds are comfortable, and more intense sounds are loud but not too loud. A 2016 survey showed that 67.5% of 350 pediatric audiologist reported to never or rarely measure LDLs with pediatric patients. The purpose of this study was to identify factors influencing this previously reported limited use of LDL measures. Method: Sixty-two pediatric audiologists in the United States were surveyed using a questionnaire that sought to improve our understanding of the (non)use of loudness perception measures with pediatric patients and to assess familiarity with various loudness perception measurements. In addition, the questionnaire gathered information about the needs of pediatric audiologists in relation to LDL measures. Results: Audiologist report being largely unfamiliar with methods of assessing loudness perception in children, with categorical loudness scaling being the method with which they are most familiar. In addition, audiologists reported being more willing and able to measure LDLs in older compared to younger pediatric patients. Limited use of pediatric loudness perception measures appears to be driven by a lack of familiarity with measurement methods and the belief that loudness perception measures may not be useful for clinical practice. Conclusions: Findings highlight audiologists' need for further information regarding the relevance of loudness perception measurements with pediatric patients and the need for easy-to-implement LDL measurement procedures for pediatric patients of all ages.