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Language Benefits of Hearing Aid Use are Significant in Fourth-Grade Children


girl with hearing aid

Tuesday, September 8, 2020

​While it is not the only factor, the quality of our children's hearing plays a pivotal role in how well they understand speech and develop spoken language skills. However, there is some ambiguity when it comes to assessing and treating kids with mild, bilateral hearing loss. In these cases, there is not always a strong clinical opinion for early fitting or consistent wearing of hearing devices. This is partly because these kids do not always appear noticeably different from their classmates in every day conversation, or on language tests, so clinicians and families may take a “wait-and-see" approach to hearing devices.

Scientists at Boys Town National Research Hospital and the University of Iowa have been collaborating on a series of studies to see what the real benefits of consistently worn and early fit hearing aids are for kids, and especially those with mild hearing loss. As part of this collaboration, Elizabeth Walker, Ph.D., Assistant Professor at the University of Iowa, and others recently assessed both written and spoken language skills of fourth-grade children to identify the language risks associated with mild hearing loss [1].

In this study, the team compared 60 children with mild, bilateral hearing loss and 69 peers with typical hearing. All participants were tested the summer after fourth grade. Dr. Walker and her team found that kids with hearing loss had significant deficits in spoken language comprehension and understanding of morphology—the structural parts of words that indicate verb tense or plurality, such as  the word endings in “He is playing" or “She walked" or “many cats". In contrast, vocabulary and reading were not significantly different between the kids with hearing loss and typical hearing.

The goal of this study was not just to see what the language differences were, but also to see how intervention with hearing aids affected these outcomes. Therefore, Dr. Walker's team also needed to know from caregivers how much the kids in the hearing loss group wore their hearing aids. Kids with milder hearing loss, whose caregivers reported more time wearing hearing aids, did better with comprehension of spoken language than kids with more severe hearing loss and/or lower hearing aid usage.

What These Findings Tell Us

Findings from this study show us that consistent hearing aid use is important for kids to reach their full language potential. Furthermore, waiting to see how kids with mild, bilateral hearing loss do before recommending hearing amplification could come at the cost of some language ability. This is something clinicians should emphasize to families of children with mild hearing loss. Along with educating families, clinicians should strongly consider early hearing testing and intervention for children with mild hearing loss.

Related reading

Last year, Ryan McCreery Ph.D., Director of Research at Boys Town Hospital, and co-authors published a paper titled, Audibility-based hearing aid fitting criteria for children with mild bilateral hearing loss [2]. That paper outlines a set of guidelines for assessing when children with mild, bilateral hearing loss should be fitted with hearing aids based on language outcomes. Read more about that study.


  1. Walker E. A., Sapp C., Dallapiazza M., Spratford M., et. al. (2020) Language and Reading Outcomes in Fourth-Grade Children With Mild Hearing Loss Compared to Age-Matched Hearing Peers. Lang Speech Hear Serv Sch. 51(1):17–28.
  2. McCreery R.W., Walker E.A., Stiles D.J., Spratford M., et. al. (2020) Audibility-based hearing aid fitting criteria for children with mild bilateral hearing loss. Lang Speech Hear Serv Sch.​ 51(1): 55–67.

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