Research AppraisalRandomised Controlled Trial

Intervention Efficacy for Children With Mild Bilateral Sensorineural Hearing Loss

Language, speech, and hearing services in schoolsKam, Anna Chi Shan, Tong, Michael Chi Fai2 Apr 2026DOI

Clinical Snapshot

60CEBM
Evidence: ModerateRandomised Controlled Trial

PICO Framework

P — Population43 Cantonese-speaking children aged 6-7 years with mild bilateral sensorineural hearing loss (pure-tone average 26-40 dB HL)
I — InterventionFrequency modulation (FM) systems (n=16) versus hearing aids (n=16)
C — ComparatorHearing aids and non-treatment control group (n=11)
O — OutcomesLanguage abilities, articulation skills, and speech perception measured using Hong Kong Cantonese Articulation Test, Hong Kong Cantonese Oral Language Assessment Scale, and Cantonese Hearing-in-Noise Test at 12 months

Bottom Line

This randomised controlled trial suggests FM systems are superior to hearing aids for improving language and articulation outcomes in young children with mild bilateral sensorineural hearing loss. The moderate effect size (Cohen's d = 0.53) for language improvements appears clinically meaningful. However, the study has methodological limitations including small sample sizes, inability to blind participants, and limited reporting of key methodological details. The findings are particularly relevant for classroom-based interventions where FM systems may provide better signal-to-noise ratios than hearing aids. Clinicians should consider FM systems as a viable alternative to hearing aids for this population, particularly in educational settings. However, individual patient factors, family preferences, and cost considerations should inform decision-making. The lack of speech perception improvements across all groups warrants further investigation.

Evidence: Moderate

Key Findings

  • P Value: p < 0.01 for language abilities, p < 0.05 for between-group comparisons, p < 0.01 for articulation improvements

  • Effect Size: Cohen's d = 0.53 for language improvements (moderate effect)

  • Primary Outcome: Language abilities showed significant improvement in FM group compared to hearing aid and control groups

  • Nnt Or Sensitivity: Not calculable from available data

  • Confidence Interval: Not reported in abstract

Clinical Application

FM systems require classroom infrastructure and teacher training but are feasible in school environments Relevant to Australian schools with hearing support programs; may require consideration under NDIS funding for assistive technology School-aged children (6-7 years) with mild bilateral sensorineural hearing loss in educational settings

Abstract

PURPOSE: This study aimed to compare the efficacy of hearing aid (HA) and frequency modulation (FM) systems in improving language, articulation, and speech perception outcomes among children with mild bilateral sensorineural hearing loss (MBHL) over a 12-month intervention period. METHOD: A prospective repeated-measures design was employed, enrolling 43 Cantonese-speaking children aged 6-7 years, with a pure-tone average of 26-40 dB HL. Participants were randomly assigned to either the HA group (n = 16) or the FM group (n = 16). A nontreatment control group (n = 11) was formed from children who declined the intervention. The outcome measures included the Hong Kong Cantonese Articulation Test, the Hong Kong Cantonese Oral Language Assessment Scale, and the Cantonese Hearing-in-Noise Test. Assessments were conducted at baseline and 12 months post-intervention. RESULTS: The FM group demonstrated significant improvements in language abilities (p < .01, Cohen's d = 0.53), particularly in word definition, expressive vocabulary, and Cantonese grammar, outperforming both the HA and control groups (p < .05). Articulation improvements were greater in the FM group, with significant gains in consonant production (p < .01). No significant improvements were observed in speech perception across the groups. CONCLUSIONS: FM systems are more effective than HAs in enhancing language and articulation outcomes in children with MBHL, particularly in noisy classroom environments. These findings highlight the importance of individualized intervention strategies and the potential of FM systems to support auditory access and language development. Future research should explore long-term outcomes and the role of contextual factors in intervention efficacy.

References

  1. 1.Kam, A. C. S., & Tong, M. C. F. (2026). Intervention efficacy for children with mild bilateral sensorineural hearing loss. Language, Speech, and Hearing Services in Schools. https://doi.org/10.1044/2025_LSHSS-25-00110
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