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Narrative Review of Loudness Perception Measures in Children

Recent surveys of pediatric audiologists have highlighted the need for improved understanding of pediatric loudness perception and their role in the hearing device fitting process. The purpose of this article is to provide a brief overview of methods used to measure loudness perception and summarize the existing literature exploring loudness perception in children. A narrative literature review was conducted and 29 articles were reviewed to (1) provide evidence for or against developmental differences, (2) describe variability across listeners of the same age, and (3) discuss evaluations of test-retest reliability on measures of loudness discomfort levels (LDLs), loudness growth, and loudness balancing. A wide variety of methods have been used to measure loudness perception in children. Results of existing studies point to potential developmental differences in LDLs but relatively consistent growth of loudness across age. Considerable across-child variability of loudness perception suggests that estimating LDLs from hearing thresholds could introduce error into the hearing device fitting/mapping process. Additional areas in need of research include work using loudness balancing measures, improved understanding of how variations in clinical loudness scaling measures could influence measured loudness perception, and examination of the benefit of individually-measured loudness perception during pediatric hearing device fitting.