Annex 12/6 - Technical devices

Annex for BIAP – Recommendation 12.6

Unilateral Hearing loss Assessment and Counselling after Newborn Hearing Screening (UNHS)


Children under the age of 1 year with a unilateral hearing loss
and the fitting of technical devices (e.g. hearing aids)



There is well proven data that in case a bi-aural fitting is indicated but one ear is neglected, the hearing process of the unattended side will be deprived. But until now there is no sufficient data that with UHL a very early hearing aid fitting (within the first 6 months of life) makes a difference on the future maturation of the auditory pathways.

Taking in account the cost of effort and stress for the family that is connected with any hearing-aid fitting in the first months of life and regarding the diagnostic uncertainties in a number of cases of mild to moderate hearing-losses the BIAP commission suggests as a compromise a start of a hearing aid fitting within the first 12 months of life (instead of a recommended start with in the first 6 months with bilateral losses).

In case of a hearing aid fitting the same principals should be respected as with bilateral fittings (see Recom. 06-11). For the evaluation of a hearing aid benefit audiometric test should include a proper masking of the normal hearing ear when tolerated by the child. Also the use of specially designed questionnaires[1] can be recommended.

The hearing-aid fitting should be only finalized, if a sufficient acceptance of the hearing-aid by the child and the parents and a daily wearing of the hearing-aid is confirmed.


1. Unilateral moderate sensorineural hearing-loss or conductive hearing loss without atresia (hearing loss of 30-60dB) and normal hearing on the
opposite ear



2. Unilateral deafness (hearing loss worse than 60dB, see exceptions above) and normal hearing on the opposite ear




3. Unilateral conductive hearing-loss (e.g. major aplasia, severe ear canal atresia) and normal hearing on the opposite ear



Information about additional technical considerations in later years

FM-systems also without the use of a hearing aid may improve the signal to noise ratio in noisy hearing situations (i.e. school) (Recom. 06-10).

[1] A proposal for such questionnaires you can find on the webpage of the Klinik für Kommunikationsstörungen in Mainz, Germany: