Lower mental fatigue and better functional listening are associated with better communication outcomes in children with mild bilateral hearing loss

To improve evidence for clinical decision-making regarding amplification for children with mild bilateral hearing loss (MBHL). We aimed to: (i) assess whether diagnosis age, unaided access to speech, hearing loss type (sensorineural/conductive) or amplification influenced auditory (functional listening, listening fatigue) and non-auditory outcomes (communication, psychosocial behaviour, attention), and (ii) evaluate whether auditory outcomes were associated with non-auditory outcomes. Outcomes were assessed using age-appropriate, validated questionnaires completed by carers. Listening-related fatigue and attention abilities were gathered only in older children (>5 years). 63 children <12 years of age. Regression analyses revealed limited predictability of communication and psychosocial outcomes in all children. Delayed functional listening was evident in aided relative to unaided children <5 years, and in those over 5, listening-related mental fatigue was greater in aided than unaided children. Further, increased mental, but not physical fatigue, was associated with worse communication and psychosocial outcomes. Increased mental and physical fatigue were asscoiated with worse attention abilities. Better functional listening was associated with better communication and attention, but not psychosocial behaviour. Unaided speech access, hearing loss type, and/or diagnosis age appear insufficient to predict developmental outcomes. Children with more perceived listening difficulties may pursue amplification. Monitoring listening-related fatigue and functional listening could help identify children needing further support.