Too often, clinical decisions for children who are deaf or hard of hearing are framed in terms of device type—hearing aid versus cochlear implant—rather than outcome. The Fall Forum discussion will challenge that mindset by presenting a non-denominational approach to pediatric hearing care: audibility first, technology type second. 

Participants will explore the science connecting speech audibility to spoken language outcomes, with emphasis on the risks children face when audibility is incomplete or inappropriately matched to their needs. Through real-world examples, the session will highlight how delays in securing access, whether from underfit hearing aids, prolonged “wait and see” approaches, or late cochlear implantation, directly affect a child’s ability to develop age-appropriate spoken language. The talk will also introduce evidence-based ways to verify audibility, anchored in speech acoustics. Attendees will consider how to reframe parent counseling conversations around what their child can hear and use in real-world conditions. This requires a change in mindset from biased thinking that “failure” with hearing aids results in a need for a cochlear implant as a last resort.

By uniting audiologists, speech-language pathologists, and families around audibility as the common goal, this session calls for a cultural shift: one where technology is selected and managed based on its ability to deliver consistent, verifiable access to the speech spectrum.