2025/10/20 by Ciara Kelly, Christopher J. Armitage, Sarah Rudman +3 · 1 voice
Psychology · Medicine · #Language Development and Disorders #Infant Development and Preterm Care #Hearing Impairment and Communication
paper · doi:10.1080/17437199.2025.2573938
openalex publication_date 2025/10/20 · openalex created_date 2025/10/21 · openalex updated_date 2026/08/01
Consistent hearing aid use protects against spoken language delays in 0–3-year-olds with hearing loss; however, use is at its lowest and most variable during this critical period for language development. The few intervention efforts to increase infant hearing aid use demonstrate limited effectiveness and lack a theoretically driven understanding of the factors influencing use, potentially inhibiting progress in increasing infant hearing aid use. We aimed to address this gap in understanding by conducting a systematic review and mixed methods synthesis of research reporting parent- and professional-reported barriers and facilitators to hearing aid use in 0–3-year-olds, using framework analysis guided by the Theoretical Domains Framework (TDF). Twenty-seven studies were included, which reported 203 unique barriers and 196 unique facilitators, representing all 14 TDF domains. The most prevalent domains identified were environmental context and resources, knowledge, skills, social influences, and emotion. The determinants of hearing aid use in children aged 0–3 years therefore appear to extend beyond the narrow subset targeted by current interventions (e.g., predominantly knowledge and skills). Interventions would benefit from: (i) targeting a wider range of determinants than existing interventions address; and (ii) applying a theoretically informed framework to guide intervention design.