2026 Early Hearing Detection & Intervention Conference
March 15-17, 2026 • Jacksonville, FL
| Softband Today, Implant Tomorrow: Navigating Pediatric Bone Conduction Device Transitions
Softband Today, Implant Tomorrow: Navigating Pediatric Bone Conduction Device Transitions
Bone conduction devices (BCDs) provide essential auditory access for children with conductive or mixed hearing loss. Non-surgical options (e.g., softband or adhesive systems) allow for early amplification, consistent with Joint Committee on Infant Hearing (JCIH) recommendations for intervention within 6 months of diagnosis. Surgical BCDs, typically offered from age 5, provide more reliable coupling and improved sound transmission. Despite clinical eligibility, many children experience delayed progression from non-surgical to surgical devices, potentially limiting optimal hearing and communication development. Real-world data on adoption patterns, transition rates, and human factors influencing acceptance remain limited.
We conducted a retrospective review of 360 pediatric patients evaluated for BCDs at a tertiary children’s hospital. Data included device type, age at fitting, follow-up adherence, duration of use, and transitions to surgical BCDs. At initial device evaluation, 63% of patients entered treatment: 91% with non-surgical devices (mean age ~3.5 years) and 9% with surgical devices (mean age ~12.9 years). Although more than half pursued intervention, adherence differed significantly. Fewer than 30% of non-surgical users achieved recommended daily wear time (=8 hours), with 57% lost to follow-up after 24 months. In contrast, surgical users demonstrated higher compliance, better datalogging, and reduced loss to follow-up (32%).
Beyond clinical eligibility, research shows human factors strongly influence acceptance. Caregiver health literacy, motivation, and perceptions of disability shape intent to use. Aesthetics, device complexity, comfort, and convenience further mediate device adoption, while perceived benefit and product value reinforce device use and adherence. Addressing both technical and psychosocial barriers through structured counseling, early referral, and family-centered education may optimize outcomes for children requiring BCDs.
- Describe real-world patterns of bone conduction device (BCD) adoption, adherence, and transition rates from non-surgical to surgical systems in a large pediatric population.
- Identify human factors, such as caregiver health literacy, motivation, aesthetics, device complexity, and perceived benefits that influence intent to use and long-term acceptance of BCDs.
- Apply strategies for counseling, early referral, and family-centered education to address psychosocial and technical barriers, with the goal of improving device adherence and optimizing speech and language outcomes.
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Presenters/Authors
Hillary Snapp
(Co-Author), University of Miami Department of Otolaryngology, HSnapp@med.miami.edu;
Hillary Snapp, AuD, PhD is the Chief of Audiology and Professor at the University of Miami Ear Institute. She is a clinician-scientist carrying out research in hearing implants and auditory spatial perception. Her work examines the mechanisms underlying the variations observed in hearing-impaired individuals for complex auditory tasks such as speech perception in noise and localization ability. Dr. Snapp established the Auditory Spatial Laboratory at the University of Miami which focuses on identifying behavioral and objective markers of hearing, and includes novel methods of evaluating spatial auditory perception, speech recognition, and processing of acoustic signals. She has lectured nationally and internationally on these topics. Dr. Snapp is the Director of Clinical Education in Audiology and serves as a lead researcher, clinician, and educator to students, residents, and fellows at the University of Miami.
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Chrisanda Sanchez
(Co-Author), University of Miami Department of Otolaryngology, cmsanchez@med.miami.edu;
Dr. Chrisanda Sanchez is a bilingual pediatric audiologist at the University of Miami. She is an Associate Professor in the Department of Otolaryngology and the Director of the Children’s Hearing Program at the University of Miami. Dr. Sanchez’s clinical career has centered around pediatrics, specializing in pediatric cochlear implants, hearing aids, and other implantable devices. Her research focuses on improving access to hearing healthcare for Spanish speaking patients and implantable devices, specifically targeting pediatric device implantation and outcomes.
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• Receives Salary for Employment from University of Miami.
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No relevant nonfinancial relationship exists.
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Financial relationship with University of Miami.
Nature: Employed by UM.
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No relevant nonfinancial relationship exists.
Jordan McNair
(Co-Author), University of Miami Department of Otolaryngology, jim4208@med.miami.edu;
Jordan McNair, AuD, is an Assistant Professor in the Department of Otolaryngology at the University of Miami, with a secondary appointment in Pediatrics. He is a clinical pediatric audiologist and currently serves as the Clinical Extern Coordinator for the Division of Audiology. Originally from Ohio, Dr. McNair was drawn to the University of Miami to complete a post-doctoral fellowship at the University of Miami Ear Institute. His positive experiences with the UM faculty during that time sparked a passion for clinical education.
Dedicated to shaping the next generation of audiologists, Dr. McNair encourages students to become future leaders and educators in the field. His personal mission is to promote diversity within audiology and to show aspiring audiologists that there is no one-size-fits-all mold for being an exceptional clinician and educator.
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Anna Fowler
(Primary Presenter,Co-Author), University of Miami Department of Otolaryngology, axf1907@med.miami.edu;
Anna Fowler, Au.D., is a pediatric audiologist at the University of Miami’s Children’s Hearing Program. She earned her Doctor of Audiology degree from the Arizona School of Health Sciences (A.T. Still University). In addition to her clinical work, she serves as the Community Outreach Co-Chair for the department, helping to strengthen partnerships with families, schools, and community organizations to improve access to hearing healthcare.
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No relevant financial relationship exists.
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No relevant nonfinancial relationship exists.
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No relevant financial relationship exists.
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No relevant nonfinancial relationship exists.
Samantha Espinal
(Co-Author), University of Miami Children's Hearing Program, sgespinal@med.miami.edu;
Dr. Samantha Espinal is a pediatric audiologist and the newborn hearing screening coordinator at the University of Miami Ear Institute’s Children’s Hearing Program. She earned her clinical doctorate in audiology from Gallaudet University and completed her externship and Leadership Education in Neurodevelopmental and Related Disabilities (LEND) training at the Kennedy Krieger Institute. Samantha is passionate about pediatric audiology, early intervention, and improving healthcare accessibility. Her day to day practices includes pediatric diagnostics, ABRs, hearing aids, and bone conduction devices.
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No relevant financial relationship exists.
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No relevant nonfinancial relationship exists.
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Madison Muccino
(Co-Author), University of Miami Department of Otolaryngology, mxm194883@miami.edu;
Madison (Maddie) Muccino, AuD is currently a pediatric audiologist in the Children’s Hearing Program in the Division of Audiology in the Department of Otolaryngology at the University of Miami. She previously worked as an audiologist at the University of Maryland Medical Center. Dr. Muccino graduated with her Doctor of Audiology degree from Rush University in 2023 and a Bachelor of Science in Communication Sciences and Disorders from Springfield College in 2019. This is Dr. Muccino’s first time attending and presenting at EHDI! Dr. Muccino is passionate about advocating for early diagnosis and intervention of hearing loss in pediatric patients and is dedicated to counseling and supporting caregivers throughout the process.
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No relevant financial relationship exists.
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No relevant nonfinancial relationship exists.
AAA DISCLOSURE:
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No relevant financial relationship exists.
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No relevant nonfinancial relationship exists.
Kaitlyn Marsh
(Co-Author), University of Miami Department of Otolaryngology, kxm1817@med.miami.edu;
Dr. Kaitlyn Marsh is currently a clinical audiologist at the University of Miami specializing in diagnostics and implantable devices. In May 2024, she obtained her Clinical Doctorate of Audiology from The University of Tennessee Health Science Center. She completed an Auditory Implant Fellowship at the University of Miami in July 2025, and her fourth-year clinical training at Thomas Jefferson University Hospital in Philadelphia, Pennsylvania in May 2024. Her clinical and research interests include implantable devices and the improvement of overall quality of life for the hearing-impaired population.
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